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BirthtofiveThis book gives youinformation on:Becoming a parentTaking care of yourself andyour childFinding practical help andsupport
Birth to1 Taking care of yourself as a parent4Vegetarian and vegan diets . 60Fat, sugar and salt . 61The postnatal check - a six week check foryou . 4Physical problems . 4Thinking about the next baby? . 8Smoking . 10Sleep and rest . 11Stress . 11Relationships . 13Sex . 14Domestic and sexual abuse . 16Eating as a family . 63Drinks . 64Food additives . 66Food allergies . 67Some common problems with eating . 68Keeping active . 71Teeth . 723 Taking care of your baby and child76Single parenting . 17Sleeping . 76Bereavement . 17Reducing the risk of unexpected death inLoneliness . 18infancy . 80Postnatal mental health and wellbeing . 18Crying . 83Money, work and benefits . 20Washing and bathing . 87Nappies . 892 Feeding your baby and young child22Taking your baby out . 92Feeding your baby . 22A new baby in the family . 93Help with breastfeeding . 22Breastfeeding . 23Staying healthy . 32Medicines and breastfeeding . 36What partners should know aboutYour baby’s health . 94Learning to use potties and toilets . 984 A guide to your child’s growth andbreastfeeding . 37developmentBreastfeeding help and support . 39Following your child’s growth andDifferent feeding situations . 40development . 104Formula feeding . 41Weight and height . 107Introducing your baby to solid food . 46Feeding your young child. 56Dairy and alternatives . 56Potatoes, bread, rice, pasta and other starchycarbohydrates . 57Fruit and vegetables . 57Beans, pulses, fish, eggs, meat and otherproteins . 58Oils and spreads . 592Twins, triplets or more . 94104
fiveEyesight . 110Talking . 111Reading . 113Feet and shoes . 113Children with additional needs . 115Dealing with challenging behaviour . 116When every day is a bad day . 1225 Learning and playing124Playing with your child . 124Keeping active . 125Get creative: ideas to help your child playand learn . 126Playing and learning with other children . 130Childcare . 1326 Keeping your child safe137Immunisations . 137The vaccines . 139Non-routine immunisations . 142Common childhood illnesses . 146No one needs a book to tell themwhat is good about being a parent.Parents turn to books when theyneed advice, when they are worriedand when they have got questions orconcerns, small or large.ContentsHearing . 113This is a book you can turn to forguidance and advice on the growthand development of your child. If thereis anything you are unsure of, or if youneed further explanation, don’t hesitate toask your health visitor or doctor.The information in this book is updatedevery year and also available online fromwww.publichealth.hscni.netMeningitis and septicaemia . 149Reducing the risk of accidents andunintentional injuries. 150Safety in the sun . 158Safety in the winter . 159Safety equipment you should have . 1607 Your rights and benefits161Glossary of useful terms162Useful organisations165Index1693
1Taking care ofyourself as a parentMany people say that becoming a parent is one of life'smost challenging and rewarding experiences, but youneed time to recover from the birth, to rest and to get toknow your baby. You will also need time and support inyour new role as a parent.The postnatal check - asix week check for youMake an appointment withyour GP for your six weekpostnatal health check. YourGP may check your bloodpressure. This is an opportunityfor you to discuss with yourGP any problems you may beexperiencing with your stitchesor wound site healing. You cantalk to your GP about familyplanning and when is the besttime to attend for your nextcervical smear. Your GP will askyou about your mood and howyou are feeling. This is to seeif you have any symptoms ofpostnatal depression, which isvery common. Don’t be afraid tobe open and honest about howyou may be feeling, as they willbe able to help.Physical problemsHaving a baby changes yourbody. If you are happy the wayyou are, don't let other peopletell you differently. If you feeluncomfortable with your body,though, you will want to makesome changes. Some things willnever be quite the same again– for example, stretch markswill fade, but will never go awaycompletely. Other changes neednot be permanent.You can tighten a saggy tummywith exercise, and weight gainedwill gradually drop off if you eatand exercise sensibly. But it’snot going to happen overnight.It took nine months to makea baby, and it will take at leastthat long to get back into shapeagain. In the meantime, give yourbody some little treats to cheeryou up. For example, if it makesyou feel good to paint your nails,then make time to do it.A lot of women experiencephysical problems either as aresult of labour and birth or4
because of the kind of workinvolved in caring for youngchildren, or both. Problems likerecurring infections, back pain, aleaky bladder and painful sexualintercourse are more commonthan people think.But if something really isbothering you, don’t be afraidto ask for help. Your GP maybe able to suggest treatmentor refer you to a specialist or aphysiotherapist specialising inwomen's health who can helpwith back and bladder problemsand painful stitches.1have a leaky bladder and morelikely to enjoy sex.You can do the followingexercises either sitting orstanding, when you are washingup, queuing in the supermarket,watching TV – anytime, anywhere: Pelvic floor exercisesThe muscles of the pelvic floorform a hammock underneath thepelvis, supporting your bladder,uterus and bowel. You usethese muscles when you passwater or empty your bowels andwhen you have sex. Pregnancy,labour and birth can stretch andweaken these muscles. If youcan improve their strength andfunction you are less likely to squeeze and draw in yourback passage at the sametime - close up and drawyour vagina (front passage)upwards;do it quickly, tighteningand releasing the musclesimmediately;do it slowly, holding thecontractions for as long asyou can (not more than 10seconds) before you relax;repeat both exercises 10times, four to six times a day.You may find it helps toimagine you are stopping abowel movement, holding in atampon or stopping yourselfpassing urine. In fact, the bestway to find the muscles is totry stopping and starting (orslowing down) the flow of urinewhile you are on the toilet.Deep stomach exerciseThis exercise will help to firmyour stomach: lie on your side with yourknees slightly bent; let your tummy sag andbreathe in gently; as you breathe out, gentlydraw in the lower part ofyour stomach like a corset,narrowing your waistline; squeeze your pelvic floor atthe same time; hold for a count of 10 thengently release; repeat 10 times.Taking care of yourself as a parentFor some problems you cando a lot to help yourself. Forexample, if you are sufferingfrom a leaky bladder or gettingthat ‘falling out’ feeling, you mayneed to strengthen the musclesaround your bladder, vagina andperineum. Pelvic floor exercisescan help. A bad back can alsobe helped by exercise andby learning to use your backcarefully.5
important that you consult yourGP or health visitor before thetrip. They can give you adviceon in-seat exercises to keepyour blood circulating.Easing back painstraight and hold the weightclose to your body - makeyour thigh muscles work asyou lift;The following tips will helprelieve an aching back: while feeding your baby,always sit with your backwell supported and straight- use a pillow or cushionbehind your waist; kneel or squat to do lowlevel jobs like bathing yourbaby or picking things upoff the floor - avoid bendingyour back; make your knees workinstead - change nappieson a waist-level surface orwhile kneeling on the floor; to lift weights like a carrycotor an older child, bend yourknees, keep your back If you do develop swollen,painful legs or have breathingdifficulties after a flight, seea GP urgently or go to thenearest emergency department.try to keep a straight backwhen you push a pram orbuggy, or carry your baby ina sling.Deep vein thrombosisDeep vein thrombosis (DVT) isa serious condition where clotsdevelop in the deep veins ofthe legs. It can be fatal if theclot travels from the legs to thelungs. Flights lasting over fivehours where you sit still for along time may increase the risk.Pregnant women and womenwho have recently had a babyare among those more at risk.If you intend to travel by air, it isEatingBeing a parent is an exhaustingbusiness and it’s easy to findthat you have no time or energyto cook or eat properly. Healthyeating is important for all ofyour family. Eating well willmake you feel better and itneed not take much time.If you are breastfeeding, youdon’t need to eat a special diet.But you should make sure youeat and drink plenty and getplenty of rest. See page 32 forinformation on eating healthilywhile breastfeeding.If you feel you need to loseweight, the most effective way6
of losing weight is to cut downon fat and sugar but not to go ona crash diet. Small regular mealswill keep up your energy levelswithout adding to your weight.If you are breastfeeding, losingweight by eating healthily andtaking regular moderate exercisesuch as a brisk 30-minute walkwill not affect the quality orquantity of your milk.1 Keep up your postnatalexercises. They willstrengthen vital musclesand improve your shape.See page 5 for practicalinformation on someimportant exercises.Join a postnatal exerciseclass. It may help to bewith other new mums. Findout if your local maternityunit has a class run bya physiotherapist whospecialises in women’shealth, or ask your healthvisitor about other localclasses. If you are going toa class other than a specialpostnatal class, be sure totell the person running thePush the pram or buggybriskly, remembering tokeep your back straight.Walking is great exerciseso try to get out as much asyou can.Squat down to pick thingsup from the floor, holdingheavy weights close toyour body. This is alsosomething you are likely to bedoing a lot. If you squat ratherthan stoop, bending yourknees and keeping your backstraight, you will strengthenyour thigh muscles and avoiddamaging your back. Play energetic gameswith older children. Youcan exercise by runningabout with them. Findoutdoor space if there is nospace at home.Swimming is good,relaxing exercise. If youtake your child with you,try to have someone elsethere too, so that you get achance to swim. Borrow or buy an exerciseDVD or search YouTube.This is a way that you can doa workout at home. You couldget a friend or your olderchildren to join in. Run upstairs. You probablyfind yourself going up anddown a hundred times aday in any case. Try to thinkof it as good exercise!Taking care of yourself as a parentPhysical activityWhen you are feeling tired,being active or taking moreexercise may seem like thelast thing you need, but activitycan relax you, help your bodyrecover after childbirth, keepyou fit or improve your fitness,and make you feel better andmore energetic. The followingsuggestions may help: class if you have had a babyin the last few months. Youwill need to take specialcare of your back andavoid exercises that coulddamage it.To stay healthy, adults aged 1964 should try to be active dailyand should: do at least 150 minutes ofmoderate aerobic activity suchas cycling or fast walkingevery week or 75 minutes ofvigorous aerobic activity everyweek;7
do strength exercises on twoor more days a week thatwork all the major muscles(legs, hips, back, abdomen,chest, shoulders and arms);minimise the amount of timebeing sedentary (sitting).Thinking about the nextbaby?Holding your new baby in yourarms, it may be impossible toimagine that you will ever havethe energy to go through itall again! But sooner or later,you may decide that you wantanother child.This section explains how youand your partner can create thebest possible circumstances foryour next pregnancy.Finding it hard to getpregnant?It can take several months ormore to get pregnant, even if ithappened really quickly the firsttime.If you are under 36 years oldand still not pregnant after oneyear, are over 36 years oldand still not pregnant after 6months, or have a known fertilityproblem, talk to your doctor orfamily planning clinic.It takes twoYou will increase your chancesof getting pregnant if you are ingood health – and that applies8to men too. A bad diet, smoking,drinking and unhealthy workingconditions can affect the qualityof sperm and stop you gettingpregnant. You should both try tomake your lifestyle as healthyas possible before you try toconceive. you have coeliac disease; you have diabetes; you are obese; you take anti-epilepticmedicines. Ask your GP foradvice as well.Folic acidRubella (German measles)Women should take 400micrograms (mcg/μg) of folicacid from the time you starttrying to conceive right up untilyou are 12 weeks pregnant. Youcan get these tablets from asupermarket or pharmacist. Eatfoods that contain this importantvitamin as well.Rubella in early pregnancycan damage your developingbaby. It is important to makesure that you have had twoMMR (measles, mumps andrubella) vaccines before youget pregnant again, to ensurethat you are protected againstrubella infection.These include green, leafyvegetables, and breakfastcereals and breads with addedfolic acid.Your weightYou will need a bigger doseof folic acid that requires aprescription if: you already have a baby withspina bifida;Maintaining a healthy weightcan improve your chances ofgetting pregnant. You mayhave put on weight during yourlast pregnancy and want togo back to your normal size.This is particularly important ifyou weigh more than 100kg(approximately 15.5 stones).
Postnatal depression andpuerperal psychosisIf you have previouslyexperienced postnataldepression or puerperalpsychosis, talk to your doctorbefore you try to get pregnant(see page 18).The best way to lose weight isby following a balanced low-fatdiet and doing exercise. It mighthelp to join a slimming classwith a friend or your partner toencourage and support you.Speak to your doctor if you needhelp or advice.Long-term conditions,medicines and drugsSome medicines can harm a babyin pregnancy but others are safe.If either you or your partner hasa long-term illness or disabilityand has to take long-termmedication, talk to your doctorabout any possible effects onfertility or pregnancy.more information visitwww.drugsandalcoholni.infoDiabetesAll women with a history ofdiabetes (type 1, type 2 andgestational) during pregnancywill be advised in the postnatalperiod of the importance ofplanning future pregnancies andensuring that their diabetes iswell controlled before they getpregnant. All Health and SocialCare Trusts have pre-pregnancydiabetes clinics in place toassist women with this. Allwomen with diabetes should bemade aware of the websitewww.womenwithdiabetes.netSexually transmittedinfections (STIs) can affectyour health and your ability toconceive. If there is any chancethat either of you has an STI, it’simportant to get it diagnosed andtreated before you get pregnant.STIs, including HIV, herpes,chlamydia, syphilis, gonorrhoea,hepatitis B and hepatitis C, canbe passed on through sex withan infected person, especially ifyou don’t use a condom. SomeSTIs can be transmitted duringsex without penetration. HIV,hepatitis B and hepatitis C canalso be passed on by sharingequipment for injecting drugs. Ifyou are HIV positive, you canpass the virus on to your babyduring pregnancy, at birth orwhen breastfeeding.Taking care of yourself as a parentSexually transmittedinfections1EpilepsyCheck with your doctor, midwifeor pharmacist before you takeany over the counter drugs.Illegal drugs will affect yourability to conceive and candamage your baby’s health. ForIf you have epilepsy, talk to yourdoctor before you try to getpregnant. Pre-pregnancy clinicsfor women with epilepsy areavailable to help you get readyfor pregnancy.9
them for their support. Forexample, ask them not tooffer you cigarettes and notto smoke around you.Vaginal birth after acaesarean sectionMany women who have had acaesarean section can have avaginal delivery for their nextbaby. This depends on whyyou had a caesarean sectionthe first time. Your obstetricianwill be able to advise you.Most women who are advisedto try for a vaginal delivery insubsequent pregnancies dohave normal deliveries.SmokingLots of people smoke becausethey think it calms their nerves,but it doesn’t. It just calmsthe cravings for nicotine,the addictive substance incigarettes. The best thing youcan do for your health and yourfamily’s health is stop smoking.It’s a worrying fact, but thechildren of smokers are threetimes as likely to grow up to besmokers themselves.Giving up smoking is not alwayseasy, but the HSC is here tohelp. You are up to four timesmore likely to stop smokingsuccessfully with support. Here10are some first steps you mightfind useful to stop smoking: Know why you want tostop. Keep a checklistof your reasons for goingsmoke-free and keep ithandy in those times whenyou are finding it tough.Good reasons includefeeling healthier, protectingyour children’s health andhaving more money to spendon other things. Change your habits.Smoking is strongly linked tocertain situations – the firstcigarette with a cup of tea orcoffee, a cigarette when thephone rings. Try to break thelink by changing your habits.For example, drink orangejuice instead of coffee for awhile. Be ready to stop. Choosea day and stop completelyon that day. The day before,get rid of cigarettes, ashtraysand lighters. Get support. Tell yourfamily and friends you havedecided to stop and ask Plan ahead. If you knowa situation is going to bedifficult, don’t just wait for itto happen. Plan how you aregoing to deal with it. Take one day at a time.At the start of each day,congratulate yourself onhaving got this far and makeit your goal to get throughthe day without smoking.Don’t worry about tomorrow. If you need to putsomething in yourmouth, try sugarfreegum. If you need to dosomething with your hands,find something to fiddlewith like a pencil or a coin –anything but a cigarette.You can also ask pharmacist,midwife, health visitor or practicenurse for advice on stoppingsmoking and details of your localfree HSC Stop Smoking Service.They can offer one-to-one orgroup sessions with trained stopsmoking advisers and, if you
are pregnant, they may evenhave a pregnancy stop smokingspecialist. They can also give youadvice about dealing with stress,weight gain and using nicotinereplacement therapy to help youmanage your cravings. Supportand advice on stopping smokingis also available atwww.stopsmokingni.info1Sleep and restWhile caring for a small child isrewarding, it can be very tiring .Here are some suggestions: Get to bed early, reallyearly, say for a week. Ifyou cannot sleep when youget to bed, do somethingrelaxing for half an hourbeforehand, whether it’sexercise, soaking in a bath orwatching TV.Try deep relaxation. Aslittle as five or 10 minutes’deep relaxation can leave youfeeling refreshed, so it’s worthlearning some techniques.Look online, or go to thelibrary for books or DVDs. Sleep when your childsleeps. Rest when your childhas a day time rest, and/orwhen they are at playgroupor nursery school. You couldask a relative or friend totake your child for a whileand spend the time sleeping,not doing chores. Take turnswith other parents to giveyourself time to rest. Setan alarm if you are worriedabout sleeping too long.If you can, share gettingup in the night with yourpartner. Take alternatenights or weeks. If you areon your own, a friend orrelative may be prepared tohave your children overnightoccasionally.Sleep deprivation can bedifficult. Your days and nightswill become easier over timefrom about 6 weeks on. This iswhen your baby starts to settleinto a routine for feeding andsleepingIf you feel all of this is getting tobe too much, then talk to yourpartner about ways that you canboth manage through this time.You can also talk to your GP orhealth visitor.Taking care of yourself as a parent See page 78 for other ways ofcoping with disturbed nights.StressSmall children ask a lot of youbut perhaps the most stressfulthing is having to cope witheverything else that is going onin your life as well as copingwith their demands. You canspend a whole day trying – andfailing! – to get one job done.Just as you start on it, your babywakes up, or a nappy needschanging, or they just need a bitof attention.11
is feeling, and work out howbest you can support eachother. Sometimes it’s betterto talk to someone outsidethe family.Sometimes you can feel asthough life is completely out ofcontrol. If you are the sort ofperson who likes to be in controland worries about getting thingsdone, this can make you feelvery tense and frustrated.Worry and unhappiness can alsocause stress. Maybe you areworried about where you areliving, money or relationships orjust a whole lot of small thingsthat nevertheless make a bigdifference to your life. You maynot be able to do anything aboutsome of these things, but thereare some things that you can doabout the stress. Here are somesuggestions. Some will be moresuitable for you than others: 12Unwind. You may findthat you can relax just byspending half an hour eachevening doing somethingthat you enjoy and that helpsyou put other things out ofyour mind. Have a bath, reada magazine or watch TV –whatever helps you unwind.Borrow a book or audiobookfrom the library aboutrelaxation. Ignore any otherchores, they can wait. Makesome time for yourself. See other people. Seeingother people can help torelieve stress. Your healthvisitor, or other parents, maybe able to recommend localmother and baby or motherand toddler groups. If youare not keen on organisedgroups, you could try to gettogether with people youmeet at the clinic, playgroupor nursery school. Netmums(www.netmums.com) has fulldetails of baby and toddlergroups in your area. Make time for yourpartner. Relationships cango wrong when you aretense and tired and youdon’t seem to spend anytime together. Make time tobe with your partner, evenif all you manage to do isfall asleep in front of the TVtogether! Express yourself. Talkingabout how you are feelingcan help, at least for a while.You and your partner need tounderstand how each other Accept help. Make themost of all the help you canfind. And remember, youcannot do everything. Thereis really no point trying. Relax! There are no prizesfor being a supermum orsuperdad. It can be difficultif you are a perfectionist, butbeing a parent is the onething that no one is perfect at.AlcoholYou may feel like alcohol helpsyou relax and unwind. In fact it’sa depressant, and will affect yourmood, judgement, self-control andcoordination. If you are tired andrun down, it will have even moreof an effect. It’s fine to drink everynow and then, but try to keeptrack of how much and whenyou drink. Never mix alcohol withantidepressants or tranquillisers.
each other than you did beforethe baby arrived and it’s a lotharder to get out together andenjoy the things you used to do.Your partner may feel left out,and you may feel resentful atwhat you see as lack of support.It does help to talk, but it’s notalways easy: You may want to say thingsthat you are afraid ofadmitting to the people youlove. You may feel guilty aboutyour feelings. You may worry that peoplewill think you are a ‘badmother’.For all these reasons it’s oftenbest to talk to someone who isnot too close to you. That wayyou can talk honestly withoutworrying about whether you areshocking them. You may findthat it helps to talk to your GPor health visitor. Alternatively,they may be able to refer you tosomeone else. When you starttalking about how you feel, youwill almost certainly find that thethings you have been worryingabout are not as bad as youthought they were.If you cannot bring yourselfto talk to someone face toface, www.netmums.com hasan online support forum. It’s agood way of talking to otherparents who have had similarexperiences, and a way toaccess professional support.Getting medical helpIf you are feeling totally lost indepression, your doctor mayprescribe antidepressant drugs.They may be enough to give youthe lift you need to start copingagain and to find a way out ofyour depression, though theycan take time to work.Antidepressants are not habitforming. As long as they areprescribed for you by your GP,there is no need to worry abouttaking them. Tranquillisersare different. They don’t helpdepression and can be habitforming, so they are bestavoided.Relationships with familyand friendsBringing a baby into your lifechanges your relationships withother people, whether you arepart of a couple or alone withyour child. Everyone’s situationis different. For example, somemothers feel that their ownmothers are taking over, whileothers resent the fact that theirmothers will not help them more.1Taking care of yourself as a parentTalking it overRemember, make time foreach other when you canand do little things to makeeach other feel cared forand included. Talk togetherand share your feelings.Share household jobs.However painful it may be,it’s best to try to be very clearabout the kind
No one needs a book to tell them what is good about being a parent. Parents turn to books when they need advice, when they are worried and when they have got questions or concerns, small or large. This is a book you can turn to for guidance and advice on the growth and development of your child. If there is anything you are unsure of, or if you
