Posts Tagged ‘brain development’

I don’t want to breastfeed
bottlefeeding your baby
I don’t want to breastfeed - can you tell me what to do?
If you do not want to breastfeed, you can either bottlefeed your baby expressed breast milk or formula milk. There are many women who do not breastfeed because they receive a lack of support and find that the advice available is insufficient. However, having a go at breastfeeding, even if this is just for one week, will benefit your baby.
If you have chosen to bottlefeed you will need to decide on a few things. First, you need to work out which type of formula you want to use. Take some time to look at the many brands on the market and opt for one that you feel will be right for your baby Ask your midwife or health visitor for advice if you are not sure You will also need to purchase bottles, teats, and a sterilizing unit. This can be confusing as there are lots to choose from, so you will need to take some time to find out about the available options and which unit will work best for you (see p.239)
Bottlefeeding sounds so complicated. Are there “dos” and “don’ts” to remember?
Yes, it is important to bottlefeed safely. The NHS provides guidelines for safe bottlefeeding
* Always make sure you use a sterilized bottle. cap, and teat for each feed
* Ideally, make up one feed at a time and discard any leftover milk at the end of a feed.
* Use boiled tepid water that has been left to cool for up to half an hour before making up a feed.
Put the water into the bottle before the formula.
Don’t pack the formula into the scoop: instead, level it off gently with a knife.
* Warm the feed — not in a microwave, but in a bowl of hot water — and test the temperature before giving it to your baby
* Avoid swapping scoops from different makes of infant formula milk as different scoops may be different measurements.
I feel guilty for not breastfeeding - should I?
No! The main thing is to ensure that your baby receives the best possible care in life that you are able to provide. If it is not possible for you to breastfeed, then formal milk feeds are a safe option. However, you need to feel comfortable with your decision and not be swayed by others. You may want to look at the advantages and disadvantages of both breast- and bottlefeeding. That way you’ll be sure you’ve made the right decision for you and your baby without feeling guilty Once you have made an informed decision, communicate this confidently to family, friends, and your healthcare provider.
Is formula milk as good as breast milk?
Breast milk is universally considered the ideal nutrition for your baby, and the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life as it provides all the nutrients a baby needs However,

Bottles and teats
Getting ready to bottlefeed your baby
There area variety of bottles and teats available in different styles.
You will need between four and six bottles and teats As well as larger bottles measuring 250ml (8fl oz), you may also want a couple of smaller bottles of 125 ml (4fl oz). Teats come with different sized holes to make the flow of milk faster or slower to suit your baby’s needs. Some teats are therefore recommended for newborns and some for hungrier older babies,
there area variety of high-quality, nutritional baby formula milks available that scientists and medical experts have spent years developing. Most infant formula milks are derived from cow’s milk, but are modified to resemble breast milk as closely as possible. If you feel confused, discuss the different brands with your midwife or health visitor.
What exactly is in formula milk and how similar is this to breast milk?
If you read the labels on different brands of formula, there are not many variances. The Infant and Dietetic Association website (see p 310) provides a table comparing the contents of the five main brands
available in the UK. Baby milk must provide energy, fat, protein, carbohydrate, vitamins, minerals, and trace elements, and the quantity of each nutrient is specified by law. The proportions of energy supplied by protein, fat, and carbohydrate in infant formulas are similar to those in mature breast milk
* The fat content. In infant formulas this is based on blends of dairy or vegetable fats that are chosen partly depending on their levels of unsaturated fat. Omega 3 fats may be added as these are vital nutrients for growing brains and bodies Formula milk does not have the fat-digesting enzyme, lipase, which accounts for the unpleasant-smelling stools of formula-fed babies.
* The protein source. In formula milk, this is either cow’s milk, in the form of casein or whey, or soya (see p,240) The amino acid content of formula is equivalent to that of breast milk to meet the needs of the rapidly growing baby.
* Lactose. This may be included in formula; mature breast milk contains about 7 per cent carbohydrate in the form of lactose, which is thought to be important for brain development.
* Vitamins, minerals, and trace elements. These are added to formulas to meet the nutritional needs of the baby and to comply with legal requirements. * Iron. This is vital to your baby’s wellbeing, being essential for healthy blood, growth, and development, and this is added to formula brands.
* Other components. Infant formula may contain other components that are found naturally in breast milk, such as long-chain polyunsaturated fatty acids (for brain and membrane development), oligosaccharides (to aid digestion and immunity), or nucleotides (to promote healthy growth and development and to help the immune system).
There are some components of breast milk that cannot be replicated in formulas For example, breast milk contains important antibodies that help protect babies against infection and illness and these are not present in formula milk. However, prebiotics, which are nutrients found in breast milk that strengthen a baby’s natural immune system, may be added to some brands of formula

How to bottlefeed
Preparing and giving feeds
Bottlefeeding, using formula or expressed breast milk, can seem daunting at first, but becomes easier once you get into a routine.
How do I start?You will need at least 4-6 bottles and teats, with at least one or two sterilized and ready. You can sterilize by steaming, microwaving, boiling, or using a sterilizing liquid. Your choice will depend on the cost and what you find easiest. Before sterilizing, rinse a bottle first with warm soapy water using a bottle brush, taking care to clean the top of the bottle and inside the teat.
How do I make up a feed? Wash your hands and make up a feed according to the instructions. Put the correct amount of tepid boiled tap water
into the sterilized bottle first and then add the right number of level scoops of powder, Never add extra powder as this could make your baby ill. Don’t put a half finished feed back in the fridge - throw it away and use a fresh bottle next time
How do I give the feed? Test that the milk is not too hot by putting some on the inside of your wrist (never use a microwave to warm up milk) Find a comfortable position and always hold your baby’s head slightly higher than his body. Put the teat gently into his mouth and slowly tip the bottle so that only milk, not air, gets into the teat You can wind your baby - gently pat or rub your baby’s back - halfway through the feed, or wait until the end. Throw away any milk that is left over.

KEEPING BOTTLES CLEAN:

Sterilizing equipment
Before using new bottles and teats, and each time you use them, wash and sterilize them. Wash them in warm, soapy water with a bottle brush, and rinse thoroughly. Sterilizing methods include: * Electric steam sterilizing, which takes about 10 minutes, plus the time it takes for equipment to cool
* Microwave steamers, which take around 5 minutes. The equipment remains sterile for up to 3 hours if the lid is left on. * Equipment can be sterilized by boiling, which takes around 10 minutes. The pan must not be used for another purpose and you may find that teats wear out more quickly
* Cold water sterilizing tablets can be used either in a special sterilizer, or in a suitable clean container with a lid. This takes around 30 minutes and the equipment can be left in the solution for up to 24 hours; the solution needs to be changed each day. * Dishwashers need to be set on a high temperature and some parents prefer to wait until after a year before using these.
Is it OK to combine breast-and bottlefeeding?
Yes, it is possible to combine breastfeeding with bottles of expressed breast milk or formula, and many women choose to do this rather than stop breastfeeding altogether.You may also decide to do this if you are returning to work.
Feeding from a bottle uses a different technique to feeding from the breast, and your baby may take a little time to get used to it, which can make it quite a struggle to introduce bottles It may help to warm the teat and to get someone else to offer the bottle the first time, as your baby may be able to smell your milk if you hold him and will be likely to want to be breastfed instead Holding him in a different position, such as propped up against your front and facing away from you, may also help
Before deciding to introduce the bottle, it’s worth considering that breastfeeding does get easier and that there is a lot of extra work involved with bottlefeeding in terms of preparing feeds. Also, as your breast milk is produced on a supply and demand basis, introducing bottles for some feeds
will affect your milk production. If you do want to combine the two, talk to your health visitor or a breastfeeding counsellor about how to manage this so that you can maintain breastfeeding
Will people treat me like a failure if I can’t breastfeed and have to use formula?
Many mothers do feel pressure from friends and family to breastfeed their newborns It is unlikely that you will be treated as a failure, as Western society is very accepting of bottlefeeding and, on the contrary, it is a continual effort to try to promote breastfeeding in our society. In November 2007, the Department of Health actually banned baby milk manufacturers from advertising infant formula for children under six months old on television and in parenting magazines.
Guidelines aside, although breastfeeding is a wonderful experience, it can sometimes be very hard work to establish If you find that you are struggling to establish breastfeeding, it’s worth seeking help from your midwife, health visitor, or breastfeeding counsellor before giving up
completely. However, if you find you simply cannot breastfeed, or you choose not to, you should try not to feel guilty as formula-fed babies grow and develop perfectly well. This is your baby and you will have your baby’s best interests foremost whatever action you decide to take.
Which formula milk should I buy?
There area number of brands that have a very similar nutritional content and you may need to chat to your local midwife or health visitor, or even family and friends with little ones, when trying to decide which one to use. Sometimes, babies are born prematurely and may need a special formula, or occasionally may react to a particular brand. If your baby was born full-term and is healthy, it is usually down to personal preference.
Manufacturers modify cow’s milk to make formula for human babies by adjusting carbohydrate, protein, and fat levels, and adding vitamins and minerals. There are two main types of formula milk, which have different ratios of the two proteins in milk: whey and casein. Those that are suitable for babies from birth contain more whey than casein The ratio of whey to casein in these milks is similar to that of breast milk, so it is thought to be easier for new babies to digest Milks that are marketed for the ”hungrier” baby (known as ”follow-on” milk) are casein-dominant and take longer to digest.
Why do some people use soya-based formula and is it safe?
Soya-based formula is made from soya beans, which are modified for use in formula with vitamins, minerals, and nutrients. Some parents consider giving a soya-based formula if their baby has an intolerance or sensitivity to cow’s milk formula. Soya infant formulas are nutritionally similar to cow’s milk-based formulas. The protein used in soya formulas is an extract of the soya bean, which has a high protein content. However, the UK government recommends that you should always seek the advice of a health professional before giving soya-based formula to
your baby. The current Department of Health advice is that soya formula milk should not be given automatically to babies with a sensitivity to cow’s milk, as there are other types of formula that are suitable for most babies with an allergy or intolerance that may be more favourable than soya. So if you are considering soya milk, make sure you seek medical advice first.
The carbohydrates used in soya milk contain glucose syrup, which may damage your baby’s teeth over a period of time, so if you are using soya formula, make sure you take your baby to the dentist once his teeth come through and tell the dentist that your baby has a soya formula. The Food Standards Agency also highlights concerns that soya-based formula could affect reproductive health. This is because soya contains phytoestrogens, substances found naturally in some plants, which may mimic cr block the action of the hormone oestrogen As this is a potentially sensitive time in a baby’s development, it is not clear whether soya-based infant formula could affect a baby’s reproductive development.
How should I hold my baby when I’m giving him the bottle?
Bottlefeeding can be a wonderful time for bonding with your baby by holding him close. Find a position that both you and your baby like — think about whether you are right- or left-handed and the age and size of your baby. You can cradle your baby or simply sit your baby on your lap. You will help reduce wind by giving your baby his bottle in as upright a position as possible. Also take care to tilt the bottle so that the teat and neck are always filled with formula and never leave your baby to feed unattended by propping the bottle up. Ask your midwife or health visitor for further advice
How long do you need to sterilize bottles for?
The recommendation is that you sterilize bottles and teats for at least the first year of your baby’s life. It is during this time that they are most vulnerable to germs and viruses, which if contracted could cause illness and possibly dehydration.
Can I make up feeds in advance?
Ideally, you should make up each feed fresh. The Department of Health and Food Standards Agency’s recommendations on the preparation and storage of formula milk advise that the risks associated with using powdered infant formula milk are reduced if each feed is made up fresh, as the longer the formula is stored, the greater the risk of bacterial growth. They do acknowledge that there are times when this is not practical, for example if you are going to leave the house for an extended period, or if you are dropping off a baby at a childminder’s or nursery. In this case, you should prepare the feeds in separate bottles as instructed and then store them in the fridge (see below). This is a departure from previous information so can seem unusual to mothers who have previously bottlefed Discuss this with your midwife and health visitor
How long can pre-made feeds stay in the fridge?
Although it is not recommended that you make up bottles of infant formula milk in advance to store in the fridge because of the risk of bacteria developing, if you need to do this, store them in the back of the fridge, not the door, to ensure they are below 5°C (4 PF) and never store feeds for longer than 24 hours (although this is considered too long for young babies). Formula milk is not suitable for freezing.
Taking a break
Is it safe to warm a bottle and take it out to use later on?
Carrying warm formula milk in an insulated carrier is not safe, as warm milk is a good breeding ground for bacteria The safer option is to make a feed up fresh for your baby just before it is required If you are out, you can carry boiled water in an insulated container ready to mix with formula powder when you need it Ready made-up milk feeds that come in little cartons are a more expensive option, but are handy for instantly decanting into a sterilized feeding bottle. If your baby is reluctant to take milk at room temperature, you could use a travel bottle-warmer, which can also be used to heat up containers and jars of baby food
What precautions should I take making feeds with bottled water when I’m travelling?
When using bottled water to make up a feed, make sure the seal is still intact. Use still, not sparlding, water, and avoid water with high concentrations of the minerals sodium, nitrate, or flouride. Boil the
One of the major plus points of bottlefeeding is that anyone can feed your baby, allowing you to have some time off and rest.
* Getting your partner involved in feeding is a great way to help him bond with and feel close to your baby
* Sharing feeds gives you a break and you can take it in turns to do night feeds
* If you are switching from breast- to bottlefeeding, it may be easier to get someone else to give your baby the bottle, as your baby may reject the bottle from you wanting to be breastfed instead water in a kettle in exactly the way you would boil tap water at home and wash and sterilize your feeding equipment as usual Large bottles of mineral water should be stored in a fridge after opening For convenience, you may prefer to use smaller bottles of mineral water if you are travelling from place to place. For extra convenience, ready-to-feed milks are available in cartons so you do not have to carry bulky tins of powdered milk with you. Although more expensive, these cut down on the amount of work you have to do and mean that you can be sure of good hygiene in the absence of adequate facilities
I’ve heard that bottlefed babies have smellier poo - is this true?
This does seem to be the case Bottlefed babies may have one bowel movement a day or only have a bowel movement once every three or four days.
Avoiding tummy upsets
Small babies are more susceptible to gastrointestinal infections so it’s important to observe strict hygiene while bottlefeeding. One of the most important aspects while bottlefeeding is to ensure that all the equipment involved in the bottlefeeding process is sterilized properly and spotlessly clean with no trace of old milk. This means sterilizing the bottles, teats, and lids (see p.239). If your baby doesn’t complete a feed, don’t be tempted to give it to him later to finish as germs that are present in the baby’s mouth may have transferred to the bottle and can then breed in the milk When you are travelling or out for the day, you need to take care transporting feeds Ready-made formula is probably the safest way to feed your baby while on the move, or adding formula to the water when you need it. Changes in water in different regions sometimes cause tummy upsets in bottlefed babies.
are normal. A bottlefed baby’s stools are pale brown smelly, and more formed than those of a breastfed baby. Some baby formula milks give a greenish tinge to the stool. It is thought that unabsorbed fat causes the unpleasant-smelling stools in formula-fed babies. Breast milk is better absorbed, which means the stools usually have less odour
Will my baby get more wind if he is bottlefed?
Wind refers to the air in your baby’s tummy. It is swallowed along with milk during feeds, but also when he cries. It will fill his tummy before he has drunk enough milk and be uncomfortable Also the faster flow of milk from a bottle can make babies take in more gulps of air. Some babies suffer with wind and need burping after every feed Breastfed babies tend to get fewer problems with wind than bottlefed ones as they control the flow of milk at the breast and so suck at a slower pace, swallowing less air with the milk They also have smaller and more frequent feeds and may be fed in an upright position, both of which can reduce wind
Some babies have trouble bringing up wind and their discomfort is obvious You can reduce wind by feeding your baby in an upright position and tilting the bottle so that the teat is full of milk and not air. If your baby doesn’t burp after a couple of minutes, he probably doesn’t need to. Wind your baby by gently rubbing his back or placing him over your shoulder Some babies only seem to be able to get rid of wind through hiccuping. If the wind is severe, your health visitor or doctor may suggest medication.
Is it OK to give my baby water as well as milk?
Formula milk does tend to be less thirst-quenching than breast milk as the strength of formula doesn’t vary whereas breast milk varies in consistency, with the beginning of a feed tending to be more watery If your bottlefed baby still seems hungry after a feed, it could therefore be that he is thirsty and some cooled boiled water may help to placate him In hot weather he may need regular top-ups of water.

What’s happening to my baby?
fetal development
Is it true that much of the really important brain development happens in the first trimester?
Your baby’s brain starts to develop soon after conception when brain cells begin to form at the tip of the embryo After about three weeks, a structure called the ”neural tube” begins to change in order to form the spinal cord, and the brain and brain cells (neurons) start to develop and send messages to each other In the early weeks, brain cells multiply at a rate of about 250,000 per minute.
After about 20 weeks of pregnancy, the rate at which brain cells multiply begins to slow down and the brain starts to organize itself into over 40 systems to direct vision, language, movement, hearing, and other functions By the time you are half way through your pregnancy, almost all the brain cells your baby needs for life are present
During the third trimester, the connections between the brain cells start to mature and the baby’s nervous system becomes more developed. Brain development is not totally complete by the time the baby is born and many important brain connections that help your baby develop skills and personality are made after the birth.
So, although fetal brain development occurs throughout pregnancy, and after, crucial foundations are certainly laid during the first three months
Is there anything I can do to help the development of my baby’s brain?
You can ensure that your diet includes good sources of omega-3 fatty acids, as these are thought to play an important part in the development of the brain They can be found in oily fish such as mackerel and salmon (limit to one or two portions a week) ; omega-3 supplements designed to take in pregnancy are available.
When will my baby’s face be formed?
The development of the face starts as early as the sixth week of pregnancy, when grooves that
will form the structures of the face and neck start to grow. A week later, the eye starts to develop and a primitive mouth and nose are evident. By the end of the first trimester the face is well formed and has a definite human appearance, although the skin is still transparent By the 24th week of pregnancy, the eye is fully developed, the eyebrows and lashes have formed, and the skin becomes less transparent, but the eye remains fused shut and does not open until around the 28th week of pregnancy
During the last trimester, your baby’s hair begins to grow on the head and fatty deposits give your baby rounded cheeks
I would like to communicate and bond with my baby before the birth. Is there anything I can do?
As your pregnancy progresses, there are many ways to focus on your baby and communicate with him, and these occasions area chance for you to relax and take time out, too.
* Relax in a warm bath and concentrate on feeling your baby’s movements, imagining what he is doing inside you.
* Talk to your baby. Your baby can detect sounds from outside the womb by the second trimester and is especially likely to tune in to your voice. You can give a running commentary on your activities, or even read to your baby Get your partner to chat too! * Rub or massage your bump. You may find that your baby responds by kicking; it’s almost like having a conversation!
* Spend some time making plans for your baby’s arrival, for example, choosing colours for the nursery
or even just buying a few sleepsuits
* Sign up for birth preparation classes for you and your partner This will give you both a chance to think about labour, birth, and your baby
* Start reading through a book of baby names and make a list of those you and your partner like * Some couples enjoy taking regular photographs of their growing bump
I’ve got a full-on career and have hardly thought about the baby. Will this stop us bonding?
Even if you work full time during pregnancy, this doesn’t have to have a negative effect on your relationship with your baby. As your baby grows, you will probably find that you start to develop a relationship with your ”bump” as you anticipate your baby’s movements and perhaps talk to your baby Make sure you plan enough maternity leave before your due date as this gives you time for practical and emotional preparations, as well as time to rest There is some evidence to suggest that too much stress in a mother can affect her unborn baby’s brain development although this is not conclusive. However, it does highlight the importance of regular opportunities to relax during pregnancy
I’m trying to get my partner involved; I keep letting him feel the baby move, what else can I do?
This is a common concern Feeling the baby move inside you is a great way for your partner to begin to connect with the baby as a separate person and seeing the baby on an ultrasound scan can help too, as can hearing the heartbeat.
It is often difficult for partners to feel involved with a pregnancy since it is not physically happening to them and can feel quite an unreal experience Try to spend time together finding out about pregnancy labour, and birth as this will help your partner to feel as informed as you and discover ways to help -you during the labour and birth and care for the baby after the birth. Some of the suggestions in the box above may also help.
My husband didn’t talk about the baby before the scan. Now he is over-protective. Is this normal?
Many fathers-to-be find it difficult to come to terms with the fact that their partner is carrying their baby, and that the baby will eventually be born and bring all the joys, trials and responsibilities of parenthood. This is all even harder to envisage when they are not physically experiencing the changes that pregnancy brings - not feeling the symptoms or feeling the movements. The ultrasound scan is often a pivotal point for partners - suddenly they are ”face to face” with their baby, and it becomes more real Perhaps your partner is now realizing his responsibilities and affection for the baby and is showing these feelings by taking care of you. If you are finding that his cosseting of you is a little too much, you might want to discuss other ways he can feel involved with the pregnancy and prepare for the baby (see box, above)! Try to embrace his involvement and enthusiasm for the pregnancy - it is a great way for you to strengthen your relationship as a couple and prepare to face parenthood together.
When can a baby first suck its thumb?
Ultrasound scans have shown unborn babies sucking their thumbs from as early as 12 to 14 weeks of pregnancy However, this is likely to be a reflex at this stage as the brain does not have any conscious control over movement until the fetus is much more developed later on in pregnancy,
Some research has suggested that if an unborn baby shows a preference for sucking, for example its right thumb, then it will prefer to lie with its head turned to the right after the birth The same research also suggested that this preference in the womb could be used to predict right or left handedness in the baby as it grew older
When will the midwife be able to hear my baby’s heartbeat?
Your midwife should be able to hear your baby’s heartbeat by the time you are around 12 weeks pregnant using a hand-held device called a sonicaid”. The heartbeat sounds rather like a galloping horse, and the rate is usually somewhere between 120 and 140 beats per minute — around double the rate of your own pulse.
There are factors that can influence whether or not the baby’s heartbeat can be picked up. For example, if you are overweight, or the baby is in an awkward position, it may be harder to hear the heart. If your midwife is unable to locate the baby’s heartbeat at 12 weeks, try not to worry, At this stage, the baby is only about 5cm (2in) long, so it’s still very tiny’ Your midwife will try again in a few weeks. Certainly by 16 weeks it should be easier to pick up and listen to the heartbeat.
When will I first feel my baby move?
Although ultrasound scans have shown that babies may start to move slightly from around 6 weeks, it is not usually until the second trimester (13-26 weeks) that the fetus will make active movements. The sensation known as ”quickening” is described as a fluttering type of feeling usually felt by mums between 16 and 20 weeks, although exactly when a movement is felt can vary from woman to woman and may be affected by various factors. If it is your first baby, you may not notice any movement until later as you won’t know what to expect. Also, if you are an active person, these slight flutters may be missed. Women with an anterior placenta (lying at the front of the womb) may feel movements later, as may larger women, as there is more flesh for the movement to be felt through.
It is not until around 28 weeks that it becomes more important to monitor the pattern of movements. From this stage, the amount your baby moves, as well as the type of movement and the time it happens, are relevant as these indicate that the placenta is sustaining the pregnancy and your baby’s muscles are developing. If you are concerned about lack of movement, contact your midwife or hospital.
What sounds can my baby hear in the uterus?
The baby’s outer ear is visible at around eight weeks and the first reaction to loud noises has been recorded at nine weeks. This has been measured in studies by playing a range of sounds through the mother’s abdomen and recording any responses, such as movement, through ultrasound scans. It is thought that babies start off hearing low tones and then higher tones are heard later on as the hearing system continues to develop.
Studies also suggest that a fetus can determine
its mother’s voice and the voices of close friends and family significantly during pregnancy One study revealed that not only did the fetus hear its mother’s voice, but its heart rate decreased, indicating that her voice had a calming effect. By 16-20 weeks, hearing is considerably developed. Premature babies born at this time react to sounds, so they are living proof that babies inside the womb at that gestation can hear Research also suggests that babies respond to stories read to them or music played during pregnancy after the birth
I’m 25 weeks’ pregnant, and my baby seems to “jump” when it hears loud noises - is this likely?
Babies born prematurely react to sounds, and loud sounds will produce a ‘’startle reflex’, so this provides strong evidence that babies inside the womb at that gestation will hear and react to loud sounds too, possibly with sudden movements
As mentioned above, studies have shown that a baby can react to sounds in the womb from as early as nine weeks’ gestation. As the fetus grows, the hearing develops, with babies responding to a greater range of sounds.
My tummy measurement has been the same for three weeks. Why isn’t my baby growing?
In pregnancy, your abdomen is measured to establish the height of the top of the womb, which indicates how the baby is growing It is important
to know whether the same person is measuring you, as there is an element of subjectivity depending on techniques. In early pregnancy, it is not necessary to measure you as this doesn’t give an indication of fetal growth, but from 26-28 weeks, growth can be assessed this way. However, even with your own personalized growth chart and with the same person measuring you at the correct time, on their own these are not an accurate means of estimating your baby’s growth. If there are any concerns, you will probably be referred to a consultant to decide whether you need further investigations, for example ultrasound scans. If you are at the end of your
pregnancy, one possible explanation may be that your baby’s head is engaging into the pelvis, so although your baby is still growing, some of his head has not been measured due to its position If you are worried, talk to your midwife and, if necessary, she can refer you for a ”growth scan”,
Do babies have hiccups in the womb? I’m sure I can feel them.
Babies hiccup from early in the third trimester. This is a normal phenomenon that is usually short-lived but often recurs at similar times each day It feels like a quick, spasmodic sensation in your abdomen. Hiccups are not harmful to the baby and in fact are a sign that your baby is healthy, in the same way that your baby’s movements are a positive sign.
It is thought that the hiccups may be caused when, occasionally, babies take a deep breath in and ingest the amniotic fluid that surrounds them. The sudden change in chest cavity pressure when they take in fluid can cause the hiccups, just as when we drink something fast. These deep breaths help to exercise breathing muscles and stimulate their lungs to produce “surfactant”, which is essential for the lungs to function. The baby cannot drown, as it receives its oxygen supply from the placenta.
When will my baby grow fingernails?
Babies begin growing fingernails from the end of the first trimester and the nails reach the fingertips between 34 and 36 weeks of pregnancy It is possible for babies to scratch themselves inside.
After birth, cutting a baby’s nails can be a cause of concern for parents. Newborn nails grow rapidly and the best time to shorten them is after a bath, when they are at their softest and the baby is more relaxed. There is some controversy over whether to use scissors, clippers, or simply bite them off. Scissors and clippers may easily cut the skin, but biting carries a higher risk of infection if the skin is broken. Pressing the nail helps to distinguish nail from skin. Using emery boards or simply peeling them off can be slightly safer options, or put your baby in scratch mittens.
At what stage could my baby survive outside of the womb?
Until relatively recently, babies born under 28 weeks’ gestation often did not survive Today, with medical advances in special care baby units, babies of 22 weeks’ gestation have survived outside the womb, although this is still very rare. The guidelines for most hospitals is that 24 weeks is the earliest point at which they will resuscitate a baby, unless the baby shows signs of life at birth.
Extremely premature babies have an increased risk of disability, even with the best medical care, and often the delivery itself can put an enormous strain on the baby.
Very experienced doctors, midwives, and nurses will be involved in the care of extremely premature births If possible, the delivery should take place in a hospital with a dedicated special care baby unit (SCBU) If this is not possible, babies are often transferred to a specialist centre when they are stable enough to be moved.
As each day and week is a milestone for your baby, the nearer to your due date you deliver, the better the chances for your baby.
I like to rub my tummy and talk to my baby as even now I feel like my baby is here - is this daft?
No, this is perfectly normal and may be soothing for him as babies can determine their mother’s voice in the womb and sometimes their heart rate decreases in response. However, I wouldn’t recommend that
you rub your tummy too vigorously or too often as, in some cases, this can cause contractions and may trigger a premature labour if you are around 37 weeks’ gestation.
Many women feel that the mother-child bond
is there before the baby is born. It is good that you are having these positive thoughts during your pregnancy, as this is an excellent foundation for your future relationship with your baby
Can my baby see bright lights? I’m 32 weeks’ pregnant.
A baby’s eye structures begin to develop from as early as 4-5 weeks, with the eyelids forming at around 8 weeks and closing between 9 and 12 weeks. By 24 weeks, all of the eye structures are fully developed and at around 28 weeks, the eyelids start to open and shut Although we tend to presume the uterus is dark, this is not so Between 30 and 32 weeks, the baby experiences light and dark environments, depending on where the mother is and the time of day. It has even been reported in studies that not only do babies react to light, but have been seen on ultrasound scans trying to grasp at the light source. When a baby is born, he reacts to lights by frowning or blinking and can see to a distance of around 15-20cm (6-8m) (the same distance to mum’s face from the breast!).
Is it normal for babies to stop moving around so much towards the end of pregnancy?
Towards the end of pregnancy, your baby’s range of movements may change as there is less room for him to extend his limbs and trunk However, you should still be aware of a regular pattern of movement. Over the last 30 years, women have been actively encouraged to count how much their babies kick However, in 2003, the National Institute for Clinical Excellence (NICE) recommended that this practice of counting movements stopped, as counting how many kicks a baby makes is not an accurate indication of whether the baby is well and each baby makes a different number of kicks Nowadays, women are encouraged instead to tune in to their babies’ pattern of activity, including the type of movement they make and the periods when they are most active. Studies have shown that over 50 per
cent of women who had a stillbirth noticed a change in the pattern of movement. The general advice is, if -you are worried about your baby’s movement pattern you should speak to your midwife or hospital.
When will my baby’s head engage?
Engagement, when your baby’s head moves from higher in your abdomen down into your pelvis in preparation for the birth, can happen at any time from 36 weeks until the onset of labour (see p 148). The head tends to engage earlier in a first pregnancy
Can my baby’s position in the womb affect when his head engages?
A baby’s position can affect how it engages into the pelvis. For example, if the baby is lying in a ”back-to-back” position, with his back lying along the mother’s back; this can make it more difficult for the baby’s head to move through the pelvis. Similarly, if the baby is in a breech, feet first, position or a transverse position (see p. 145), then engagement will not be possible unless the baby moves and a Caesarean delivery may be necessary.
It is thought that the mother’s level of activity and the positions she adopts can influence the position of the baby in the womb. Nowadays, it is more common for babies to lie in a back-to-back position and it is thought that this may be due to people leading a more sedentary lifestyle. In the past, when women were possiby more active, perhaps performing tasks such as scrubbing the floor on their hands and knees, there was less incidence of this position
Will my baby develop much in the last month of pregnancy?
During the final month of pregnancy, your baby is busy preparing for birth. He will be practising breathing movements and sucking, and will start to turn towards light. You may notice that there are fewer vigorous movements now — this is natural as there is less space within the uterus. However, you should still be noticing plenty of nudges and wriggles.The downy hair that covered your baby’s body starts to disappear and the hair on the head and your baby’s nails continue to grow Meconium, the waste product that will be your baby’s first poo, starts to form in the bowels at this time. During this last month, most of your baby’s organs are fully mature and the lungs will continue to develop. ”Full term’ is considered to be from 37 weeks.
I feel very emotional at times and am scared that I won’t love my baby - is this normal?
The feelings you have are not uncommon An increase in hormones during pregnancy can cause some extreme and deep feelings, some of which are irrational Pregnancy is a major life event and, as well as the physical changes that are going on in your body, the emotional pressures are vast. There may be a range of pressures that are adding to how you are feeling, such as relationship problems, financial pressures, caring for other children, lack of space in your house, or returning to work after the birth. It is fine if these are occasional feelings, but if you find
that you are constantly snapping or crying, tired, having difficulty sleeping and eating, or sleeping and eating too much, are unable to concentrate, feel reluctant to leave the house, feel sad and anxious most of the time, or have developed obsessive compulsive disorder (OCD), then you need to speak to your midwife or doctor for help and advice as these are all symptoms of depression.
I’ve recently lost a parent and am very traumatized. Can stress affect my baby’s development?
This is a major life-changing event and with the additional fluctuation in hormone levels and the physical changes that are occurring in pregnancy you are obviously under a great deal of stress However, it may be helpful to bear in mind that your body is designed to deal with episodes of stress
There are studies that have suggested that women experiencing long-term stress may have an increased risk of pre-eclampsia (see p.89) and premature birth, although how reliable this evidence is has been questioned It has also been suggested that there may be a link between extreme stress in pregnancy and children becoming hyperactive, but again this is inconclusive The most important thing to do, now that you have recognized you may be at risk of long-term stress, is to speak to your doctor or midwife, particularly as there has been a recent increase in levels of support and treatment offered
to pregnant and new mothers in your situation, which may help to limit any adverse effects of stress.
YOUR BABY’S MOVEMENTS
First kick
The moment when you feel your baby’s first movements is a truly emotional experience, as you start to become completely aware of, and connect with, the baby growing inside
you. Usually, the first movements are felt as a fluttering sensation, or a ”quickening”, as your baby starts to stretch and turn. This can be felt from around 18 weeks, although for some women it is much later; if you have had a baby before you are likely to be aware of these movements earlier, but for a first baby, awareness of the baby’s movements is usually later, around 22 weeks It is not until about 24 weeks that you will really start to feel regular, more definite movements and you will soon become accustomed to your baby’s activities.