moKee Birth School online:
preparing for labour

3 min read

by Madlena Szeliga

Usually, when you enter your 3rd trimester you realise your due date is just around the corner. You make all the final decisions about the labour and you try to be as prepared as possible. You can't control everything when it comes to birth, but you can make sure the things you CAN control are all covered.
Here we gathered all the "preparing to labour" related questions, our participants asked during the latest Q&A session at moKee Birth School Online. Sophie Martin, qualified midwife (aka The Infertile Midwife) answered them all for you.

It is really brilliant- start at 35/6 weeks. Massage skin between vagina and anus- get any natural based oil (coconut, olive etc) and put thumbs in and stretch it gently out. It is fantastic at reducing the bigger, 3rd, 4th degree tears.

It is similar to Epino. It’s a ball that you put in the vagina and it’s to try and stretch the perineum, to reduce tears. We don’t specifically recommend them – there’s no evidence to say they work. Anecdotally, many women have found them useful.

This is popular at the moment - it is suggested that eating 6 or 7 dates a day at the end of pregnancy, might help ripen the cervix. You can eat dates in loads of forms, smoothie, date bars etc Although there hasn’t been lots of evidence to support this, it is growing in popularity.

The midwife will be feeling your tummy at every appointment in the 3rd trimester and will be able to tell you.

When the baby is lying across your tummy this is transverse. In early pregnancy- it doesn’t matter what position your baby is in. But if you are towards the pregnancy the end then we want to try and get the baby to be head down. An External Cephalic Version (ECV) is where a midwife or Dr will try and turn the baby into the head-down position. They are generally safe procedures but needs individual assessment as to whether this is suitable for you and your baby. If your baby is breech, then is may be offered to you.

Unlikely if the head is engaged – always a small chance, as babies can do weird and wonderful things, but very unlikely.

Ideally, you want the baby at the front of the tummy. So my top tip is to stop slouching. The back is the heaviest part of the baby, so if you slouch the back comes to your back. UFO – Upright, forward, open will be your mantra! You can get a chair with no arms on it, turn it around and sit backwards. Or scrubbing the floor position – (you don’t actually scrub the floor!) But get on hands and knees, gravity will pull baby forward. Breaststroke swimming can help.

by Madlena Szeliga

Usually, when you enter your 3rd trimester you realise your due date is just around the corner. You make all the final decisions about the labour and you try to be as prepared as possible. Read the most common questions (and the answers) on preparing for labour.

Blog 1 moKee Birth School online: preparing for labour
02 Jun 2020

moKee Birth School online: preparing for labour

moKee Birth School online:
preparing for labour

3 min read

by Madlena Szeliga

Usually, when you enter your 3rd trimester you realise your due date is just around the corner. You make all the final decisions about the labour and you try to be as prepared as possible. You can't control everything when it comes to birth, but you can make sure the things you CAN control are all covered.
Here we gathered all the "preparing to labour" related questions, our participants asked during the latest Q&A session at moKee Birth School Online. Sophie Martin, qualified midwife (aka The Infertile Midwife) answered them all for you.

It is really brilliant- start at 35/6 weeks. Massage skin between vagina and anus- get any natural based oil (coconut, olive etc) and put thumbs in and stretch it gently out. It is fantastic at reducing the bigger, 3rd, 4th degree tears.

It is similar to Epino. It’s a ball that you put in the vagina and it’s to try and stretch the perineum, to reduce tears. We don’t specifically recommend them – there’s no evidence to say they work. Anecdotally, many women have found them useful.

This is popular at the moment - it is suggested that eating 6 or 7 dates a day at the end of pregnancy, might help ripen the cervix. You can eat dates in loads of forms, smoothie, date bars etc Although there hasn’t been lots of evidence to support this, it is growing in popularity.

The midwife will be feeling your tummy at every appointment in the 3rd trimester and will be able to tell you.

When the baby is lying across your tummy this is transverse. In early pregnancy- it doesn’t matter what position your baby is in. But if you are towards the pregnancy the end then we want to try and get the baby to be head down. An External Cephalic Version (ECV) is where a midwife or Dr will try and turn the baby into the head-down position. They are generally safe procedures but needs individual assessment as to whether this is suitable for you and your baby. If your baby is breech, then is may be offered to you.

Unlikely if the head is engaged – always a small chance, as babies can do weird and wonderful things, but very unlikely.

Ideally, you want the baby at the front of the tummy. So my top tip is to stop slouching. The back is the heaviest part of the baby, so if you slouch the back comes to your back. UFO – Upright, forward, open will be your mantra! You can get a chair with no arms on it, turn it around and sit backwards. Or scrubbing the floor position – (you don’t actually scrub the floor!) But get on hands and knees, gravity will pull baby forward. Breaststroke swimming can help.

by Madlena Szeliga

Usually, when you enter your 3rd trimester you realise your due date is just around the corner. You make all the final decisions about the labour and you try to be as prepared as possible. Read the most common questions (and the answers) on preparing for labour.

0

moKee Birth School online:
questions and answers on pregnancy

3 min read

by Madlena Szeliga

When pregnant - especially for the first time - everything is new. You feel so many things for the first time, not only the baby's little kicks. Some of those experiences can be alarming, some of them may cause a lot of discomfort. There are tests, and measurements, and appointments, and weeks, and dates. And many, many questions.

Here we gathered all pregnancy-related questions, our participants asked during latest Q&A session at moKee Birth School Online. Sophie Martin, qualified midwife (aka The Infertile Midwife) answered them all for you.

Midwives recommend the left side because you don’t end up squashing your big blood vessels. It is not the end of the world if you lay on your right, the most important thing to remember is not to lay flat on your back.

This is a bacteria that grows in women’s vaginas and ordinarily doesn’t cause any problems. The tests are not usually offered on the NHS and that’s because it only tells you if you had it on the day you did the test- the bacteria is transient. Sometimes you have it and sometimes you don’t. Some people will choose to do a test privately, but always remember the result are only telling you whether you had GBS on the day you took the test. So it really is a personal choice if you want to test for it. It can be picked up accidentally- a swab for any reason, in your urine for instance.

You still have got plenty of time to get the injection- it is really common the UK- it is actually for the baby, when they are born they are vulnerable for whooping cough and don’t get a vaccine until 8 weeks old. If you have the vaccine, you make antibodies which are then passed on to the baby to give them some protection until they get their own vaccination.

Main growth happens in third trimester and we don’t measure tummies until at least 26 weeks. So having a check up at 29 weeks is fine. Pay attention to your movements as that is the most important way of knowing how well your baby is. If you are worried about your babies movements, please contact your midwife.

In the UK we just do 12 weeks scan and 20 weeks scan. No need for another scan unless there are any concerns about your baby from the tummy measurements. Some parents opt to get private scans and that is ok.

The top number, the systolic should be between 90 - 140 - more than 140 it is worrying. And bottom number - diastolic - should be between 50 - 90. Your midwife should be checking this at every appointment.

Anything below the 10th centile is small. We know that babies come in all shapes and sizes. So as long as you measure between 10th and 95th centile we consider that to be normal. The femur is the thigh bone.

We want your baby to be showing a continuous growth velocity. If the growth becomes accelerated, it would be recommended to have a scan. Remember that babies come in all shapes and sizes. Usually you’re growing a baby that the right for you, unless you have diabetes or other pregnancy complications. If your midwife is worried about your tummy measurements she will make the appropriate referral to get this checked out.

There is no set number of movements- whatever is normal for your baby. People usually feel movement around 20 weeks, around 24 weeks you’d feel every day. By the third trimester, there is an established pattern. Please don’t compare to previous pregnancies or your friends. Some people with an anterior placenta feel it loads but others don’t feel it quite so much. If you are concerned please contact your maternity unit.

When you are feeling kicks in your vagina, that can sometimes be a sign the baby is breech. At your next appointment ask your midwife to feel for the babies position. It is not concerning for the baby to be breech at this stage, as they have lots of time to turn.

Your baby doesn’t breathe in the womb, so the heart has holes in to bypass the lungs. Although the lungs get some blood so they can continue to grow. But if you take ibuprofen whilst pregnant it could cause the holes in the heart to close early. Please don’t take any whilst you are pregnant.

It is pain in your hips and your back. Relaxin is a great hormone that builds up during pregnancy and you also have progesterone - it makes all your ligaments loose and floppy but also can be painful. There’s a great website, Fit for pregnancy - it’s made by the women’s health physios of the UK – it’s NHS recommended and has got some great advice. Support belts work best when they are fitted by a physio. It is important to try and keep legs together rather than abducted. When getting out of the car take out both legs at the same time.

This is hard to assess - if you are worried call your midwife.

When the placenta is sat on top of the cervix this is known as placenta praevia. Sometimes it will be fully over it or just a little bit. If it is fully coving cervix it is unlikely to move at this stage. You will have scans to check the position of the placenta. With placenta praevia, the only option is for caesarean section.

Obstetric Cholestasis is a liver condition of pregnancy. It doesn’t usually have a physical rash, but the symptoms are extreme itching. Particularly on the palms of your hands and soles of your feets. If you have pregnancy rash, see your GP.

You can help this by not lying on you back and not slouching, however this is difficult to assess virtually, so please contact your maternity unit.

This is hard, as there isn’t always a cure. Encouraging the baby to move to a different position by laying on your side may help.

Heartburn is hard! It’s fine to take Rennies, Gaviscon – take them if you need to. Spicy and fried foods can make the symptoms worse. Try eating small meals, rather than bigs ones. Don’t eat late at night. And for some people it helps to sleep propped up slightly. Some women swear by milk!

Try and engage your baby, more space under ribs. Sitting on a ball, etc.

by Madlena Szeliga

We gathered all pregnancy-related questions that our participants asked during the latest Q&A session at moKee Birth School Online. The qualified midwife, Sophie Martin, answered to all of them and shared her experience. Read now at moKee's blog!

Blog 1 moKee Birth School online: questions and answers on pregnancy
02 Jun 2020

moKee Birth School online: questions and answers on pregnancy

moKee Birth School online:
questions and answers on pregnancy

3 min read

by Madlena Szeliga

When pregnant - especially for the first time - everything is new. You feel so many things for the first time, not only the baby's little kicks. Some of those experiences can be alarming, some of them may cause a lot of discomfort. There are tests, and measurements, and appointments, and weeks, and dates. And many, many questions.

Here we gathered all pregnancy-related questions, our participants asked during latest Q&A session at moKee Birth School Online. Sophie Martin, qualified midwife (aka The Infertile Midwife) answered them all for you.

Midwives recommend the left side because you don’t end up squashing your big blood vessels. It is not the end of the world if you lay on your right, the most important thing to remember is not to lay flat on your back.

This is a bacteria that grows in women’s vaginas and ordinarily doesn’t cause any problems. The tests are not usually offered on the NHS and that’s because it only tells you if you had it on the day you did the test- the bacteria is transient. Sometimes you have it and sometimes you don’t. Some people will choose to do a test privately, but always remember the result are only telling you whether you had GBS on the day you took the test. So it really is a personal choice if you want to test for it. It can be picked up accidentally- a swab for any reason, in your urine for instance.

You still have got plenty of time to get the injection- it is really common the UK- it is actually for the baby, when they are born they are vulnerable for whooping cough and don’t get a vaccine until 8 weeks old. If you have the vaccine, you make antibodies which are then passed on to the baby to give them some protection until they get their own vaccination.

Main growth happens in third trimester and we don’t measure tummies until at least 26 weeks. So having a check up at 29 weeks is fine. Pay attention to your movements as that is the most important way of knowing how well your baby is. If you are worried about your babies movements, please contact your midwife.

In the UK we just do 12 weeks scan and 20 weeks scan. No need for another scan unless there are any concerns about your baby from the tummy measurements. Some parents opt to get private scans and that is ok.

The top number, the systolic should be between 90 - 140 - more than 140 it is worrying. And bottom number - diastolic - should be between 50 - 90. Your midwife should be checking this at every appointment.

Anything below the 10th centile is small. We know that babies come in all shapes and sizes. So as long as you measure between 10th and 95th centile we consider that to be normal. The femur is the thigh bone.

We want your baby to be showing a continuous growth velocity. If the growth becomes accelerated, it would be recommended to have a scan. Remember that babies come in all shapes and sizes. Usually you’re growing a baby that the right for you, unless you have diabetes or other pregnancy complications. If your midwife is worried about your tummy measurements she will make the appropriate referral to get this checked out.

There is no set number of movements- whatever is normal for your baby. People usually feel movement around 20 weeks, around 24 weeks you’d feel every day. By the third trimester, there is an established pattern. Please don’t compare to previous pregnancies or your friends. Some people with an anterior placenta feel it loads but others don’t feel it quite so much. If you are concerned please contact your maternity unit.

When you are feeling kicks in your vagina, that can sometimes be a sign the baby is breech. At your next appointment ask your midwife to feel for the babies position. It is not concerning for the baby to be breech at this stage, as they have lots of time to turn.

Your baby doesn’t breathe in the womb, so the heart has holes in to bypass the lungs. Although the lungs get some blood so they can continue to grow. But if you take ibuprofen whilst pregnant it could cause the holes in the heart to close early. Please don’t take any whilst you are pregnant.

It is pain in your hips and your back. Relaxin is a great hormone that builds up during pregnancy and you also have progesterone - it makes all your ligaments loose and floppy but also can be painful. There’s a great website, Fit for pregnancy - it’s made by the women’s health physios of the UK – it’s NHS recommended and has got some great advice. Support belts work best when they are fitted by a physio. It is important to try and keep legs together rather than abducted. When getting out of the car take out both legs at the same time.

This is hard to assess - if you are worried call your midwife.

When the placenta is sat on top of the cervix this is known as placenta praevia. Sometimes it will be fully over it or just a little bit. If it is fully coving cervix it is unlikely to move at this stage. You will have scans to check the position of the placenta. With placenta praevia, the only option is for caesarean section.

Obstetric Cholestasis is a liver condition of pregnancy. It doesn’t usually have a physical rash, but the symptoms are extreme itching. Particularly on the palms of your hands and soles of your feets. If you have pregnancy rash, see your GP.

You can help this by not lying on you back and not slouching, however this is difficult to assess virtually, so please contact your maternity unit.

This is hard, as there isn’t always a cure. Encouraging the baby to move to a different position by laying on your side may help.

Heartburn is hard! It’s fine to take Rennies, Gaviscon – take them if you need to. Spicy and fried foods can make the symptoms worse. Try eating small meals, rather than bigs ones. Don’t eat late at night. And for some people it helps to sleep propped up slightly. Some women swear by milk!

Try and engage your baby, more space under ribs. Sitting on a ball, etc.

by Madlena Szeliga

We gathered all pregnancy-related questions that our participants asked during the latest Q&A session at moKee Birth School Online. The qualified midwife, Sophie Martin, answered to all of them and shared her experience. Read now at moKee's blog!

0

moKee Birth School online: how to get your baby to sleep well

3 min read

by Suzi Smith

 

Read the blog post or listen to the podcast on Spotify:

Hazel, AKA, TwinningitUK, is a maternity nurse and sleep specialist. Here she gives her tips to getting babies sleeping well.

Get into good habits when you start out, it builds a really strong foundation for babies sleeping well. Hazel is a gentle sleep coach, looking at sleep from an holistic approach; looking at everything that’s going on in the baby’s world and the parent’s family to determine what routine the baby should be in when it comes to sleep.

A lot of parents get worried that their baby is not a ‘normal sleeper’. So, it’s about talking about what is normal and what isn’t. 80% of babies still wake in the night up until 2 years old, so it’s perfectly normal to have a baby who doesn’t sleep through the night. In fact, waking in the night is safe for babies, try and remember this.

Safe sleep advice, how to put a baby to sleep safely

Keeping the baby in the room with you for the first 6 months is advised, it also makes life easier as they’re right next to you. The temperature of the room needs to be between 16-20 degrees. Dress the baby according to the temperature. If it’s a hot day keep the curtains closed all day to keep it cooler. If it is excessively hot, you can open a window but don’t have the baby in line with the draft because the draft will dry their airways out.

In winter, keep the room temperature between 16-20 degrees and this actually feels cold to walk into but it’s how it should be. Layer them, if it gets too warm you strip them off. Sleep bags are available now and are great. Use a 1-1/5 tog in summer and in winter, a tog 2. An empty cot is needed, baby’s cot needs to be completely empty. A blanket can be in there, providing it’s really tucked in at the sides. No decorations or teddys, they are not safe. Ensure that baby’s feet are at the bottom of the cot. They tend to shuffle around, so keep them at the bottom of the cot. Place them on their back when you put them down to sleep. When they start to roll, that’s fine for them to roll onto their front.

The mattress is really important. If you can’t afford a brand new cot, get a new god quality mattress for the baby and it needs to be firm.

Newborn sleeping

The 4th trimester is the first 12 weeks of life with a baby. There is a lot of adjustment going on, humans are the only mammal that is born and helpless and needs their parents 24/7. For the first couple of weeks, allow that time to bond with your baby as much as possible, have lots of skin to skin time, it will reduce their stress levels and help them sleep better.

Babies are born with two fears; fear of falling and the fear of loud noises. Startle reflex is when a baby is falling asleep and then suddenly moves due to either a loud noise or a fear of falling. Swaddling a new baby can be effective if they have a strong startle reflex. This can help them sleep. Until 12 weeks babies don’t produce melatonin, which is the hormone which helps us fall asleep. Babies don’t have that function in the brain to produce that hormone until they are 3 months old. If you have a premature baby, it’s important to work off their corrected age. If a baby is born at 36 weeks, this is 4 weeks early, so they may not start producing melatonin until they are 16 weeks. So work off their corrected age. They don’t know the difference between night and day so it’s parents’ job to teach them.

Up until 6 weeks babies will sleep and go to the loo, that’s pretty much it. You might get 15-20 minutes of awake time, but you won’t get much out of them other than that, so expect them to sleep a lot.

If however your baby is sleeping continuously and not feeding well or not producing 6-8 wet nappies a day then speak with you Health Visitor or midwife.

 

6 weeks

At 6 weeks babies have a growth spurt so they can tend to get irritated towards the end of the day. Their calorie intake needs are increasing. You might find that they cluster feed if you are breastfeeding (short bursts of frequent feeding) as they are needing more milk and cluster feeding will help to increase your milk supply. If you are bottle feeding you may find that they want a higher volume of milk. Let them lead you, this phase will pass.

 

12 weeks

At 12 weeks, you may notice that they are more awake during the day, they are more interested in things around them. You’ll notice a sleep pattern beginning to develop. They’ll have around four naps a day. It’s good to get them into a routine, let baby lead you on this and look out for when they are showing signs of tiredness and how long them can stay awake for.

 

Sleep promotes sleep

Hyperactivity is a sign of extreme exhaustion. Learn your baby’s sleep signs as best as possible. Be responsive to your baby. Babies cry for hunger, tiredness, overtired, if they’re too hot or too cold. Do not judge a baby’s temperature on their hands or feet. Hands and feet are the first things that are cold. Feel the back of their necks to see how hot they are. Are they having enough to drink, have they had enough sleep during the day? Sleep promotes sleep, the more over tired a baby is in the day, the harder it is to sleep in the night. It’s good to teach babies to sleep well in the day so that in the night they have the skills to fall back to sleep independently.

 

Sleep regression

Sleep regression or sleep development happens at around 4 months, 7 months and 12-18 months and it’s when a baby’s sleep pattern changes. At 4 months they become more adult in how they sleep. They’ll fall into different stages of sleep, lighter stages of sleep. They are not used to this so it’s strange for them. They are asleep but they can hear things going into the lighter stages of sleep. Normally this can take a week to two to adjust. White noise is great as it can drown out any outside sound influences. At 7-8 months there is another change. Your baby is learning to roll and baby wants to practice their skills in their cot. They want to practice this at maybe 1am, but don’t worry, this passes. Ways to combat this is to allow them to have lots of tummy time in the day and not in their cot. At 12-18 months stage, when a baby is starting to walk, the baby stands up in the cot and wants to walk around. These are all natural stages of developments and it’s a phase. When this is happening try and support them with giving practice during the day so that at night time they’ve got it out of their system.

Baby sleeping bags, mattresses and lighting

To use a baby sleeping bag or blanket. If you have a baby under 8-9 pounds you need to ensure that the sleep bag is OK for a baby of a certain weight. Make sure it fits nice and snuggly on them and is not pulling up when they shuffle down. You can buy various tog levels for it. Cellular blankets are great. They generally come in one thickness, and work better for newborns. Sleep bags are a great sleep association, when they go into the sleep bags, the babies associate sleep with them, so it makes them ready to go to sleep. Waterproof mattress protectors are great, they are usually breathable so just have a look at when you buy it. When they are waking for the morning, have the room really light. In the evening, have the lights dim. After 12 weeks, as the darkness kicks in it triggers a message to the brain to start melatonin which triggers them to feel sleepy. Red lighting in a nursery is great as it helps babies sleep, but blue lighting is detrimental to a baby’s sleep. It really interrupts their sleep, so look for a red lamp or bulb with a very low wattage.

 

Top Tip

If you’re having issues with moving a baby from you to their sleep space without waking them, to make them feel secure after being moved and so they feel like they are still on you, use a hot water bottle and put it in the Moses basket. Warm the space for a few minutes and then remove it. Then put baby in and put a firm hand on their chest so baby still thinks that you are still there. This works wonders.

by Suzi Smith

Hazel, AKA, TwinningitUK, as the guest of moKee Birth School online shared her experience and advice on how to get the baby to sleep well. Read more on moKee's blog and get a good nights sleep finally by following our tips.

Blog 1 moKee Birth School online: how to get your baby to sleep well
28 May 2020

moKee Birth School online: how to get your baby to sleep well

moKee Birth School online: how to get your baby to sleep well

3 min read

by Suzi Smith

 

Read the blog post or listen to the podcast on Spotify:

Hazel, AKA, TwinningitUK, is a maternity nurse and sleep specialist. Here she gives her tips to getting babies sleeping well.

Get into good habits when you start out, it builds a really strong foundation for babies sleeping well. Hazel is a gentle sleep coach, looking at sleep from an holistic approach; looking at everything that’s going on in the baby’s world and the parent’s family to determine what routine the baby should be in when it comes to sleep.

A lot of parents get worried that their baby is not a ‘normal sleeper’. So, it’s about talking about what is normal and what isn’t. 80% of babies still wake in the night up until 2 years old, so it’s perfectly normal to have a baby who doesn’t sleep through the night. In fact, waking in the night is safe for babies, try and remember this.

Safe sleep advice, how to put a baby to sleep safely

Keeping the baby in the room with you for the first 6 months is advised, it also makes life easier as they’re right next to you. The temperature of the room needs to be between 16-20 degrees. Dress the baby according to the temperature. If it’s a hot day keep the curtains closed all day to keep it cooler. If it is excessively hot, you can open a window but don’t have the baby in line with the draft because the draft will dry their airways out.

In winter, keep the room temperature between 16-20 degrees and this actually feels cold to walk into but it’s how it should be. Layer them, if it gets too warm you strip them off. Sleep bags are available now and are great. Use a 1-1/5 tog in summer and in winter, a tog 2. An empty cot is needed, baby’s cot needs to be completely empty. A blanket can be in there, providing it’s really tucked in at the sides. No decorations or teddys, they are not safe. Ensure that baby’s feet are at the bottom of the cot. They tend to shuffle around, so keep them at the bottom of the cot. Place them on their back when you put them down to sleep. When they start to roll, that’s fine for them to roll onto their front.

The mattress is really important. If you can’t afford a brand new cot, get a new god quality mattress for the baby and it needs to be firm.

Newborn sleeping

The 4th trimester is the first 12 weeks of life with a baby. There is a lot of adjustment going on, humans are the only mammal that is born and helpless and needs their parents 24/7. For the first couple of weeks, allow that time to bond with your baby as much as possible, have lots of skin to skin time, it will reduce their stress levels and help them sleep better.

Babies are born with two fears; fear of falling and the fear of loud noises. Startle reflex is when a baby is falling asleep and then suddenly moves due to either a loud noise or a fear of falling. Swaddling a new baby can be effective if they have a strong startle reflex. This can help them sleep. Until 12 weeks babies don’t produce melatonin, which is the hormone which helps us fall asleep. Babies don’t have that function in the brain to produce that hormone until they are 3 months old. If you have a premature baby, it’s important to work off their corrected age. If a baby is born at 36 weeks, this is 4 weeks early, so they may not start producing melatonin until they are 16 weeks. So work off their corrected age. They don’t know the difference between night and day so it’s parents’ job to teach them.

Up until 6 weeks babies will sleep and go to the loo, that’s pretty much it. You might get 15-20 minutes of awake time, but you won’t get much out of them other than that, so expect them to sleep a lot.

If however your baby is sleeping continuously and not feeding well or not producing 6-8 wet nappies a day then speak with you Health Visitor or midwife.

 

6 weeks

At 6 weeks babies have a growth spurt so they can tend to get irritated towards the end of the day. Their calorie intake needs are increasing. You might find that they cluster feed if you are breastfeeding (short bursts of frequent feeding) as they are needing more milk and cluster feeding will help to increase your milk supply. If you are bottle feeding you may find that they want a higher volume of milk. Let them lead you, this phase will pass.

 

12 weeks

At 12 weeks, you may notice that they are more awake during the day, they are more interested in things around them. You’ll notice a sleep pattern beginning to develop. They’ll have around four naps a day. It’s good to get them into a routine, let baby lead you on this and look out for when they are showing signs of tiredness and how long them can stay awake for.

 

Sleep promotes sleep

Hyperactivity is a sign of extreme exhaustion. Learn your baby’s sleep signs as best as possible. Be responsive to your baby. Babies cry for hunger, tiredness, overtired, if they’re too hot or too cold. Do not judge a baby’s temperature on their hands or feet. Hands and feet are the first things that are cold. Feel the back of their necks to see how hot they are. Are they having enough to drink, have they had enough sleep during the day? Sleep promotes sleep, the more over tired a baby is in the day, the harder it is to sleep in the night. It’s good to teach babies to sleep well in the day so that in the night they have the skills to fall back to sleep independently.

 

Sleep regression

Sleep regression or sleep development happens at around 4 months, 7 months and 12-18 months and it’s when a baby’s sleep pattern changes. At 4 months they become more adult in how they sleep. They’ll fall into different stages of sleep, lighter stages of sleep. They are not used to this so it’s strange for them. They are asleep but they can hear things going into the lighter stages of sleep. Normally this can take a week to two to adjust. White noise is great as it can drown out any outside sound influences. At 7-8 months there is another change. Your baby is learning to roll and baby wants to practice their skills in their cot. They want to practice this at maybe 1am, but don’t worry, this passes. Ways to combat this is to allow them to have lots of tummy time in the day and not in their cot. At 12-18 months stage, when a baby is starting to walk, the baby stands up in the cot and wants to walk around. These are all natural stages of developments and it’s a phase. When this is happening try and support them with giving practice during the day so that at night time they’ve got it out of their system.

Baby sleeping bags, mattresses and lighting

To use a baby sleeping bag or blanket. If you have a baby under 8-9 pounds you need to ensure that the sleep bag is OK for a baby of a certain weight. Make sure it fits nice and snuggly on them and is not pulling up when they shuffle down. You can buy various tog levels for it. Cellular blankets are great. They generally come in one thickness, and work better for newborns. Sleep bags are a great sleep association, when they go into the sleep bags, the babies associate sleep with them, so it makes them ready to go to sleep. Waterproof mattress protectors are great, they are usually breathable so just have a look at when you buy it. When they are waking for the morning, have the room really light. In the evening, have the lights dim. After 12 weeks, as the darkness kicks in it triggers a message to the brain to start melatonin which triggers them to feel sleepy. Red lighting in a nursery is great as it helps babies sleep, but blue lighting is detrimental to a baby’s sleep. It really interrupts their sleep, so look for a red lamp or bulb with a very low wattage.

 

Top Tip

If you’re having issues with moving a baby from you to their sleep space without waking them, to make them feel secure after being moved and so they feel like they are still on you, use a hot water bottle and put it in the Moses basket. Warm the space for a few minutes and then remove it. Then put baby in and put a firm hand on their chest so baby still thinks that you are still there. This works wonders.

by Suzi Smith

Hazel, AKA, TwinningitUK, as the guest of moKee Birth School online shared her experience and advice on how to get the baby to sleep well. Read more on moKee's blog and get a good nights sleep finally by following our tips.

0

moKee Birth School online:
guide to breastfeeding

6 min read

by Becca Smith @beccasmith_tomlins

 

Read the blog post or listen to the podcast on Spotify:

How to breastfeed with Sophie Martin, The Infertile Midwife

Don’t put any pressure on yourself to breastfeed, but if you can it is great. The Royal College of Obstetricians and Gynaecologists has said that it is safe to breastfeed during Covid 19; there are lots of benefits to breastfeeding and it is considered safer to continue breastfeeding, rather than to stop at this time.

The benefits of breastfeeding

It is recommended to breastfeed for six months exclusively, this means no water, no juice just breastmilk for the first six months of life. It is recommended to continue alongside food up until the baby is two years old. Culturally it’s rare to see this but it is recommended by WHO. In the UK just 17% of babies are still breastfeeding after three months of age.

The benefits to the baby for breastfeeding are reduced risk of infections and fewer hospital attendances. There is a reduced risk of Sudden Infant Death Syndrome (SIDS). It reduces the risk of childhood leukaemia, diabetes, obesity, asthma, eczema, food allergies and it reduces the risk of cardiac problems later in life.

For mum the benefits are a reduced risk of breast cancer, ovarian cancer, osteoporosis, cardiac problems and obesity. It’s also cheaper and quicker than formula, it’s free!

Positioning

Breastfeeding is a skill and it requires patience and practice. There are two people involved in breastfeeding so you both have to learn the technique together to perfect the latch. Skin to skin is so important for establishing breastfeeding. Undress your baby but it can have a nappy on. Take your bra and top off and be bare chested. Bare skin needs to touch bare skin. It can seem like a lot of effort to undress yourself and the baby for each feed but it is the one thing that can make the biggest difference.

It is super important to be in a comfortable position as you might be there for up to 45 minutes. Use pillows and get comfy as you won’t be able to move much. Have a book and drink nearby as you’re going to need to drink lots of water when breastfeeding.

An acronym will help with remembering the best positioning of the baby- CHIN.

Close - your baby needs to be really close to you, skin to skin. Baby needs to be as close on your breasts as possible. The baby’s chin should be touching your breast before latch.

Head free - in order for baby to have a good latch they need to be able to throw their head back, so support their shoulders and neck but don’t hold their head. If you’re trying to eat and someone is pressing on the back of your head, it’s annoying and harder to eat. So leave the head free to throw it back as they latch on.

In line - the baby’s head has to be in line with their body, the head and shoulders need to straight together. Baby will find it easier to swallow with their head in line with their body, not to the side.

Nose to nipple - baby’s nose needs to be opposite the nipple. The baby’s mouth shouldn’t be opposite the nipple as this will lead to a shallow latch, when ideally we want biggest latch that they can get. The nipple needs to look like it’s going up the nose. Global health media has a great video to showcase this.

Unicef also has a great leaflet called ‘Off to the best start’, see here.

When bay is latched, their cheeks should be nice and round. There should be no dimples and they shouldn’t be sucking in, it’s sign it’s not in the right place.

Feeding the baby in cross cradle is great but you can do the rugby ball position which is where you hold your baby under your arm with cushions. The principles are always the same. Nose to nipple and pointing the nipple up the nose.

Laid back feeding is when you encourage the baby to find the breast themselves. Be skin to skin and put them on your tummy/chest and put a blanket on them and then they start to make their way to the nipple themselves. That’s why nipples are darker than the rest of the body – the baby can see light and dark contrasts.

You will keep the baby warm with skin to skin. But just make sure that you are covering their back with a blanket. Skin to skin helps regulate their breathing too.

Feeding signs

How do you know when your baby is hungry? If your newborn is awake, they usually want to eat. So if they’re awake, try to get them on the breast. They also start sucking their hands which is a sign of hunger. If they lick or smack their lips, it also means that they want to eat as well as if they turn their head, actively looking for the breast.

Crying is the last way that your baby will let you know that they’re hungry. It is much easier to feed your baby when they are calm, so pick your baby up before they start crying. In the night you’ll be sleeping, so the baby will cry to wake you up. It’s not the end of the world, but in the day, look out for the signs.

How often should you feed a newborn baby? Healthy, term babies should be fed 8-10 times in 24 hours. That’s not within the first 24 hours- they are usually sleepy on their first day of life so don’t always feed as much. The most important thing to note is that it’s on demand feeding. There is no set interval for feeding your baby. 8 to 10 times in 24 would be every three hours, but we don’t expect your baby to feed at regular intervals. Don’t make your baby wait to feed them, feed them when they’re hungry. Sometimes they’ll cluster feed and then go a bit longer without one. Make a note of when they’re feeding so that you’re getting those feeds in.

If your breasts are feeling full, you can feed your baby too, it works both ways!

Breastfeeding is all about supply and demand. The more your baby feeds, that sends a message to your brain to tell your body to make more milk. For the first three days, colostrum is made and it’s thick and full of nutrients; we call it liquid gold. By day three, baby’s tummy will have grown and your baby needs more milk. Your body doesn’t know that you need to make that milk until the baby tells the body. This is done by feeding. Around day two your baby will be very hungry and that baby will want to feed all the time. On the morning of day three the baby has fed all night and your breasts are really full. That is called the full milk. It’s got all the nutrients but it’s more runny than the colostrum.

How to know if your baby is getting enough milk?

The urine output is a good way to tell if your baby is feeding enough. You should expect one wet nappy when the baby is one day old, two when two days old, three when three and all the way up until day six when we want six wet nappies per day. A lot of the nappies in the shops have a yellow line which goes down the nappy. It will turn blue when the baby has done a wee. Have a notebook or app and write down every time the baby does a wee too.

Bowl movements are a good sign that baby is eating. Babies should be pooing at least once a day. They can go a day or more without pooing though. It’s the colour of the poo which is most important. Poo is black like tar for the first poo, this is called meconium . By day three it will start to go green which is when the milk comes in. It gets runnier and by day five the poo should be really runny and bright yellow, like mustard. A lot of parents think it’s an upset tummy, but it’s not.

Weight loss is a good indicator as to whether the baby is getting enough milk. Your midwife will weigh your baby at five days old and we expect a small amount weight loss at this time but no more than 8% of their body weight. Don’t panic, your midwife will do a specific plan on what to do to get them back on track if they have lost more than this.

How often the baby is feeding is an indicator of how much they’re getting. If they’re not feeding 8-10 times a day, then they’re not getting enough. If they feed more than 8-10times in 24 hours, it might not also be enough as they’re still hungry. Note how long feeds last too. The length of a feed is a good indicator. Most feeds should be between 5-45 minutes. If it’s longer they may not be getting enough milk.

The sucking pattern of the baby during a feed is also a sign. You shouldn’t hear the baby feed when they feed, you should hear swallowing but not sucking. If this is the case, often the latch is too shallow. Pop a clean finger into the mouth to break the suction and take the baby off. Don’t pull the baby off the nipple as they have a suction and they’re just going to pull on the nipple and it’s really painful. Please don’t be tempted to let them carry on. You need to unlatch them if it’s not right as your nipples can get really sore. Just start again.

Baby should come off the breast themselves, they often unlatch or fall asleep. Once they’ve stopped remove them from the breast.

The shape of the nipple after the feed is a good indicator on the latch and how much milk the baby is getting. The nipple should be nice and round, looking the same as before. In a shallow latch the nipple will look like it’s been pinched, or like a brand new lipstick. This is not how it should be.

Hand expressing

This is when you squeeze milk out of your breast by hand. If you need to express milk in the first few days, don’t use a breast pump, as there’s not enough milk. If you have a blocked milk duck, hand expressing will help. Think of your breast as a muscle; you need to warm up your breast. Have a bath or a shower or use a hot compress. Massage the breast too with your knuckles. Gently massage towards the nipple. Do it all the way round your breast to warm it up. After a few minutes you can put your hand in a c shape and put it 2-3 cm away from the nipple and then squeeze, a few times. Don’t squeeze hard and keep going until you see droplets of milk. Be patient. When it starts flowing keep squeezing until it slows down and stops. Don’t squeeze the nipple; the milk ducts are not in the nipple, they’re in the breast tissue.

Then move your hands to a different position until it comes out and then stops. Keep doing this until you’ve done the whole of the breast. The more you stimulate the breasts, the more milk you produce. A lot of women will start hand expressing from 36 weeks. You can freeze it and save it for baby once they are born.

Storing the breast milk is easy, it can stay out for 6 hours, in the fridge for 6 days, don’t put it in the door of the fridge as it’s slightly warmer. It can then stay for 6 months in the freezer and always label with the date you expressed it.

Common problems

Sore nipples are caused by a shallow latch, so the baby is sucking on the nipple. They need to be sucking on the breast not the nipple. Treat the sore nipples with nipple creams. Breast milk is also amazing to help heal, so put it on your nipple! Getting air to your nipples can be great too. Always sort the problem with the latch, sucking on the end rather than on the breast. Work hard to put nose to nipple, make sure baby is reaching up and over the nipple.

Engorged breasts are when breasts have got overfull which again could be due to a poor latch. They get hard and sore and look shiny. You might get mastitis, if you don’t treat it. Empty your breast fully every time you feed. Give the baby one feed on one breast, it must be fully drained before moving on to the second breast. Feel your breast as it should feel soft after. Don’t offer baby a second beast if you haven’t finished the first one.

Mastitis is an inflammation or infection in the breasts. You can see a hot patch on the breast- bright red and warm to touch. You need to keep feeding and get the milk flowing. A hot compress or a shower can help and get the baby to pump where the red patch is, to empty the problem. If you have a temperature or feel flu like, get antibiotics to stop the infection. Keep feeding as you’ll make the situation worst if you don’t.

Thrush- you can get thrush in your breasts and this is a shooting pain which you’ll get it in both breasts. After a feed you might notice your baby’s tongue is a little bit white. If baby’s tongue is still very white a few hours later, you might have thrush. It’s not harmful for you or the baby but get the treatment as it can be painful for you. See your GP.

by Becca Smith @beccasmith_tomlins

It is recommended to breastfeed for six months exclusively, this means no water, no juice just breastmilk for the first six months of life. It is recommended to continue alongside food up until the baby is two years old. Read our blog post and use tips & guidance from Sophie Martin, known as The Infertile Midwife.

Blog 1 moKee Birth School online: guide to breastfeeding
25 May 2020

moKee Birth School online: guide to breastfeeding

moKee Birth School online:
guide to breastfeeding

6 min read

by Becca Smith @beccasmith_tomlins

 

Read the blog post or listen to the podcast on Spotify:

How to breastfeed with Sophie Martin, The Infertile Midwife

Don’t put any pressure on yourself to breastfeed, but if you can it is great. The Royal College of Obstetricians and Gynaecologists has said that it is safe to breastfeed during Covid 19; there are lots of benefits to breastfeeding and it is considered safer to continue breastfeeding, rather than to stop at this time.

The benefits of breastfeeding

It is recommended to breastfeed for six months exclusively, this means no water, no juice just breastmilk for the first six months of life. It is recommended to continue alongside food up until the baby is two years old. Culturally it’s rare to see this but it is recommended by WHO. In the UK just 17% of babies are still breastfeeding after three months of age.

The benefits to the baby for breastfeeding are reduced risk of infections and fewer hospital attendances. There is a reduced risk of Sudden Infant Death Syndrome (SIDS). It reduces the risk of childhood leukaemia, diabetes, obesity, asthma, eczema, food allergies and it reduces the risk of cardiac problems later in life.

For mum the benefits are a reduced risk of breast cancer, ovarian cancer, osteoporosis, cardiac problems and obesity. It’s also cheaper and quicker than formula, it’s free!

Positioning

Breastfeeding is a skill and it requires patience and practice. There are two people involved in breastfeeding so you both have to learn the technique together to perfect the latch. Skin to skin is so important for establishing breastfeeding. Undress your baby but it can have a nappy on. Take your bra and top off and be bare chested. Bare skin needs to touch bare skin. It can seem like a lot of effort to undress yourself and the baby for each feed but it is the one thing that can make the biggest difference.

It is super important to be in a comfortable position as you might be there for up to 45 minutes. Use pillows and get comfy as you won’t be able to move much. Have a book and drink nearby as you’re going to need to drink lots of water when breastfeeding.

An acronym will help with remembering the best positioning of the baby- CHIN.

Close - your baby needs to be really close to you, skin to skin. Baby needs to be as close on your breasts as possible. The baby’s chin should be touching your breast before latch.

Head free - in order for baby to have a good latch they need to be able to throw their head back, so support their shoulders and neck but don’t hold their head. If you’re trying to eat and someone is pressing on the back of your head, it’s annoying and harder to eat. So leave the head free to throw it back as they latch on.

In line - the baby’s head has to be in line with their body, the head and shoulders need to straight together. Baby will find it easier to swallow with their head in line with their body, not to the side.

Nose to nipple - baby’s nose needs to be opposite the nipple. The baby’s mouth shouldn’t be opposite the nipple as this will lead to a shallow latch, when ideally we want biggest latch that they can get. The nipple needs to look like it’s going up the nose. Global health media has a great video to showcase this.

Unicef also has a great leaflet called ‘Off to the best start’, see here.

When bay is latched, their cheeks should be nice and round. There should be no dimples and they shouldn’t be sucking in, it’s sign it’s not in the right place.

Feeding the baby in cross cradle is great but you can do the rugby ball position which is where you hold your baby under your arm with cushions. The principles are always the same. Nose to nipple and pointing the nipple up the nose.

Laid back feeding is when you encourage the baby to find the breast themselves. Be skin to skin and put them on your tummy/chest and put a blanket on them and then they start to make their way to the nipple themselves. That’s why nipples are darker than the rest of the body – the baby can see light and dark contrasts.

You will keep the baby warm with skin to skin. But just make sure that you are covering their back with a blanket. Skin to skin helps regulate their breathing too.

Feeding signs

How do you know when your baby is hungry? If your newborn is awake, they usually want to eat. So if they’re awake, try to get them on the breast. They also start sucking their hands which is a sign of hunger. If they lick or smack their lips, it also means that they want to eat as well as if they turn their head, actively looking for the breast.

Crying is the last way that your baby will let you know that they’re hungry. It is much easier to feed your baby when they are calm, so pick your baby up before they start crying. In the night you’ll be sleeping, so the baby will cry to wake you up. It’s not the end of the world, but in the day, look out for the signs.

How often should you feed a newborn baby? Healthy, term babies should be fed 8-10 times in 24 hours. That’s not within the first 24 hours- they are usually sleepy on their first day of life so don’t always feed as much. The most important thing to note is that it’s on demand feeding. There is no set interval for feeding your baby. 8 to 10 times in 24 would be every three hours, but we don’t expect your baby to feed at regular intervals. Don’t make your baby wait to feed them, feed them when they’re hungry. Sometimes they’ll cluster feed and then go a bit longer without one. Make a note of when they’re feeding so that you’re getting those feeds in.

If your breasts are feeling full, you can feed your baby too, it works both ways!

Breastfeeding is all about supply and demand. The more your baby feeds, that sends a message to your brain to tell your body to make more milk. For the first three days, colostrum is made and it’s thick and full of nutrients; we call it liquid gold. By day three, baby’s tummy will have grown and your baby needs more milk. Your body doesn’t know that you need to make that milk until the baby tells the body. This is done by feeding. Around day two your baby will be very hungry and that baby will want to feed all the time. On the morning of day three the baby has fed all night and your breasts are really full. That is called the full milk. It’s got all the nutrients but it’s more runny than the colostrum.

How to know if your baby is getting enough milk?

The urine output is a good way to tell if your baby is feeding enough. You should expect one wet nappy when the baby is one day old, two when two days old, three when three and all the way up until day six when we want six wet nappies per day. A lot of the nappies in the shops have a yellow line which goes down the nappy. It will turn blue when the baby has done a wee. Have a notebook or app and write down every time the baby does a wee too.

Bowl movements are a good sign that baby is eating. Babies should be pooing at least once a day. They can go a day or more without pooing though. It’s the colour of the poo which is most important. Poo is black like tar for the first poo, this is called meconium . By day three it will start to go green which is when the milk comes in. It gets runnier and by day five the poo should be really runny and bright yellow, like mustard. A lot of parents think it’s an upset tummy, but it’s not.

Weight loss is a good indicator as to whether the baby is getting enough milk. Your midwife will weigh your baby at five days old and we expect a small amount weight loss at this time but no more than 8% of their body weight. Don’t panic, your midwife will do a specific plan on what to do to get them back on track if they have lost more than this.

How often the baby is feeding is an indicator of how much they’re getting. If they’re not feeding 8-10 times a day, then they’re not getting enough. If they feed more than 8-10times in 24 hours, it might not also be enough as they’re still hungry. Note how long feeds last too. The length of a feed is a good indicator. Most feeds should be between 5-45 minutes. If it’s longer they may not be getting enough milk.

The sucking pattern of the baby during a feed is also a sign. You shouldn’t hear the baby feed when they feed, you should hear swallowing but not sucking. If this is the case, often the latch is too shallow. Pop a clean finger into the mouth to break the suction and take the baby off. Don’t pull the baby off the nipple as they have a suction and they’re just going to pull on the nipple and it’s really painful. Please don’t be tempted to let them carry on. You need to unlatch them if it’s not right as your nipples can get really sore. Just start again.

Baby should come off the breast themselves, they often unlatch or fall asleep. Once they’ve stopped remove them from the breast.

The shape of the nipple after the feed is a good indicator on the latch and how much milk the baby is getting. The nipple should be nice and round, looking the same as before. In a shallow latch the nipple will look like it’s been pinched, or like a brand new lipstick. This is not how it should be.

Hand expressing

This is when you squeeze milk out of your breast by hand. If you need to express milk in the first few days, don’t use a breast pump, as there’s not enough milk. If you have a blocked milk duck, hand expressing will help. Think of your breast as a muscle; you need to warm up your breast. Have a bath or a shower or use a hot compress. Massage the breast too with your knuckles. Gently massage towards the nipple. Do it all the way round your breast to warm it up. After a few minutes you can put your hand in a c shape and put it 2-3 cm away from the nipple and then squeeze, a few times. Don’t squeeze hard and keep going until you see droplets of milk. Be patient. When it starts flowing keep squeezing until it slows down and stops. Don’t squeeze the nipple; the milk ducts are not in the nipple, they’re in the breast tissue.

Then move your hands to a different position until it comes out and then stops. Keep doing this until you’ve done the whole of the breast. The more you stimulate the breasts, the more milk you produce. A lot of women will start hand expressing from 36 weeks. You can freeze it and save it for baby once they are born.

Storing the breast milk is easy, it can stay out for 6 hours, in the fridge for 6 days, don’t put it in the door of the fridge as it’s slightly warmer. It can then stay for 6 months in the freezer and always label with the date you expressed it.

Common problems

Sore nipples are caused by a shallow latch, so the baby is sucking on the nipple. They need to be sucking on the breast not the nipple. Treat the sore nipples with nipple creams. Breast milk is also amazing to help heal, so put it on your nipple! Getting air to your nipples can be great too. Always sort the problem with the latch, sucking on the end rather than on the breast. Work hard to put nose to nipple, make sure baby is reaching up and over the nipple.

Engorged breasts are when breasts have got overfull which again could be due to a poor latch. They get hard and sore and look shiny. You might get mastitis, if you don’t treat it. Empty your breast fully every time you feed. Give the baby one feed on one breast, it must be fully drained before moving on to the second breast. Feel your breast as it should feel soft after. Don’t offer baby a second beast if you haven’t finished the first one.

Mastitis is an inflammation or infection in the breasts. You can see a hot patch on the breast- bright red and warm to touch. You need to keep feeding and get the milk flowing. A hot compress or a shower can help and get the baby to pump where the red patch is, to empty the problem. If you have a temperature or feel flu like, get antibiotics to stop the infection. Keep feeding as you’ll make the situation worst if you don’t.

Thrush- you can get thrush in your breasts and this is a shooting pain which you’ll get it in both breasts. After a feed you might notice your baby’s tongue is a little bit white. If baby’s tongue is still very white a few hours later, you might have thrush. It’s not harmful for you or the baby but get the treatment as it can be painful for you. See your GP.

by Becca Smith @beccasmith_tomlins

It is recommended to breastfeed for six months exclusively, this means no water, no juice just breastmilk for the first six months of life. It is recommended to continue alongside food up until the baby is two years old. Read our blog post and use tips & guidance from Sophie Martin, known as The Infertile Midwife.

0

moKee Birth School online:
how to have a healthy pregnancy

4 min read

by Suzi Smith  

How to have a healthy pregnancy with Marie Louise, The Modern Midwife

It’s really important to look after yourself during this time. If you have anxiety it can affect you and your baby. Sometimes it can be difficult sleeping, struggling to eat, so here are some tips on how to have a healthy pregnancy.

Everyone has an opinion on what you should and shouldn’t be doing during pregnancy. A lot of the time people aren’t trained to give advice, so it’s important to note the advice politely but then double check that it’s correct advice by asking your Midwife.

Your nutrition, the food you put in your body, the chemicals you’re exposed and stress, all tell your baby a story of the world that they’re being born into. Food goes into the amniotic fluid, so it’s been proven that babies who are exposed to foods in the womb, often like the food once they try it. So be mindful of what you’re putting into your body, but don’t fixate on it.

Your need for micronutrients increase during pregnancy but you don’t need to eat for two. This is a really common myth which you should ignore. You should be taking supplements, ideally take a food grown supplement because it’s thought that the body absorbs it better than man made supplements. Ensure that you take vitamin D, no matter the season. Pregnant women do need to take it daily and in winter it is more important.

All pregnant women should take folic acid for the first three months of pregnancy only, this is when the baby’s spine is forming so the most amount of growing and developing happens. If your baby grows as it does in the first three months throughout pregnancy it would be 1.5tonnes. Pregnancy supplements are really great as they include all of the vitamins that you need but you can buy them individually.

It’s important to get a really balanced diet, so know your food groups. You need to make sure that you’re having protein with every meal, they include amino acids. They are the building blocks for life. If you are vegan, you need to pay attention to this. Good sources of protein include chickpeas, lentils, protein from nuts and remember that you can eat nuts during pregnancy, unless you’re allergic. Lean meats are a great source of protein as are fish and eggs. Get them in every meal if you can.

Carbohydrates are important when it comes to your diet. You can get carbs from vegetables, fruit, brown bread, pasta and oats. Ideally it’s good to avoid white or processed bread because they don’t have many nutrients. Opt for wholegrain carbs and whole grain breads. Try not to cut out food groups during pregnancy and especially after birth as they are great for energy.

Healthy fats are found in natural food whereas trans fats are found in biscuits for example, so opt for natural fats. Olive oil, nuts, seeds and avocados all contain healthy fats. You can also use these ingredients to make a smoothie.

Ensure that you’re well hydrated, it’s so important. You need to be drinking at least two litres per day. It’s great for your whole body. Your blood volume increases by 50% in pregnancy and you have more hormones in your body which can increase headaches, so drink lots of water to prevent this.

Try to avoid take outs! Make your favourite take outs at home with natural ingredients so that you avoid food colourings, bad fats etc… Try making fish and chips without the batter, create a Chinese takeaway by seasoning lots- get adventurous!

Bulk cooking is great to do ahead of your baby coming as it will be hugely helpful once you come home. If you have time, cook lots of healthy hearty meals and freeze them. It won’t as much of pleasure to cook when you have a newborn.

Moneywise, the healthier options of organic are often more expensive and now there’s lots of financial pressure so make sure that you check to see if you’re eligible for any food grants during pregnancy to help.

Vitamin B12 is essential to take if you’re vegan or veggie. You can get it in marmite and eggs but you can get little drops that you put under your tongue.

Iron rich foods are important to ensure that you’re getting enough iron. That’s why Midwives do your blood tests at 28 weeks, they give you a Full blood Count. They are looking for your iron level and antibodies. Dark leafy green veg are a great source of iron. Make sure you have iron rich foods with vitamin C as this helps with the absorption. Take them with a glass of orange juice and ensure not with milk as it actually prevents the absorption.  

It’s a myth that you can’t eat runny eggs in pregnancy. Guidelines used to say that you couldn’t but research has proven that it’s safe as long as they have the red lion stamp on the egg.

Diet can help with constipation, making sure that you’re having enough fibre. It’s so important and chia seeds, flack seeds , fruits, wholegrain carbs, all of these will help getting your bowel going.

When you eat a healthy diet it can increase and enhance your mood. It does make a difference to how you feel so please take note of what you’re eating. However, remember not to become obsessed with your diet. Follow the 80:20 rule; 80% of the time eat as healthy as you can and then 20% of the time have a break and fully enjoy your biscuits, chocolate and treats!

When it comes to have a alcohol, it’s up to you. Know that whatever you put in your body, it will affect your baby, there is no known safe amount of alcohol to drink but it is common for pregnant women to have the odd glass. Current NHS guidelines say to avoid altogether but do what works for you.

Body scanning is a good way to check in with your body through pregnancy so that you really understand all of the changes that are happening. Do it everyday maybe when you’re in the shower and just focus on every part of your body to see how it feels. It will help you focus on relaxing parts of your body.

Lastly, exercise. A bit of stretching and yoga is great for blood flow and it’s great for mental health and a way to look after your body. Women who eat well, and exercise regularly have a reduced rate of c sections. Be mindful of getting some sort of exercise in, even a few stretches can be great.

by Suzi Smith  

It’s really important to look after yourself during this time. If you have anxiety it can affect you and your baby. Sometimes it can be difficult sleeping, struggling to eat, so here are some tips on how to have a healthy pregnancy.

Blog 1 moKee Birth School online: How to have a healthy pregnancy
11 May 2020

moKee Birth School online: How to have a healthy pregnancy

moKee Birth School online:
how to have a healthy pregnancy

4 min read

by Suzi Smith  

How to have a healthy pregnancy with Marie Louise, The Modern Midwife

It’s really important to look after yourself during this time. If you have anxiety it can affect you and your baby. Sometimes it can be difficult sleeping, struggling to eat, so here are some tips on how to have a healthy pregnancy.

Everyone has an opinion on what you should and shouldn’t be doing during pregnancy. A lot of the time people aren’t trained to give advice, so it’s important to note the advice politely but then double check that it’s correct advice by asking your Midwife.

Your nutrition, the food you put in your body, the chemicals you’re exposed and stress, all tell your baby a story of the world that they’re being born into. Food goes into the amniotic fluid, so it’s been proven that babies who are exposed to foods in the womb, often like the food once they try it. So be mindful of what you’re putting into your body, but don’t fixate on it.

Your need for micronutrients increase during pregnancy but you don’t need to eat for two. This is a really common myth which you should ignore. You should be taking supplements, ideally take a food grown supplement because it’s thought that the body absorbs it better than man made supplements. Ensure that you take vitamin D, no matter the season. Pregnant women do need to take it daily and in winter it is more important.

All pregnant women should take folic acid for the first three months of pregnancy only, this is when the baby’s spine is forming so the most amount of growing and developing happens. If your baby grows as it does in the first three months throughout pregnancy it would be 1.5tonnes. Pregnancy supplements are really great as they include all of the vitamins that you need but you can buy them individually.

It’s important to get a really balanced diet, so know your food groups. You need to make sure that you’re having protein with every meal, they include amino acids. They are the building blocks for life. If you are vegan, you need to pay attention to this. Good sources of protein include chickpeas, lentils, protein from nuts and remember that you can eat nuts during pregnancy, unless you’re allergic. Lean meats are a great source of protein as are fish and eggs. Get them in every meal if you can.

Carbohydrates are important when it comes to your diet. You can get carbs from vegetables, fruit, brown bread, pasta and oats. Ideally it’s good to avoid white or processed bread because they don’t have many nutrients. Opt for wholegrain carbs and whole grain breads. Try not to cut out food groups during pregnancy and especially after birth as they are great for energy.

Healthy fats are found in natural food whereas trans fats are found in biscuits for example, so opt for natural fats. Olive oil, nuts, seeds and avocados all contain healthy fats. You can also use these ingredients to make a smoothie.

Ensure that you’re well hydrated, it’s so important. You need to be drinking at least two litres per day. It’s great for your whole body. Your blood volume increases by 50% in pregnancy and you have more hormones in your body which can increase headaches, so drink lots of water to prevent this.

Try to avoid take outs! Make your favourite take outs at home with natural ingredients so that you avoid food colourings, bad fats etc… Try making fish and chips without the batter, create a Chinese takeaway by seasoning lots- get adventurous!

Bulk cooking is great to do ahead of your baby coming as it will be hugely helpful once you come home. If you have time, cook lots of healthy hearty meals and freeze them. It won’t as much of pleasure to cook when you have a newborn.

Moneywise, the healthier options of organic are often more expensive and now there’s lots of financial pressure so make sure that you check to see if you’re eligible for any food grants during pregnancy to help.

Vitamin B12 is essential to take if you’re vegan or veggie. You can get it in marmite and eggs but you can get little drops that you put under your tongue.

Iron rich foods are important to ensure that you’re getting enough iron. That’s why Midwives do your blood tests at 28 weeks, they give you a Full blood Count. They are looking for your iron level and antibodies. Dark leafy green veg are a great source of iron. Make sure you have iron rich foods with vitamin C as this helps with the absorption. Take them with a glass of orange juice and ensure not with milk as it actually prevents the absorption.  

It’s a myth that you can’t eat runny eggs in pregnancy. Guidelines used to say that you couldn’t but research has proven that it’s safe as long as they have the red lion stamp on the egg.

Diet can help with constipation, making sure that you’re having enough fibre. It’s so important and chia seeds, flack seeds , fruits, wholegrain carbs, all of these will help getting your bowel going.

When you eat a healthy diet it can increase and enhance your mood. It does make a difference to how you feel so please take note of what you’re eating. However, remember not to become obsessed with your diet. Follow the 80:20 rule; 80% of the time eat as healthy as you can and then 20% of the time have a break and fully enjoy your biscuits, chocolate and treats!

When it comes to have a alcohol, it’s up to you. Know that whatever you put in your body, it will affect your baby, there is no known safe amount of alcohol to drink but it is common for pregnant women to have the odd glass. Current NHS guidelines say to avoid altogether but do what works for you.

Body scanning is a good way to check in with your body through pregnancy so that you really understand all of the changes that are happening. Do it everyday maybe when you’re in the shower and just focus on every part of your body to see how it feels. It will help you focus on relaxing parts of your body.

Lastly, exercise. A bit of stretching and yoga is great for blood flow and it’s great for mental health and a way to look after your body. Women who eat well, and exercise regularly have a reduced rate of c sections. Be mindful of getting some sort of exercise in, even a few stretches can be great.

by Suzi Smith  

It’s really important to look after yourself during this time. If you have anxiety it can affect you and your baby. Sometimes it can be difficult sleeping, struggling to eat, so here are some tips on how to have a healthy pregnancy.

0

How to choose the perfect baby name

3 min read

by Becca Smith @beccasmith_tomlins

A lot of girls growing up have a list. A list of names that they would call their children. Seems bizarre but I always had a mental list of all the baby names I loved. This would change from year to year but it’s something I talked about with my friends and I remember saying to them that they couldn’t ‘steal’ my names!

Well, when the moment came to actually choose a name for a real baby it was hard. We didn’t know the sex of our babies until they were born so we had a list of both girl and boy names which my husband and I would go back and forth on. One day we’d love a particular name and the next it would be binned because it reminded us of someone or something we disliked. It was only until we actually met both our boys that we decided on their names. Our first born is Rupert Fox and our second, Arlo Henry. Names are so personal but a few years on we still love them and they haven’t dated.

So here are a few tips from what I learnt when deciding on the perfect baby name!

1) Research

It’s important to do your homework. I’d recommend getting a baby name book- I found this so helpful and it was nice to relax and sit down and flick through the A-Z of baby names – you come across some really interesting ones! I also simply googled a lot of baby names and weirdly when I was reading the newspaper I’d really take note of the names!

2) Who else has that name?

Now it’s important to make sure you think about the people in your family and friendship circle. Who else has that name you have set your heart on? Would they mind? Would you mind?

3) Family traditions?

Now if you have a family tradition when it comes to names it’s important to have a chat with your partner and family if you’re going to continue the family tradition! My husband’s dad has the same name as him and to be honest it didn’t even cross my mind to speak to them and see if they’d mind if we didn’t keep this tradition going! We decided to choose our own names and to be honest it was more out of practicality- having three people with the same could become very confusing!

4) Family history

If you’re looking for something a bit different why don’t you think about your heritage and if there are any interesting names you think could work for you? I’ve got some German in me so I definitely looked at any popular names in Germany that could work. My son’s name, Rupert is actually the German equivalent of Rupert, so it seemed to fit for us.

5) Spelling

If you’re keen for a particular name but think it’s too common why don’t you add your own twist and change the spelling? Megan could be changed to Meghan, Sarah to Sara etc.

6) Nicknames

When thinking of a name it’s important to think what nicknames might come from it. If you don’t like the shortened version of a name then you should probably find another name as they will probably be called the shortened version by friends etc.

7) Does it work with the surname?

Check that it works with your surname! Does it rhyme?! Or does it form a silly phrase when said together?! It’s important!

8) Siblings

Now, if you want to literally ‘Keep up with the Kardashians’ then you could follow them in calling all of your brood with names that start with the same letter. But if you fancy mixing it up I think it’s important to make sure you are happy with how they all sound together. If your daughter is called Rosie and you name you son Jim, you will (if old enough!) be reminded of a children’s TV programme popular in the UK decades ago! If you name your daughter Cher and your son Sony then think about what that will make people think!

9) Will it work when they are a grown up?!

Baby names can be seriously cute but they have to live with them forever (usually), so think about if it will be serious enough for when they are grown up?! Think about if your son or daughter were to become the Prime Minister!

10) Meet them first and then decide

Lots of people have to test out names on their babies until they find one that fits. We did that with our second. We were set on a name but when he came out he just didn’t look like it- so my husband literally scrolled through A-Z of baby names and came across Arlo (again, he had previously vetoed it) and I pounced on it. He looked like an Arlo and my husband soon came around after he had seen me give birth!

 

Share your baby names with us at @wearemokee!

by Becca Smith @beccasmith_tomlins

A lot of girls growing up have a list. A list of names that they would call their children. Seems bizarre but I always had a mental list of all the baby names I loved. This would change from year to year but it’s something I talked about with my friends and I remember saying to them that they couldn’t ‘steal’ my names!

Blog 1 How to Pick The Perfect Baby Name | moKee says!
07 May 2020

How to Pick The Perfect Baby Name | moKee says!

How to choose the perfect baby name

3 min read

by Becca Smith @beccasmith_tomlins

A lot of girls growing up have a list. A list of names that they would call their children. Seems bizarre but I always had a mental list of all the baby names I loved. This would change from year to year but it’s something I talked about with my friends and I remember saying to them that they couldn’t ‘steal’ my names!

Well, when the moment came to actually choose a name for a real baby it was hard. We didn’t know the sex of our babies until they were born so we had a list of both girl and boy names which my husband and I would go back and forth on. One day we’d love a particular name and the next it would be binned because it reminded us of someone or something we disliked. It was only until we actually met both our boys that we decided on their names. Our first born is Rupert Fox and our second, Arlo Henry. Names are so personal but a few years on we still love them and they haven’t dated.

So here are a few tips from what I learnt when deciding on the perfect baby name!

1) Research

It’s important to do your homework. I’d recommend getting a baby name book- I found this so helpful and it was nice to relax and sit down and flick through the A-Z of baby names – you come across some really interesting ones! I also simply googled a lot of baby names and weirdly when I was reading the newspaper I’d really take note of the names!

2) Who else has that name?

Now it’s important to make sure you think about the people in your family and friendship circle. Who else has that name you have set your heart on? Would they mind? Would you mind?

3) Family traditions?

Now if you have a family tradition when it comes to names it’s important to have a chat with your partner and family if you’re going to continue the family tradition! My husband’s dad has the same name as him and to be honest it didn’t even cross my mind to speak to them and see if they’d mind if we didn’t keep this tradition going! We decided to choose our own names and to be honest it was more out of practicality- having three people with the same could become very confusing!

4) Family history

If you’re looking for something a bit different why don’t you think about your heritage and if there are any interesting names you think could work for you? I’ve got some German in me so I definitely looked at any popular names in Germany that could work. My son’s name, Rupert is actually the German equivalent of Rupert, so it seemed to fit for us.

5) Spelling

If you’re keen for a particular name but think it’s too common why don’t you add your own twist and change the spelling? Megan could be changed to Meghan, Sarah to Sara etc.

6) Nicknames

When thinking of a name it’s important to think what nicknames might come from it. If you don’t like the shortened version of a name then you should probably find another name as they will probably be called the shortened version by friends etc.

7) Does it work with the surname?

Check that it works with your surname! Does it rhyme?! Or does it form a silly phrase when said together?! It’s important!

8) Siblings

Now, if you want to literally ‘Keep up with the Kardashians’ then you could follow them in calling all of your brood with names that start with the same letter. But if you fancy mixing it up I think it’s important to make sure you are happy with how they all sound together. If your daughter is called Rosie and you name you son Jim, you will (if old enough!) be reminded of a children’s TV programme popular in the UK decades ago! If you name your daughter Cher and your son Sony then think about what that will make people think!

9) Will it work when they are a grown up?!

Baby names can be seriously cute but they have to live with them forever (usually), so think about if it will be serious enough for when they are grown up?! Think about if your son or daughter were to become the Prime Minister!

10) Meet them first and then decide

Lots of people have to test out names on their babies until they find one that fits. We did that with our second. We were set on a name but when he came out he just didn’t look like it- so my husband literally scrolled through A-Z of baby names and came across Arlo (again, he had previously vetoed it) and I pounced on it. He looked like an Arlo and my husband soon came around after he had seen me give birth!

 

Share your baby names with us at @wearemokee!

by Becca Smith @beccasmith_tomlins

A lot of girls growing up have a list. A list of names that they would call their children. Seems bizarre but I always had a mental list of all the baby names I loved. This would change from year to year but it’s something I talked about with my friends and I remember saying to them that they couldn’t ‘steal’ my names!

0

moKee Birth School online:
complications in labour

5 min read

by Suzi Smith  

 

Read the blog post or listen to the podcast on Spotify:

Sophie, The Infertile Midwife, explains complications during labour

Complications during labour are less frightening if you know why these complications are happening. It’s important to ask your doctor why these complications are happening and what all of your options are. Remember that the Doctors and Midwives must have your consent to do anything during labour.

Instrumental birth, or assisted birth is where you give birth vaginally but you have some help. One in eight women give birth like this, getting a bit of help with a Kiwi or with forceps which are used by a Doctor.

The Kiwi has replaced the ventouse. An assisted birth can only happen if you’re fully dilated and it’s good to know that if you’re not fully dilated the only option is to have a c section if your baby is in distress and needs delivering quickly. The reasons that you might have this is because your baby isn’t happy and needs to be delivered quickly, you might have been pushing for a long time, and for some women with medical reasons they can’t push. Your doctor should be explaining the reason why they are suggesting an assisted birth. It’s important to understand why you need forceps over a Kiwi. When a doctor is assessing the situation, they’ll be making a recommendation on what they’ve found from a vaginal examination. It’s usually to do with the position of the baby. They feel the bones on the baby’s head and figure out where the baby is.

It’s safer to use forceps if you’re baby is preterm - before 37 weeks of pregnancy. It’s important to know that having a caesarean section at fully dilated is not always considered the safest way to give birth. This is because when you are fully dilated, the baby is deep inside the birth canal. There are some manoeuvres that need to happen to dislodge the baby, if it is particularly deep.

In terms of the procedure, the doctor decides on the instrument to use and gets consent. If you don’t already have a catheter in place they’ll put it in, drain the bladder and take it out. It’s really important to have an empty bladder as it gets in the way of baby coming out and they’ll ensure that you have pain relief with either an epidural or a local anaesthetic. Midwives put your legs into the stirrups so when you’re having a contraction you still have to push and then the Doctor pulls at the same time. Usually just pulling three times until baby comes out.

The kiwi is made of plastic and the sponge goes onto the baby’s head on the back. The doctor will insert it into your vagina. They pump it up so the suction stays on the baby’s head. It’s a really small instrument but It can leave a suction mark on the baby’s head but it will go away super quickly. Because they’re soft they are more likely to fail than the forceps.

Forceps look like a big pair of spoons, a big pair of salad tongs. They go around your baby’s head and they are more effective than the Kiwi and they do go on the side of the baby’s head. They’re metal and will cause slight bruising but this will be gone in a couple of days. You are most at risk of bleeding after birth with an assisted birth so in order to prevent this, Midwives recommend active management in the third stage to deliver the placenta. After the baby has born and you’re about to deliver the placenta, we suggest having an injection into the leg to reduce risk of bleeding and to deliver the placenta.

You also have a risk of tearing so you might have an episiotomy. It is very rare to have a big tear- 4 in 100 women get a third or fourth degree tear with a kiwi, and only 8 to 12 in every 100 from a forceps. That is why you are offered an episiotomy to reduce big tearing.

Caesarean Section

C sections are a surgical procedure where the baby comes out via the lower abdomen. There are lots of reasons as to why you might have a c section. If the baby is breech - coming bottom first, then you may have a planned caesarean. If your placenta is covering the cervix the baby can’t come out naturally, so a c section has to happen. Multiple pregnancies, twins or triplets, are often delivered via c section. It might be safer for you to have a c section rather than a vaginal birth due to a medical condition.

Emergency c sections happen for a variety of reasons. If your baby isn’t very happy and you’re not fully dilated, if labour is very slow and lots of things have been tried, a c section will be offered.

A spinal is often used to numb you but if you’ve already got an epidural, they’ll give you a really big dose to make you feel numb. You’ll feel touch but no pain. You’ll have a catheter and you’ll be in an operating theatre on your back but tilted to the side. In the 3rd trimester don’t lie flat on your back because the weight of your baby sits on your big blood vessels, which will stops oxygen getting around your body as well we getting to your baby.

Midwives shave you before theatre, as they don’t want hair in the wound. You don’t need to shave or wax before but go ahead if you want to. From the time the Doctors start to the time the baby is born, it’s usually 5 minutes and then 30- 40 mins when they put you back together again. Most people are so distracted by their baby and they won’t realise the time. You will feel touch but no pain and when they are trying to deliver the baby you’ll feel like someone is doing the washing up in your tummy. You’ll feel people moving inside you. You feel a lot of pressure on your tummy just before the baby is being delivered. The midwife will check the baby once it’s delivered to ensure that it’s breathing and then they usually come straight to you for a cuddle. You can’t cut a cord but usually the Doctor’s leave it nice and long, so you can trim it down, and have that nice moment. You can do skin to skin in theatre, so just let the Midwife know that you want to. After they clean you up and you go to a recovery area and then you’ll go to the post natal ward. All of the usual post theatre care will happen; nurses will do your observations regularly.

Perineal Tears

The perineum is the bit between the vagina and anus. It is really common to sustain an injury during childbirth. 9 out of 10 first time mums will have some sort of trauma to the perineum. That could be a tiny graze which doesn’t need any stitches right up to 3/4th degree tears which are really rare. 1 in 100 will have a 3rd or 4th degree tear. Most common is the 2nd degrees tear which are little- damage to the skin and muscle. They heal really quickly but you will be sore for a few days.

It is important to wash your hands before you go to the loo as well as after when you’re post delivery. Your hands might not be clean so you need to wash your hands before you touch the wound and change your pad, which you should do regularly. Make sure the area stays really clean and dry, don’t put any lotions on it, you do not need to put anything on your tear as it can irritate them and you’ll be more prone to have an infection. Just use water when washing, no soaps. Have knicker off time too; air is good for the wound.

Make sure that you do your Pelvic floor exercises throughout pregnancy but also post birth as they are important if you’ve had a tear, they help to heal it, bringing lots of blood to the wound. If you have any discharge, or if the wound seems smelly, please tell your Midwife. Midwives should check it when they come and check up on your and baby.

Perineal massage can help prevent tears and it is good for first time mums. Start from 35 weeks and it can be useful to do after a warm bath when muscles are softer. Take your thumbs and out them inside your vagina and press down and stretch out. It should feel like you’re stretching things but not painful. Use a lubricant, such as a natural based oil, olive oil, almond oil for example and try and do it every day.

Ask your midwife for being hands on at birth to help reduce tearing. This is where the midwife will put their hand on the perineum when the baby is coming out. It helps you to have a controlled delivery. If the baby is delivered slowly you are less likely to tear.

Finally, have a warm compress on your perineum during birth. A sanitary pad with warm water on it helps draw blood to the area and then you’re less likely to have a tear.

by Suzi Smith  

Complications during labour are less frightening if you know why these complications are happening. It’s important to ask your doctor why these complications are happening and what all of your options are. Remember that the Doctors and Midwives must have your consent to do anything during labour.

Blog 1 moKee Birth School online: complications in labour
06 May 2020

moKee Birth School online: complications in labour

moKee Birth School online:
complications in labour

5 min read

by Suzi Smith  

 

Read the blog post or listen to the podcast on Spotify:

Sophie, The Infertile Midwife, explains complications during labour

Complications during labour are less frightening if you know why these complications are happening. It’s important to ask your doctor why these complications are happening and what all of your options are. Remember that the Doctors and Midwives must have your consent to do anything during labour.

Instrumental birth, or assisted birth is where you give birth vaginally but you have some help. One in eight women give birth like this, getting a bit of help with a Kiwi or with forceps which are used by a Doctor.

The Kiwi has replaced the ventouse. An assisted birth can only happen if you’re fully dilated and it’s good to know that if you’re not fully dilated the only option is to have a c section if your baby is in distress and needs delivering quickly. The reasons that you might have this is because your baby isn’t happy and needs to be delivered quickly, you might have been pushing for a long time, and for some women with medical reasons they can’t push. Your doctor should be explaining the reason why they are suggesting an assisted birth. It’s important to understand why you need forceps over a Kiwi. When a doctor is assessing the situation, they’ll be making a recommendation on what they’ve found from a vaginal examination. It’s usually to do with the position of the baby. They feel the bones on the baby’s head and figure out where the baby is.

It’s safer to use forceps if you’re baby is preterm - before 37 weeks of pregnancy. It’s important to know that having a caesarean section at fully dilated is not always considered the safest way to give birth. This is because when you are fully dilated, the baby is deep inside the birth canal. There are some manoeuvres that need to happen to dislodge the baby, if it is particularly deep.

In terms of the procedure, the doctor decides on the instrument to use and gets consent. If you don’t already have a catheter in place they’ll put it in, drain the bladder and take it out. It’s really important to have an empty bladder as it gets in the way of baby coming out and they’ll ensure that you have pain relief with either an epidural or a local anaesthetic. Midwives put your legs into the stirrups so when you’re having a contraction you still have to push and then the Doctor pulls at the same time. Usually just pulling three times until baby comes out.

The kiwi is made of plastic and the sponge goes onto the baby’s head on the back. The doctor will insert it into your vagina. They pump it up so the suction stays on the baby’s head. It’s a really small instrument but It can leave a suction mark on the baby’s head but it will go away super quickly. Because they’re soft they are more likely to fail than the forceps.

Forceps look like a big pair of spoons, a big pair of salad tongs. They go around your baby’s head and they are more effective than the Kiwi and they do go on the side of the baby’s head. They’re metal and will cause slight bruising but this will be gone in a couple of days. You are most at risk of bleeding after birth with an assisted birth so in order to prevent this, Midwives recommend active management in the third stage to deliver the placenta. After the baby has born and you’re about to deliver the placenta, we suggest having an injection into the leg to reduce risk of bleeding and to deliver the placenta.

You also have a risk of tearing so you might have an episiotomy. It is very rare to have a big tear- 4 in 100 women get a third or fourth degree tear with a kiwi, and only 8 to 12 in every 100 from a forceps. That is why you are offered an episiotomy to reduce big tearing.

Caesarean Section

C sections are a surgical procedure where the baby comes out via the lower abdomen. There are lots of reasons as to why you might have a c section. If the baby is breech - coming bottom first, then you may have a planned caesarean. If your placenta is covering the cervix the baby can’t come out naturally, so a c section has to happen. Multiple pregnancies, twins or triplets, are often delivered via c section. It might be safer for you to have a c section rather than a vaginal birth due to a medical condition.

Emergency c sections happen for a variety of reasons. If your baby isn’t very happy and you’re not fully dilated, if labour is very slow and lots of things have been tried, a c section will be offered.

A spinal is often used to numb you but if you’ve already got an epidural, they’ll give you a really big dose to make you feel numb. You’ll feel touch but no pain. You’ll have a catheter and you’ll be in an operating theatre on your back but tilted to the side. In the 3rd trimester don’t lie flat on your back because the weight of your baby sits on your big blood vessels, which will stops oxygen getting around your body as well we getting to your baby.

Midwives shave you before theatre, as they don’t want hair in the wound. You don’t need to shave or wax before but go ahead if you want to. From the time the Doctors start to the time the baby is born, it’s usually 5 minutes and then 30- 40 mins when they put you back together again. Most people are so distracted by their baby and they won’t realise the time. You will feel touch but no pain and when they are trying to deliver the baby you’ll feel like someone is doing the washing up in your tummy. You’ll feel people moving inside you. You feel a lot of pressure on your tummy just before the baby is being delivered. The midwife will check the baby once it’s delivered to ensure that it’s breathing and then they usually come straight to you for a cuddle. You can’t cut a cord but usually the Doctor’s leave it nice and long, so you can trim it down, and have that nice moment. You can do skin to skin in theatre, so just let the Midwife know that you want to. After they clean you up and you go to a recovery area and then you’ll go to the post natal ward. All of the usual post theatre care will happen; nurses will do your observations regularly.

Perineal Tears

The perineum is the bit between the vagina and anus. It is really common to sustain an injury during childbirth. 9 out of 10 first time mums will have some sort of trauma to the perineum. That could be a tiny graze which doesn’t need any stitches right up to 3/4th degree tears which are really rare. 1 in 100 will have a 3rd or 4th degree tear. Most common is the 2nd degrees tear which are little- damage to the skin and muscle. They heal really quickly but you will be sore for a few days.

It is important to wash your hands before you go to the loo as well as after when you’re post delivery. Your hands might not be clean so you need to wash your hands before you touch the wound and change your pad, which you should do regularly. Make sure the area stays really clean and dry, don’t put any lotions on it, you do not need to put anything on your tear as it can irritate them and you’ll be more prone to have an infection. Just use water when washing, no soaps. Have knicker off time too; air is good for the wound.

Make sure that you do your Pelvic floor exercises throughout pregnancy but also post birth as they are important if you’ve had a tear, they help to heal it, bringing lots of blood to the wound. If you have any discharge, or if the wound seems smelly, please tell your Midwife. Midwives should check it when they come and check up on your and baby.

Perineal massage can help prevent tears and it is good for first time mums. Start from 35 weeks and it can be useful to do after a warm bath when muscles are softer. Take your thumbs and out them inside your vagina and press down and stretch out. It should feel like you’re stretching things but not painful. Use a lubricant, such as a natural based oil, olive oil, almond oil for example and try and do it every day.

Ask your midwife for being hands on at birth to help reduce tearing. This is where the midwife will put their hand on the perineum when the baby is coming out. It helps you to have a controlled delivery. If the baby is delivered slowly you are less likely to tear.

Finally, have a warm compress on your perineum during birth. A sanitary pad with warm water on it helps draw blood to the area and then you’re less likely to have a tear.

by Suzi Smith  

Complications during labour are less frightening if you know why these complications are happening. It’s important to ask your doctor why these complications are happening and what all of your options are. Remember that the Doctors and Midwives must have your consent to do anything during labour.

0

moKee Birth School online:
caring for newborn

6 min read

by Suzi Smith  

Newborn babies are incredible little creatures, they come out perfectly. When you see their perfect little faces you’ll be blown away. Here are some tips from Marie Louise, known as The Modern Midwife, to help you care for your newborn.

When babies are born it’s a whole new world for them, they’ve never heard clear voices, seen bright lights, breathed before and now they have been born into a whole new environment. It’s also 15 degrees cooler. Physiologically, their bodies are also having to adapt to the new environment. For example, in pregnancy the fetal circulatory system is the opposite to us; Oxygenated blood is carried in their veins and deoxygenated blood is carried in their arteries. They need to switch over their circulatory system and learn to breathe on their own as soon as they’re born. It’s really beneficial to be aware of all of this as babies are sometimes labelled needy or you’re asked ‘if you’ve got a good baby’. All newborn babies cry and don’t really sleep in the first few weeks as they are just adjusting to being a human.

First of all to understand what you newborn baby needs to go through and to help you cut out the judgement of being a parent; babies crying and not sleeping is no reflection on you, it’s what they’re meant to do.

The second thing is that the 4th trimester is an extension of your body. They are 100% reliant on their parents in the first three months so your newborn baby is totally reliant on your body after birth. Your baby needs to be close to you. Babies gain comfort from being close to their parents. There are three main ways to calm down your baby.

Skin to skin is loved by babies; it relaxes their muscles, their breath deepens, it’s a physical communication between the two bodies. When the baby is happy, relaxed and feels safe, it is then able to go into a state of thriving rather than surviving. Babies’ need this to be able to grow and this takes energy. Oxytocin is expressed when babies are happy and calm and it helps to grow their brain and develop their body.

Warmth - when a baby is close to you, you’re keeping them warm. Get your birth partner to have skin to skin or have it with them later if you’re unable to, even six hours later or six days, being close will help your baby. Warm babies feed better, as they can spend their energy on growth rather than staying warm. Cold babies have to regulate their blood sugar levels to stay warm, so if they’re already warm, their bodies can concentrate on growing.

Sound is great for newborns. The sound of mum’s blood when in the womb is loud for a baby, rushing round your body. So, babies actually don’t like silence, they actually prefer a little bit of noise. Whooshing noises are preferred as that is what they were used to. It’s quite disturbing to put your baby in a silent room as it’s not what they’re used to. Give your baby some white background noise. Babies can also hear from inside the womb and it’s been proven that they can remember specific songs and voices. Make your baby a playlist and play it to them whilst pregnant. Then when they’re born, when they’re a little unsettled, it will remind them of a comforting time. You can also go into a place in your house where you feel relaxed, put some candles and incense on and then put on the playlist and spend that time really focusing on how you feel about your baby, thinking about meeting your baby. Your oxytocin levels will rise when you’re thinking about it. When your baby is born, they may remember that moment receiving oxytocin and lovely feelings when listening to this playlist.

Babies have never seen a face before when born, yet newborn babies are instinctively drawn to faces. A baby will spend longer looking at a face than it will spend looking at anything else. They have an innate response to want to focus on a face. They will start to recognise the people they’re around mostly within three weeks of life. Get quite close to your baby, their eyesight is not great but they’ll be able to see you. Talk to your baby and get really close to your baby regularly. Try not to have too many visitors too soon around your newborn baby. This is because they need to get familiar with you and your partner. During lockdown mums are sad that their family and friends can’t come and see their baby, but this could be viewed as a positive thing as it means that this time is so precious and beneficial for just parents and baby.

Interaction and language with newborns is vital to help them develop. Newborns are absorbing everything and some scientists describes this as a time that is unforgettable yet unmemorable. A lot of this time is shaping the brain. A high level of interaction includes talking and responding to your baby when they cry, they get used to the different words, such as nappy, sleep. This starts to build on their understanding of the words and their world. Language is one of the best ways that human interact, we express ourselves through language. Babies that heard more words in a day, remember and recall more. It’s also proven that their vocab was better when they were at schooling age.

From a clinical perspective, how do I know if my baby is well. There are few things to assess them to see if they are well. If at any point you have any concerns over your baby’s behaviour, speak to your health care provider immediately.

Midwives assess babies by firstly looking at their colour. The colour tells how well perfused they are. How well blood is going round the body. Sometimes they look yellow but this can be normal when born have a really high blood count so their body has to take time breaking this down which can turn them a bit yellow.

If the whites of their eyes are yellow, they are sleeping a lot and through feed, not interested in feeding, aren’t weeing and pooing, speak to your midwife urgently.

We also touch babies to see how warm they are. We touch the back of their neck and their stomach to see how warm they feel. Room temperature for a baby should be between 16-20 degrees. Measure the room temperature as warm babies grow and feed better.

How a baby goes to the toilet is another way to assess your baby. Are they having a wee regularly, how is their poo? At first your baby will pass something called meconium, it’s black sticky and difficult to get off – a but like marmite! Don’t worry that’s normal

Poo will start to change after a few days. If you don’t notice any change in your baby’s poo, speak to your Midwife. Baby should be weeing but generally the nappy is heaver with the wee and a slight change of colour. It’s a great way to assess how well they are.

The cord. In your tummy the baby’s cord is delivering stem cells and Oxygen rick blood and nutrients to them throughout pregnancy. When they are born we cut and clamp the cord and the cord is still attached to your baby. It looks strange after birth, it’s a bit floppy and it’s white in colour. After a couple of days it starts to dry up and it will look brown and shrivelled. If it is not smelly then you don’t need to do anything with it. Leave it alone and it will fall off between 7-10 days after birth. Make sure that you leave it outside of the nappy, so it doesn’t get wet and cause an infection.

Another way to assess your baby is to see if they are alert. Are they alert for their feeds, they should be looking around when awake and moving their body. They do sleep a lot but they shouldn’t be floppy or lethargic when awake. They should be responsive and have good muscle tone. Please phone an ambulance if you have a floppy baby immediately.

Second night syndrome is when the baby is very unsettled on night two of being born. There are two explanations for this. The first is that baby is quite tired from the birth and then the baby sleeps really well on the first night and then on the second night they realise that life as they know is over and they cry for a lot of the night. The second explanation is that babies will wake very frequently to encourage mum’s milk supply to come through. It’s an innate behaviour. Do not worry! It is not a reflection of you or your parenting, it is usually normal newborn behaviour, especially if you have chosen to breastfeed. At some point in the first week, most parents will have a very disturbed sleep and this is completely normal.

Do not leave a newborn baby to cry. Controlled crying techniques are not advised for newborn babies, it’s is up to your how you parent and what you do later on but in those early newborn days I would avoid any kind of sleep training or ignoring crying. Newborn babies are crying for a reason. You won’t be making a rod for your own back by cuddling your baby when they cry, despite what some people might say.

And finally, don’t forget to care for yourself, that is about caring for your newborn too. You are so important to your baby, so take care of yourself. Take time out to look after yourself and especially your mental health. Be honest with yourself about how you’re feeling and talk to people around you who will be able to help.

by Suzi Smith

Newborn babies are incredible little creatures, they come out perfectly. When you see their perfect little faces you’ll be blown away. Here are some tips from Marie Louise, known as The Modern Midwife, to help you care for your newborn.

Blog 1 moKee Birth School online: caring for newborn
04 May 2020

moKee Birth School online: caring for newborn

moKee Birth School online:
caring for newborn

6 min read

by Suzi Smith  

Newborn babies are incredible little creatures, they come out perfectly. When you see their perfect little faces you’ll be blown away. Here are some tips from Marie Louise, known as The Modern Midwife, to help you care for your newborn.

When babies are born it’s a whole new world for them, they’ve never heard clear voices, seen bright lights, breathed before and now they have been born into a whole new environment. It’s also 15 degrees cooler. Physiologically, their bodies are also having to adapt to the new environment. For example, in pregnancy the fetal circulatory system is the opposite to us; Oxygenated blood is carried in their veins and deoxygenated blood is carried in their arteries. They need to switch over their circulatory system and learn to breathe on their own as soon as they’re born. It’s really beneficial to be aware of all of this as babies are sometimes labelled needy or you’re asked ‘if you’ve got a good baby’. All newborn babies cry and don’t really sleep in the first few weeks as they are just adjusting to being a human.

First of all to understand what you newborn baby needs to go through and to help you cut out the judgement of being a parent; babies crying and not sleeping is no reflection on you, it’s what they’re meant to do.

The second thing is that the 4th trimester is an extension of your body. They are 100% reliant on their parents in the first three months so your newborn baby is totally reliant on your body after birth. Your baby needs to be close to you. Babies gain comfort from being close to their parents. There are three main ways to calm down your baby.

Skin to skin is loved by babies; it relaxes their muscles, their breath deepens, it’s a physical communication between the two bodies. When the baby is happy, relaxed and feels safe, it is then able to go into a state of thriving rather than surviving. Babies’ need this to be able to grow and this takes energy. Oxytocin is expressed when babies are happy and calm and it helps to grow their brain and develop their body.

Warmth - when a baby is close to you, you’re keeping them warm. Get your birth partner to have skin to skin or have it with them later if you’re unable to, even six hours later or six days, being close will help your baby. Warm babies feed better, as they can spend their energy on growth rather than staying warm. Cold babies have to regulate their blood sugar levels to stay warm, so if they’re already warm, their bodies can concentrate on growing.

Sound is great for newborns. The sound of mum’s blood when in the womb is loud for a baby, rushing round your body. So, babies actually don’t like silence, they actually prefer a little bit of noise. Whooshing noises are preferred as that is what they were used to. It’s quite disturbing to put your baby in a silent room as it’s not what they’re used to. Give your baby some white background noise. Babies can also hear from inside the womb and it’s been proven that they can remember specific songs and voices. Make your baby a playlist and play it to them whilst pregnant. Then when they’re born, when they’re a little unsettled, it will remind them of a comforting time. You can also go into a place in your house where you feel relaxed, put some candles and incense on and then put on the playlist and spend that time really focusing on how you feel about your baby, thinking about meeting your baby. Your oxytocin levels will rise when you’re thinking about it. When your baby is born, they may remember that moment receiving oxytocin and lovely feelings when listening to this playlist.

Babies have never seen a face before when born, yet newborn babies are instinctively drawn to faces. A baby will spend longer looking at a face than it will spend looking at anything else. They have an innate response to want to focus on a face. They will start to recognise the people they’re around mostly within three weeks of life. Get quite close to your baby, their eyesight is not great but they’ll be able to see you. Talk to your baby and get really close to your baby regularly. Try not to have too many visitors too soon around your newborn baby. This is because they need to get familiar with you and your partner. During lockdown mums are sad that their family and friends can’t come and see their baby, but this could be viewed as a positive thing as it means that this time is so precious and beneficial for just parents and baby.

Interaction and language with newborns is vital to help them develop. Newborns are absorbing everything and some scientists describes this as a time that is unforgettable yet unmemorable. A lot of this time is shaping the brain. A high level of interaction includes talking and responding to your baby when they cry, they get used to the different words, such as nappy, sleep. This starts to build on their understanding of the words and their world. Language is one of the best ways that human interact, we express ourselves through language. Babies that heard more words in a day, remember and recall more. It’s also proven that their vocab was better when they were at schooling age.

From a clinical perspective, how do I know if my baby is well. There are few things to assess them to see if they are well. If at any point you have any concerns over your baby’s behaviour, speak to your health care provider immediately.

Midwives assess babies by firstly looking at their colour. The colour tells how well perfused they are. How well blood is going round the body. Sometimes they look yellow but this can be normal when born have a really high blood count so their body has to take time breaking this down which can turn them a bit yellow.

If the whites of their eyes are yellow, they are sleeping a lot and through feed, not interested in feeding, aren’t weeing and pooing, speak to your midwife urgently.

We also touch babies to see how warm they are. We touch the back of their neck and their stomach to see how warm they feel. Room temperature for a baby should be between 16-20 degrees. Measure the room temperature as warm babies grow and feed better.

How a baby goes to the toilet is another way to assess your baby. Are they having a wee regularly, how is their poo? At first your baby will pass something called meconium, it’s black sticky and difficult to get off – a but like marmite! Don’t worry that’s normal

Poo will start to change after a few days. If you don’t notice any change in your baby’s poo, speak to your Midwife. Baby should be weeing but generally the nappy is heaver with the wee and a slight change of colour. It’s a great way to assess how well they are.

The cord. In your tummy the baby’s cord is delivering stem cells and Oxygen rick blood and nutrients to them throughout pregnancy. When they are born we cut and clamp the cord and the cord is still attached to your baby. It looks strange after birth, it’s a bit floppy and it’s white in colour. After a couple of days it starts to dry up and it will look brown and shrivelled. If it is not smelly then you don’t need to do anything with it. Leave it alone and it will fall off between 7-10 days after birth. Make sure that you leave it outside of the nappy, so it doesn’t get wet and cause an infection.

Another way to assess your baby is to see if they are alert. Are they alert for their feeds, they should be looking around when awake and moving their body. They do sleep a lot but they shouldn’t be floppy or lethargic when awake. They should be responsive and have good muscle tone. Please phone an ambulance if you have a floppy baby immediately.

Second night syndrome is when the baby is very unsettled on night two of being born. There are two explanations for this. The first is that baby is quite tired from the birth and then the baby sleeps really well on the first night and then on the second night they realise that life as they know is over and they cry for a lot of the night. The second explanation is that babies will wake very frequently to encourage mum’s milk supply to come through. It’s an innate behaviour. Do not worry! It is not a reflection of you or your parenting, it is usually normal newborn behaviour, especially if you have chosen to breastfeed. At some point in the first week, most parents will have a very disturbed sleep and this is completely normal.

Do not leave a newborn baby to cry. Controlled crying techniques are not advised for newborn babies, it’s is up to your how you parent and what you do later on but in those early newborn days I would avoid any kind of sleep training or ignoring crying. Newborn babies are crying for a reason. You won’t be making a rod for your own back by cuddling your baby when they cry, despite what some people might say.

And finally, don’t forget to care for yourself, that is about caring for your newborn too. You are so important to your baby, so take care of yourself. Take time out to look after yourself and especially your mental health. Be honest with yourself about how you’re feeling and talk to people around you who will be able to help.

by Suzi Smith

Newborn babies are incredible little creatures, they come out perfectly. When you see their perfect little faces you’ll be blown away. Here are some tips from Marie Louise, known as The Modern Midwife, to help you care for your newborn.

0

moKee Birth School online:
pain relief

6 min read

by Suzi Smith

 

Read the blog post or listen to the podcast on Spotify:

The 4th session of moKee Birth School online is behind us! Sophie, The Infertile Midwife, shared her tips to helping with pain relief during childbirth.

Self help methods

Breathing exercises are a good way to manage pain but they aren’t going to take the pain away, they are all about pain management. Breathing exercises are really helpful during labour as it’s important to breathe when you’re having contractions. Your uterus squeezes down and momentarily the blood flow to the placenta is reduced. But if you’re holding your breath, there’s even less oxygen so it’s really important to breathe.

There are lots of places to learn about relaxation breathing but it’s all about breathing in through your nose for as long as you can and then out of your mouth making the breathes long and slow. This can be a great way to get through each contraction.

Hypnobirthing is not going to take the pain away but it helps to focus the energy to get through each surge. There are a lot of breathing exercises involved. It’s quite similar to mindfulness and it’s something you have to prep and practice. You have to do this towards the end of pregnancy, the more you prepare the greater rewards you reap during labour. There’s not a huge amount of studies into hypnobirthing- there are no harmful effects to you or your baby but we don’t know how well it helps with pain relief. It can really help manage adrenaline and cortisol which are stress hormones. It’s natural to have these hormones during labour but midwives don’t want it getting in the way of oxytocin, which is the happiness hormone. That’s why hypnobirthing helps- oxytocin goes up and cortisol goes down. If things deviate away from your birth plan, this can really help you ground you and calm everything down. You can attend classes which are currently online, but you can pick up a book or look online for recordings to download.

Massage is something your partner can do in labour. Some people find that the pressure is nice during the contractions but dome people don’t like to be touched. Put pressure on the lower back during the contractions, feet and shoulder rubbing all helps. Get your partner to practice a shoulder massage/foot massage ahead of labour.

Pain relief- birthing pool

These are really popular but there haven’t been a huge number of studies into birthing pool use to manage pain. The studies that have been done show that if you use a pool you’re less likely to use an epidural and you’ll usually find labour less painful. The pool needs to be between 37.5 degrees and 36.5 degrees. You want it to be around body temperature so you’re not overheating- baby needs to avoid coming out into hot or cold water. The midwife will be checking the temperature throughout. Have a thermometer to check if at home. Midwives can still listen to baby’s hearts in the pool and a wireless CTG monitor can also be used in the pool. For some hospitals it’s policy to protect the perineum as the baby is born, so that baby comes out nice and slowly. This can’t happen if you give birth in the pool, so some choose to get out of the pool to give birth. The good thing about using a pool is that it allows you to use gas and air whilst you’re in there.

Tense machine

It’s stands for Transcutaneous Electrical Nerve Stimulation It is a really good idea to use this in the early or latent stages of labour. Before you’re in active labour and at home, get it going. You can buy or rent the machine and it’s a handheld device with wires and sticky patches which go on your back. It sends a small impulse down the wires and it tingles on your body. That impulse goes down your nerves quicker than the pain does, so it blocks the pain signal getting to your brain. There are lots of different settings- start on the lowest stage. Press the boost button when you feel the contraction happening and turn off when the contraction is finished. You can’t use it when you’re in the pool or bath remember though.

Entonox is also called gas and air. It’s a mix of 50% nitrous oxide and 50% oxygen. You simply inhale the gas and air and it can be used in all birth settings, including home births. Only use this when you have a contraction. When it starts to build, breathe it in and then stop using when it’s over. This works immediately and it wares off when you stop breathing it in. It can make you feel a little bit sick and it can give you a dry mouth so in between have sips of water and pack a lip balm. There are no effects on the baby so this is a really safe option.

Paracetamol- use this in the early and later stages of labour, especially whist you’re at home. It’s the first choice of pain relief for women as we know it’s safe for baby and mum. Do not take if you have any allergies. Just take two tablets (1g) every 4-6 hours but no more than 4 times in 24 hours.

Codeine

This is a really mild opioid so it does have similar side effects to other opioids. It’s much milder though and it’s taken orally. You can take it on its own or have a tablet mixed with paracetamol. This is good to take at the early stage of labour.

Opioids

These are great pain relief options and it’s commonly called pethidene or diamorphine. They are both very similar and are usually given as an injection into your bottom or thigh and can be available at home births. It’s best given at the early stages of labour and this is because they cross the placenta and can make baby a bit drowsy. So, to avoid this the midwife assess how likely it is that you’ll give birth shortly. They work by making you feel really relaxed. Some people can even sleep during contractions. Side effects are drowsiness, nausea and vomiting. Midwifes often give an anti sickness medication too. Midwives will not allow you to get into the pool within two hours of taking the medication.

Pcpa- patient controlled xxxxx

So a PCA is a pump that is attached to a drip in your vein. You have a button to press every time you want pain relief. Usually it’s a drug called remifentanil. It’s not very common to use in labour and is often used if the women is unable to have an epidural. It is an opioid so similar side effects include sickness and feeling sleepy. It can make the baby a bit sleepy after birth so you need to be assessed before being given it.

Epidural

Epidurals are only available in obstetric unit. If you do want one you have to be transferred to the unit. This is because they are more complicated than other pain reliefs and need to be administrated by an anaesthetist. You have more checks ups and you’ll need a cannula in your arm to give you fluid, so it helps to keep your blood pressure stable. To site an epidural, your anaesthetist asks you to curl up like a prawn, to push your spine out. They give you a local anaesthetic to numb your back too. Once you’re in position they pop a needle into you back and put a thin tube through the needle. They then take the needle away and the tube stays in your back. This tube allows the drugs to be administered. The anaesthetist gives you an initial does and within 30 mins you should be comfortable. You can then top up your medication if you feel uncomfortable. It has a lock out so you can’t overdose. Your legs get quite heavy. It doesn’t make first stage of labour longer but it can make the second stage of labour longer. If you do have an epidural it doesn’t increase your changes of having a c section but it does increase forceps.

You should try to be as mobile as possible. It depends how heavy your block is; some people will be able to walk, some won’t. If you can’t move about ask for a peanut ball which will help you keep your legs open. You’ll need to have a catheter if you aren’t mobile, so that you can empty your bladder and baby can descend into your pelvis.

When it’s fully functioning you’ll be able to feel touch but not pain. You’ll be aware of a contraction but you won’t feel pain. If you do end up needing a c section your anaesthetist will you a huge dose to make sure that you’re numb. Side effects are not common but so that you’re fully informed:

  • You might be itchy whilst having it, feeling shivery
  • It can give you a fever during labour
  • One in 100 will get a severe headache after the epidural but it can be treated
  • There could be a drop in blood pressure- one in 50
  • Sometimes it doesn’t work first time so it might have to be done again- it is fairly common, 1-10/20 cases.
  • Nerve damage- one out of 10000/20000 will get temporary never damage. One in 240000 will have permanent damage
  • Meningitis- this is really rare and 1 in 100,000 women could get it

A spinal is similar but there are a few differences. A spinal is a one off injection, there is no tube that stays in your back. If you’re having a c section this is the pain relief that you usually have. You will be numb from the bottom of your breasts downwards. It’s a heavy block and they work really quickly. You won’t be able to move your legs but you might feel touch.

Lastly a general anaesthetic. Not common when in labour but this might happen if none of the other pain relief options are appropriate or if a c section needs to be done really urgently. Your partner is not allowed into theatre with you and your baby can come out sleepy. You’ll feel tied and sick when you wake up and you’ll need further pain relief. Rare side effects include breathing tubes damaging your wind pipes. There is a fairly common risk of mild affections, around 1 in 100. One risk is acid going from your stomach into your lungs and that is a 1 in 1000 chance. Doctors will give you an anti acid to stop this happening. There is also a very slight chance of brain damage- 1 or two people a year in the UK.

by Suzi Smith  

Learn more about pain relief during childbirth and get to know the advices from Sophie Martin, the experienced midwife. Find out how breathing, massage, birthing pool or the tense machine might help you during the labour.

Blog 1 moKee Birth School online: pain relief
30 Apr 2020

moKee Birth School online: pain relief

moKee Birth School online:
pain relief

6 min read

by Suzi Smith

 

Read the blog post or listen to the podcast on Spotify:

The 4th session of moKee Birth School online is behind us! Sophie, The Infertile Midwife, shared her tips to helping with pain relief during childbirth.

Self help methods

Breathing exercises are a good way to manage pain but they aren’t going to take the pain away, they are all about pain management. Breathing exercises are really helpful during labour as it’s important to breathe when you’re having contractions. Your uterus squeezes down and momentarily the blood flow to the placenta is reduced. But if you’re holding your breath, there’s even less oxygen so it’s really important to breathe.

There are lots of places to learn about relaxation breathing but it’s all about breathing in through your nose for as long as you can and then out of your mouth making the breathes long and slow. This can be a great way to get through each contraction.

Hypnobirthing is not going to take the pain away but it helps to focus the energy to get through each surge. There are a lot of breathing exercises involved. It’s quite similar to mindfulness and it’s something you have to prep and practice. You have to do this towards the end of pregnancy, the more you prepare the greater rewards you reap during labour. There’s not a huge amount of studies into hypnobirthing- there are no harmful effects to you or your baby but we don’t know how well it helps with pain relief. It can really help manage adrenaline and cortisol which are stress hormones. It’s natural to have these hormones during labour but midwives don’t want it getting in the way of oxytocin, which is the happiness hormone. That’s why hypnobirthing helps- oxytocin goes up and cortisol goes down. If things deviate away from your birth plan, this can really help you ground you and calm everything down. You can attend classes which are currently online, but you can pick up a book or look online for recordings to download.

Massage is something your partner can do in labour. Some people find that the pressure is nice during the contractions but dome people don’t like to be touched. Put pressure on the lower back during the contractions, feet and shoulder rubbing all helps. Get your partner to practice a shoulder massage/foot massage ahead of labour.

Pain relief- birthing pool

These are really popular but there haven’t been a huge number of studies into birthing pool use to manage pain. The studies that have been done show that if you use a pool you’re less likely to use an epidural and you’ll usually find labour less painful. The pool needs to be between 37.5 degrees and 36.5 degrees. You want it to be around body temperature so you’re not overheating- baby needs to avoid coming out into hot or cold water. The midwife will be checking the temperature throughout. Have a thermometer to check if at home. Midwives can still listen to baby’s hearts in the pool and a wireless CTG monitor can also be used in the pool. For some hospitals it’s policy to protect the perineum as the baby is born, so that baby comes out nice and slowly. This can’t happen if you give birth in the pool, so some choose to get out of the pool to give birth. The good thing about using a pool is that it allows you to use gas and air whilst you’re in there.

Tense machine

It’s stands for Transcutaneous Electrical Nerve Stimulation It is a really good idea to use this in the early or latent stages of labour. Before you’re in active labour and at home, get it going. You can buy or rent the machine and it’s a handheld device with wires and sticky patches which go on your back. It sends a small impulse down the wires and it tingles on your body. That impulse goes down your nerves quicker than the pain does, so it blocks the pain signal getting to your brain. There are lots of different settings- start on the lowest stage. Press the boost button when you feel the contraction happening and turn off when the contraction is finished. You can’t use it when you’re in the pool or bath remember though.

Entonox is also called gas and air. It’s a mix of 50% nitrous oxide and 50% oxygen. You simply inhale the gas and air and it can be used in all birth settings, including home births. Only use this when you have a contraction. When it starts to build, breathe it in and then stop using when it’s over. This works immediately and it wares off when you stop breathing it in. It can make you feel a little bit sick and it can give you a dry mouth so in between have sips of water and pack a lip balm. There are no effects on the baby so this is a really safe option.

Paracetamol- use this in the early and later stages of labour, especially whist you’re at home. It’s the first choice of pain relief for women as we know it’s safe for baby and mum. Do not take if you have any allergies. Just take two tablets (1g) every 4-6 hours but no more than 4 times in 24 hours.

Codeine

This is a really mild opioid so it does have similar side effects to other opioids. It’s much milder though and it’s taken orally. You can take it on its own or have a tablet mixed with paracetamol. This is good to take at the early stage of labour.

Opioids

These are great pain relief options and it’s commonly called pethidene or diamorphine. They are both very similar and are usually given as an injection into your bottom or thigh and can be available at home births. It’s best given at the early stages of labour and this is because they cross the placenta and can make baby a bit drowsy. So, to avoid this the midwife assess how likely it is that you’ll give birth shortly. They work by making you feel really relaxed. Some people can even sleep during contractions. Side effects are drowsiness, nausea and vomiting. Midwifes often give an anti sickness medication too. Midwives will not allow you to get into the pool within two hours of taking the medication.

Pcpa- patient controlled xxxxx

So a PCA is a pump that is attached to a drip in your vein. You have a button to press every time you want pain relief. Usually it’s a drug called remifentanil. It’s not very common to use in labour and is often used if the women is unable to have an epidural. It is an opioid so similar side effects include sickness and feeling sleepy. It can make the baby a bit sleepy after birth so you need to be assessed before being given it.

Epidural

Epidurals are only available in obstetric unit. If you do want one you have to be transferred to the unit. This is because they are more complicated than other pain reliefs and need to be administrated by an anaesthetist. You have more checks ups and you’ll need a cannula in your arm to give you fluid, so it helps to keep your blood pressure stable. To site an epidural, your anaesthetist asks you to curl up like a prawn, to push your spine out. They give you a local anaesthetic to numb your back too. Once you’re in position they pop a needle into you back and put a thin tube through the needle. They then take the needle away and the tube stays in your back. This tube allows the drugs to be administered. The anaesthetist gives you an initial does and within 30 mins you should be comfortable. You can then top up your medication if you feel uncomfortable. It has a lock out so you can’t overdose. Your legs get quite heavy. It doesn’t make first stage of labour longer but it can make the second stage of labour longer. If you do have an epidural it doesn’t increase your changes of having a c section but it does increase forceps.

You should try to be as mobile as possible. It depends how heavy your block is; some people will be able to walk, some won’t. If you can’t move about ask for a peanut ball which will help you keep your legs open. You’ll need to have a catheter if you aren’t mobile, so that you can empty your bladder and baby can descend into your pelvis.

When it’s fully functioning you’ll be able to feel touch but not pain. You’ll be aware of a contraction but you won’t feel pain. If you do end up needing a c section your anaesthetist will you a huge dose to make sure that you’re numb. Side effects are not common but so that you’re fully informed:

  • You might be itchy whilst having it, feeling shivery
  • It can give you a fever during labour
  • One in 100 will get a severe headache after the epidural but it can be treated
  • There could be a drop in blood pressure- one in 50
  • Sometimes it doesn’t work first time so it might have to be done again- it is fairly common, 1-10/20 cases.
  • Nerve damage- one out of 10000/20000 will get temporary never damage. One in 240000 will have permanent damage
  • Meningitis- this is really rare and 1 in 100,000 women could get it

A spinal is similar but there are a few differences. A spinal is a one off injection, there is no tube that stays in your back. If you’re having a c section this is the pain relief that you usually have. You will be numb from the bottom of your breasts downwards. It’s a heavy block and they work really quickly. You won’t be able to move your legs but you might feel touch.

Lastly a general anaesthetic. Not common when in labour but this might happen if none of the other pain relief options are appropriate or if a c section needs to be done really urgently. Your partner is not allowed into theatre with you and your baby can come out sleepy. You’ll feel tied and sick when you wake up and you’ll need further pain relief. Rare side effects include breathing tubes damaging your wind pipes. There is a fairly common risk of mild affections, around 1 in 100. One risk is acid going from your stomach into your lungs and that is a 1 in 1000 chance. Doctors will give you an anti acid to stop this happening. There is also a very slight chance of brain damage- 1 or two people a year in the UK.

by Suzi Smith  

Learn more about pain relief during childbirth and get to know the advices from Sophie Martin, the experienced midwife. Find out how breathing, massage, birthing pool or the tense machine might help you during the labour.

0