An important message to pregnant women

 An important announcement. 

THE SOUTH AFRICAN SOCIETY OF OBSTETRICIANS AND GYNAECOLOGISTS (SASOG) CALLS ON PREGNANT AND BREASTFEEDING WOMEN TO VACCINATE

The South African Society of Obstetricians and Gynaecologists marks National Women’s Day 2021 by encouraging all women to be vaccinated against Covid-19 to protect themselves against severe disease.  This includes women who are pregnant and those who are breastfeeding.  In the case of pregnant women, SASOG recommends taking the vaccine after 14 weeks of pregnancy.

Studies show that the risk for critical illness is higher for pregnant than non-pregnant women, particularly in the 3rd trimester.  It has been found that, while most women will have no COVID-19 symptoms in pregnancy, pregnant women who experience COVID-19 symptoms have a higher risk of being admitted to ICU, needing mechanical ventilation and dying, than non-pregnant women of the same age.  Taking the vaccine also means a potential reduction in the risk of Pulmonary TB associated with Covid-19 and a reduction in the risk of passing on the virus to vulnerable members of the household. 

While there is a lack of information on pregnancies during vaccine trials, there is mounting evidence that taking the vaccine during pregnancy is safe for both mother and fetus and that the vaccine provides protection of the newborn from Covid-19.

SASOG also recommends that women who are planning to become pregnant or undergo fertility treatment should become vaccinated and need not delay conception.

“If you are uncertain about which vaccine you should take or the risks that the vaccine poses to you or your baby, we strongly advise that you consult your doctor or clinic who will be able to provide you with the most up to date and reliable information to assist you in making your decision”, concludes Dr Haynes van der Merwe, SASOG President.

Dreams and nightmares during pregnancy

 Two weeks to go – in a whirlpool of dreams

According to doctor’s estimations, Hannah’s baby weighs between 3.3 and 3.5 kgs. A good weight for a newborn. Hannah is in good health, just very tired and ‘lazy’, sleeping well but having weird, and sometimes really scary dreams.

Dreams and nightmares happen a lot during pregnancy. I remember having really weird dreams when I was pregnant. Dreams are not just a figment of the imagination. I believe dreams are manifestations of your subconscious, and when you string them out and search them for their meaning, they can be interpreted to make sense, help you solve a problem and even face your fears.

A very well-used book in my bookcase is Denise Linn’s book called ‘Signposts – The Universe is Whispering to You.’ In her introduction, Denise writes “In every moment the universe is whispering to you. There are messages for you carried on the winds. There is wisdom for you in the morning songs of the birds outside your window and in the soft murmurs of an ebbing sea. All ordinary everyday events in your life carry communications from the realm of spirit.”

Hannah shared her nightmare with me. Admitting that she is not a good swimmer, Hannah found herself swimming in a shark tank. There was a strong whirlpool and she was desperately trying to get away from the sharks. She woke up in a sweat and was very frightened.

Let’s unpack the meaning of this nightmare with the help of Signposts.

Water – “is a universal sign. It’s connected to our emotions and the mysterious realms of the archetypal female energy, representing fertility, new life, and new creative potential. Birth is associated with amniotic fluid or ‘waters’. Disturbed water can indicate chaos, but Denise writes that this ‘is not necessarily a bad sign, as sometimes it takes a huge upheaval to release old belief patterns’.” Hannah told me that during this pregnancy, she has made a conscious effort to ‘let go’ past hurts and move forward.

Shark – according to Denise, this could be a sign of hidden fear. Before a woman gives birth, it’s normal to have hidden fears of the unknown or what to expect. The sharks in her dream acknowledge Hannah’s fears

Swimming – perhaps Hannah has a hidden fear of swimming, and her dream could motivate her to go for swimming lessons in the future? Denise writes: ‘Do you feel like you are swimming against the current?’ Her advice is to ‘go with the flow and life can become fun instead of a great effort’.

In her book, Denise asks the question: ‘Do you feel that you are having trouble staying afloat amidst emotional changes?’ Her advice: ‘Relax and let the current carry you to the centre of your soul.’

 

Now that Hannah is approaching her final two weeks, she should just ‘go with the flow’ and have a bit of fun. This suits her personality perfectly!

Understanding this nightmare reveals special messages for Hannah. Dreams, even if they’re nightmarish, can carry powerful messages and help your inner soul resolve issues in a way that only you can understand.

Dealing with deep emotions before birth is very important because the connection between a mother and her newborn is profound. While overwhelming emotions of elation come about not only through endorphins (happiness hormones), birth can exhume buried traumas – from as early as a woman’s childhood or even her subconscious babyhood. Buried issues can create a barrier between a woman and her baby, inhibiting bonding. Babies can sense this distancing, and become upset to the point of fussing at the breast, not feeding or fretting when left to sleep. This is when the ‘baby blues’ could develop into post-natal depression.

The best way to overcome these issues is to have someone to talk to. Ideally, your partner, but sometimes you need a good friend you can open up to. Church groups often offer counseling and a therapist is trained to help reveal past and forgotten hurts. Talk about them and let them go so that as a new mother, you can move on and look into your future with hope, joy, and fulfillment. 

 

Symptoms of late pregnancy

 

Three weeks to go – In my little bubble

Hannah’s slowly coming to the end of her marathon. Her baby girl could start knocking to come into the world any day now. Here are the typical late pregnancy symptoms she’s experiencing:

False labour

Feeling like a lazy cat on the couch – with intermittent spurts of energy

Tight shoes – even though they’re a size bigger

Swollen ankles by the end of the day

Fingers that feel like a bunch of bananas

Porridge brain (type porridge brain into the subject block on the gadgets panel to learn more about this syndrome)

Symptoms nobody warned Hannah about:

Having to depend on her partner for just about everything – from opening a jar to getting off the couch. I remind Hannah that this is not a sign of weakness, but rather admitting that there are times when we need help. Something women find difficult to do because we’re so fiercely independent. Partners often feel left out and want to know what they can do to help.

Hannah finds that she may be hearing her partner, but she’s not listening to him. When he asks a question, she has no idea what he’s talking about!

She feels like a sloth. If anything falls on the floor, Hannah couldn’t be bothered to pick it up when she doesn’t manage to do this with her toes!

Everything is an effort – even the things Hannah once enjoyed

All her good intentions (yoga, regular exercising, eating only healthy) have gone out the window while Hannah fantasises about the things she’s going to do when her pregnancy is over.

There’s a light at the end of the tunnel – and it’s not a train coming towards her:

Hannah is realistic and knows that this difficult stage of her pregnancy WILL PASS. She sympathises with overweight people who have to deal with a bulky body for life.

Hannah has a new appreciation for her mom and respects her for what she did for herself and her sisters. “I don’t know how she did it – being a single-mom,” Hannah told me. “I don’t know how I would have managed without my partner.”

“I am looking forward to the day when I can go back to work and pick up my career where I left off. Already we are making plans to move into a bigger space where my partner can work from home. I would prefer going to an office – but we will have to wait and see what 2022 brings.”

“I am learning to trust my instincts and listen to my body.”

“Knowing the date for my c-section means I don’t have to worry about when I will go into labour.”

“I know that I must enjoy living in my ‘perfect little bubble’ for now. I don’t think I will ever have this time again.”

Must do tips:

Have your finances in order

Share chores with your partner

Ask for help

Talk to your partner about how you feel about being intimate

Discuss parenting values.  

 

 

 

 

Breastfeeding - a community effort

 World Breastfeeding Week – 1 – 7 August

Why is breastfeeding so important?

Justus von Liebig, a chemist introduced formula in 1865. Back then, the marketing tactics persuaded women that formula-feeding was superior to breast milk. Today, bottle feeding is just easier. Now that we understand the benefits of breastfeeding, both for mom and baby, especially the development of the immune system, the tide is turning, and more women are opting to breastfeed, especially during the first six months.

Sharing this responsibility.

Successful breastfeeding begins before the birth when future parents learn as much as they can about breastfeeding. Hospitals have also adopted a breastfeeding policy, using ‘The Ten Steps to Successful Breastfeeding’ guidelines, and closing the milk kitchen where formula feeds were mixed.  Nurses and midwives working in these units attend regular breastfeeding updates so that they can advise new moms on how to prevent breastfeeding problems. Lactation Consultants specialise in breastfeeding difficulties and help moms with home visits or online consultations. They’re also registered with medical aid providers.

Immediately after the birth, the baby is put skin-to-skin on the mother’s chest for what is called the ‘first magic hour. This is when the baby is most alert, the sense of smell the strongest, and when bonding between mom and baby begins. Left undisturbed, the baby instinctively nuzzles looking for the nipple. When the baby suckles, s/he gets their first taste of sweet colostrum (baby’s first milk) and mom’s breastfeeding hormones kick in.

Dealing with Covid-19:

To minimise the risk of getting Covid-19 in the hospital, when there are no complications, mom and baby are sent home after the first 24 hours. Women who have had a c-section go home on their third day. All women are encouraged to get breastfeeding help and advice from organisations like La Leche League, the Gauteng Breastfeeding Forum, their ante-natal midwife or a Lactation Consultant.

According to Professor Priya Soma-Pillay, obstetrician gynaecologist who heads the research centre for maternal, foetal and new-born child health at Pretoria University, lactating women can safely be inoculated and continue breastfeeding.

Benefits of breastfeeding:

MOM or Mother’s Own Milk is unique and perfectly formulated according to the needs of each individual baby because her milk comes from what she eats and contains invaluable antibodies to protect her baby from infections

Colostrum – or baby’s first milk – has been called ‘liquid gold’ because contains everything a newborn needs. Just one teaspoonful at each feed for the first 12 hours is enough

Colostrum has a laxative effect that helps to prevent or minimise ‘baby jaundice’

Breastmilk has unique immunological benefits – in other words, it prepares the gut to absorb nutrients while minimising the risks of developing allergies and poor gut health

Babies benefit from amino acids (proteins) only found in breastmilk. These help to feed a baby’s fast-growing brain. 

Breastfeeding can help to reduce a woman’s risks of breast cancer

Breastfeeding helps mom to burn extra calories she may have gained during pregnancy

Breastfeeding means fresh milk at the right temperature is always ‘on tap’

Night-time feeds are easier to deal with

Research has shown that breastfed babies are less likely to get asthma, allergies and colic. Breastfeeding also helps to reduce the risks of obesity and type 11 diabetes in adulthood.

 Breastfeeding is economical and more hygienic.

For more breastfeeding information, type ‘breastfeeding’ in the subject line on the gadgets page.

 

Deciding what to pack for the hospital and feeding options

 

Four weeks to go - Breastfeeding dilemma – do I, don’t I?

Hannah says her baby girl is moving like crazy – day and especially at night. I’ve heard it said that the way a baby moves in the womb is a pretty good indication of their personality. With both her parents self-confessed ‘firecrackers of ‘get up and go’, it’s not surprising that Hannah’s little one will be a bundle of energy too. Time will tell.  

Hannah has been packing her bag for the hospital. Now that she knows she will be having a c-section, there’s no need to pack a ‘labour bag’. Only the essentials for her hospital stay which shouldn’t be for longer than three nights.  Hannah’s hospital will supply a bag of essential ‘goodies’ like pads, disposable panties and nappies. She only needs to bring toiletries and pj’s, her going-home clothes, sleep-suits and blankets for her baby. Her dilemma is: what does she pack for feeding?

If Hannah chooses to breastfeed, she will need feeding bra’s, disposable breast pads, possibly nipple cream and a cabbage in the fridge at home (in case her breasts are uncomfortably full on her third day when she comes home from the hospital).

Her paediatrician has recommended formula feeding (Hannah is HIV positive, taking ARV’s and has an undetectable viral load – which means that there’s a possibility she could breastfeed providing her viral load stays undetectable). If Hannah chooses to formula feed, she needs to bring formula, bottles, teats and all the necessary feeding and sterilising paraphernalia. This is because maternity hospitals no longer have a ‘milk kitchen’ for formula-fed babies. This is because all women are encouraged to breastfeed.

This is a toughie for women like Hannah. In the first place, not every woman WANTS to breastfeed and women should ENJOY their babies and not feel OBLIGED to breastfeed. An example of women who can’t breastfeed is those who have had a breast reduction – especially if the nipple was removed and reattached. Similarly, depending on the type of surgery, women who have had a breast enlargement or treatment for cancer such as a partial mastectomy or reconstructive surgery. There are also medical reasons, such as severe type 1 diabetes, certain auto-immune diseases or conditions requiring chronic medication like epilepsy.

Weighing up the pros and cons:

Hannah worries that if she doesn’t breastfeed, she will miss out on ‘bonding’, and the convenience of having milk ‘on tap’ – especially at night when she can simply lift her baby from the crib, and latch her. MOM (Mother’s Own Milk) is custom made for each individual baby which means not having to stress about which formula to use. Another bonus is that breastmilk changes according to the baby’s needs. (To learn more about breastfeeding, simply type the word breastfeeding into the subject line on the blog dashboard)

On the other hand, if Hannah chooses to formula feed, her partner, mom or sister can feed her baby – a satisfying and bonding experience for them. Formula feeding means that you don’t need to ‘wear your baby everywhere you go. Breastfeeding in public is still taboo – especially in restaurants where the strongest objectors are men. Formula-fed babies adapt more easily to a routine, and moms are spared discomforts like engorged breasts, cracked nipples or a hungry baby when the milk supply is low.

This is Hannah’s choice. My only advice for her (and all other women facing this dilemma) is: trust your instincts. This maternal instinct is a gift of motherhood. Learning to trust your instincts is the first and most important lesson you’ll learn. It comes naturally. Do you remember what happened 9 months ago? You realised that something was different – and instinctively asked ‘Am I be pregnant?’

Breastfeeding and Covid-19:

According to Professor Priya Sama-Pillay, head of obstetrics and Gynaecology and the Research Centre on Maternal, foetal and new-born and child health, Pretoria University, pregnant women should be vaccinated (preferably at or after 14 weeks), breastfeeding women can be safely vaccinated and shouldn’t stop breastfeeding.

Women who contract Covid-19 and are infectious can continue breastfeeding, but should be extra cautious – wearing a mask and sanitising. If she is unwell, she can express her milk, (this is safe to feed to her baby) taking all the necessary precautions to prevent contamination.

Photograph: Aloise Ireland