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Maternity Registration Form

Maternity Registration Form

Even if you've had a baby at the Coombe in the past, all maternity patients must fill in a Patient Registration Form. Please return the completed form to us in order to receive your first appointment. Click the word 'more' (below) to download a copy of the form.

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Frequently Asked Questions

 

Questions on Early Pregnancy

Questions About Ultrasound/Fetal Assessment

Questions on Labour and Childbirth

Questions on Early Parenting


Questions on Early Pregnancy

  1. How can I ensure that I will not put on too much weight during my pregnancy as I seem to be eating so much more?
  2. How much weight should I expect to gain during pregnancy?
  3. I have always hated the taste of milk, how can I take enough calcium for the baby and myself during my pregnancy?
  4. I seem to be feeling sick all the time and find it hard to keep anything down, what can I do?
  5. I like to drink a glass of red wine with my dinner in the evening. Is it safe to continue to do this during my pregnancy?
  6. How do I avoid developing these crazy food cravings that you hear about in pregnancy?
  7. There is a history of allergies and food intolerance in our family. What can I eat during my pregnancy to minimise the risk of my child being affected by allergies?
  8. What exactly does it mean when you are told you have to be ‘induced’?
  9. I want my partner to be present at the birth, but I think he is reluctant. Should I insist that he be there?
  10. I had an emergency caesarean with my first baby. How can I have a natural birth this time round?
  11. I have a very great fear of childbirth and for some weeks now have been having nightmares about it, how can I prepare myself not to panic when the time comes?
  12. I have heard such different stories about the pain of childbirth, how can I know what pain-relief I will need?
  13. If I opt for a natural birth but then find I need something to help me, will I be able to change my mind?
  14. Is there any way I can avoid having stitches with my second baby as I found these the worst part of the experience when I had my first?
  15. My skin has changed colour and looks patchy, it this normal?
  16. Why do I need to pass urine so often but only pass a tiny amount?
  17. I suffer from diabetes and was wondering how it will affect my pregnancy?
  18. Does bleeding during pregnancy mean I'll lose my baby?
  19. What should I definitely give up now that I am pregnant?
  20. Is my baby at risk because I am older?
  21. Is it safe to fly whilst pregnant?
  22. I plan to breastfeed my baby. Is there anything I need to do during pregnancy to prepare my breasts and nipples?
  23. I have developed pre-eclampsia during my pregnancy. Will it go after the birth of my baby?

Questions About Ultrasound/Fetal Assessment

  1. What is ultrasound?
  2. Why should I have a scan?
  3. Will it hurt?
  4. When would I have one?
  5. What does it tell me?
  6. How safe is it?
  7. Who organizes it?
  8. Why would a repeat assessment be advised?
  9. How do I prepare for the assessment?
  10. How long does it usually take?
  11. How long do results take?
  12. Who provides the service?

Questions on Labour and Childbirth

  1. I’m terrified of the pain I will feel during labour. How can I plan my pain relief before I start labour?
  2. What are the symptoms that labour has begun?
  3. What happens if the umbilical cord is wrapped around the baby’s neck?

Questions on Early Parenting

  1. My baby cries every evening for about an hour and my friends say that this is colic.
  2. My new baby is now two months old and my three year old seems to resent her taking any of my attention.
  3. I have been exhausted since I came home with my first baby. I am so tired and wish she would not cry every three hours. What can I do?
  4. When my baby wakens up at night for a feed we usually take her into bed with us. Is this okay to do?
  5. My baby seems content after a feed but I am told I should wind him by putting him over my shoulder and tapping his back
  6. How often should baby have a dirty nappy and is it different for bottle or breast-fed babies?
  7. My baby seems to sleep a lot, and I have to wake him up for his feeds. Is he just lazy or is there a problem?
  8. Should he feed from both breasts? My baby only takes one breast at each feed. Is this alright?
  9. What is colic?
  10. My baby was weighed today and has lost weight. Is this normal?
  11. My baby’s bowel motions are greenish-black. Is there something wrong?

Questions on Early Pregnancy

How can I ensure that I will not put on too much weight during my pregnancy as I seem to be eating so much more?

You did not mention how many weeks pregnant you are or if you had lost weight in early pregnancy due to morning sickness. If this was the case, then as soon as you began to feel better, you would automatically eat more to re-gain the lost weight. You state that you are eating ‘so much more’ but do not say that you have put on weight. So how much weight should a woman put on in pregnancy? This all depends on your pre-pregnancy weight. Women who are underweight at the time of conception should put on more than a woman who is normal weight at the beginning of pregnancy.

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How much weight should I expect to gain during pregnancy?

There is no hard and fast rule, approximately 10-12 kg or 22 – 27 lbs. If you are underweight you may need to put on more, if overweight you should try not to put on too much weight. However, do not try to lose weight when you are pregnant. These days women are very aware of the importance of having a balanced diet both before and during pregnancy. However, when we are tired, we often turn to sweet foods for that instant surge of ‘false’ energy that sugary foods and drinks give us. Try to avoid doing this.

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I have always hated the taste of milk, how can I take enough calcium for the baby and myself during my pregnancy?

The body is an amazing machine with the ability to maximise the absorption of whatever nutrient it needs from the food we eat and with such a wide variety of foods available today, deficiencies are rarely seen. The questioner only mentions milk; she does not say whether she eats cheese or yoghurt in her diet. If she does include cheese and/or yoghurt in her diet then her calcium intake would be adequate. Even if she doesn’t, there are many other foodstuffs which are good sources of calcium: white bread from which calcium is absorbed more efficiently than wholemeal bread; fortified breakfast cereals eaten dry or with fruit such as stewed prunes, stewed apples or any other fruit you might like; tinned fish such as sardines or salmon with their edible bones are excellent sources of calcium; dried fruit such as sultanas, figs, dates and almonds; egg yolk; vegetables – spring greens, spinach, white or red cabbage have limited amounts; oranges are also a source.

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I seem to be feeling sick all the time and find it hard to keep anything down, what can I do?

Try eating something light such as dry toast or a water biscuit in bed before you get up and do not drink anything for one or two hours after eating. This can sometimes solve the problem, however, there is no guarantee. This is the one time you must not worry about nutrition. The important thing is being able to drink water. If you cannot keep liquids down you need to go into hospital. If you can eat certain foods, e.g. mashed potato, toast, cereal or pasta with a little salt, pepper and butter on it, stick to those. Drink between, rather than with, meals. Keep away from cooking smells and get as much rest as possible. You should feel better after 12 to 13 weeks, when the baby is formed and your hormones have re-adjusted. Do not worry about the baby’s nutrition; whatever he needs will be taken from your body stores.

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I like to drink a glass of red wine with my dinner in the evening. Is it safe to continue to do this during my pregnancy?

More and more research shows that it is best not to drink alcohol at all when you are pregnant. This is especially important during the first trimester (first 12 weeks) when the baby is being formed. Many women lose their taste for drink when they are pregnant and this might well be ‘nature’s protection’. If you feel that giving up alcohol completely is too much to ask, then a glass of wine with a meal once a week could be something you might think about. White wine is reputedly less toxic than red. In the U.S.A. there are poster campaigns stating pregnancy and alcohol don’t mix if a) you are planning a baby; b) you are pregnant; c) you are a new parent. No beer, wine or alcohol is the best choice of all, and we can only agree.

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How do I avoid developing these crazy food cravings that you hear about in pregnancy?

The women I’ve met who had cravings had them for very available foods. ‘I can’t stop eating oranges’ or ‘I seem to have gone mad on cheese’ are phrases that come to mind. Certainly the more bizarre cravings seem to be a thing of the past. And of course we can get strawberries in March now or have ice-cream in the middle of the night if we want it. Again, the huge variety of foods on offer means that there are less, if any, deficiencies. Women today get the kind of antenatal care that simply was not available to other generations. Blood tests are taken and dietary advice from the hospital dietitian is available on an individual basis for any woman who might need it. In my experience the ‘crazy cravings’ you refer to are found only in the pages of text book

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There is a history of allergies and food intolerance in our family. What can I eat during my pregnancy to minimise the risk of my child being affected by allergies?

With histories of allergies in the family, the best protection you can give your baby is to breastfeed from birth. The colostrum produced for the first few days after birth is particularly good at fostering maturation of the baby’s gut, thus promoting tolerance and preventing food allergies later in childhood. Infants who were given no cows milk, eggs or peanuts during infancy and whose mother also avoided those foods while breastfeeding developed fewer food allergies and had less eczema in the first two years of life. It is important for mothers who intend to breastfeed to insist that their babies should not be given any formula in the hospital. If a nursing mother is trying to curb allergies in her baby and is not going to be around for a feed, she should pump breast milk and leave it for her baby. No solid food should be given to the baby before six months of age and then foods should be introduced, one at a time, starting with a rice cereal prepared with expressed breast milk or water, then vegetables, then fruit. Prepared foods containing eggs should be avoided.

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What exactly does it mean when you are told you have to be ‘induced’?

An induced labour is one that does not occur spontaneously. Women are induced for many reasons, most commonly because they have gone past their due date, because of worries about the mother’s health or the baby’s health. To be induced means that labour will be started artificially and this can be done by either placing prostaglandin gel in the vagina or by breaking the waters.

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I want my partner to be present at the birth, but I think he is reluctant. Should I insist that he be there?

While we do encourage partners to be present at the birth, I do not think it wise to insist on this. It is important for women to have a support person present and, while that person is ideally the partner, this is not mandatory

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I had an emergency Caesarean with my first baby. How can I have a natural birth this time round?

The risk of having a repeat Caesarean section having had an emergency Caesarean section with the first baby depends on a number of factors. Sometimes the indication for requiring an emergency Caesarean section, i.e. if the baby is breech, also occurs in the second pregnancy. In such a case Caesarean section could be indicated. Certainly the best way to have a natural birth the second time around is to go into spontaneous labour. Women who have had one previous Caesarean section who labour spontaneously in the next pregnancy have the best chance of achieving a normal vaginal delivery.

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I have a very great fear of childbirth and for some weeks now have been having nightmares about it, how can I prepare myself not to panic when the time comes?

In general I would reassure women who have a great fear of childbirth. With modern analgesia (pain relief) and care, childbirth need not be a bad experience. One of the best ways to prepare oneself for childbirth is to attend the antenatal classes and raise your concerns with the people who are taking care of you.

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I have heard such different stories about the pain of childbirth, how can I know what pain relief I will need?

There are no fixed rules with regard to pain relief in labour. Some women find they need little or no pain relief while others wish to access some or all forms of pain relief available. In general, I would recommend that pain relief in labour is approached with an open mind by both the mother-to-be and the carers.

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If I opt for a natural birth but then find I need something to help me, will I be able to change my mind?

If a woman opts for a natural birth and then changes her mind, then of course all options for pain relief would be available. I think it is important that the woman and the midwives and doctors looking after her maintain good communications during the labour as circumstances will frequently change. Therefore the best options can be agreed between the woman and the carers.

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Is there any way I can avoid having stitches with my second baby as I found these the worst part of the experience when I had my first?

In general it is less common to have stitches on a second baby than on a first baby. There is no proven value of routine episiotomy. Many women have tried various substances such as oil to make the perineum more supple, although there is no convincing data that this reduces the chance of requiring suturing. What is probably most important is that an experienced midwife delivers the baby and that the mother would, if possible, not push when asked not to by the midwife.

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My skin has changed colour and looks patchy, it this normal?

Yes. Due to hormonal changes that occur in pregnancy, there are a number of skin changes that occur even from an early stage in pregnancy. Virtually all of these changes reverse very quickly after pregnancy and indeed may actually disappear during the course of the pregnancy itself.

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Why do I need to pass urine so often but only pass a tiny amount?

During pregnancy the hormone progesterone relaxes the urethral sphincter and also causes the bladder to contract more often. Secondly, the effect of the pregnant uterus on the bladder reduces its physical capacity, necessitating you to pass urine more often.

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I suffer from diabetes and was wondering how it will affect my pregnancy?

Diabetes can have a number of effects on the pregnancy and pregnancy can have a number of effects on diabetes. Most hospitals now offer a special Diabetic Clinic which is usually attended by both an Obstetrician and Diabetic Physician so that the specific problems associated with diabetes in pregnancy can be addressed.

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Does bleeding during pregnancy mean I’ll lose my baby?

Any fresh vaginal bleeding in pregnancy is abnormal whether that be in the first, second or third trimester. However, it does not necessarily mean that the pregnancy will be lost. There are a number of causes why bleeding may occur and these include a low lying placenta, separation of the placenta and bleeding from local causes on the cervix or neck of the womb. If you do have any bleeding in pregnancy then you should refer yourself into your maternity hospital.

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What should I definitely give up now that I am pregnant?

It is advisable that you curtail your intake of alcohol and cigarette smoking, preferably to give the latter up completely. With regard to diet, one should avoid foods which are high in Listeria and these would include soft cheeses, pate, coleslaw etc. However, a good balanced diet should be encouraged in pregnancy. It is worth discussing this with your doctor.

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Is my baby at risk because I am older?

Certain abnormalities become more likely with advancing maternal age. The obvious ones are chromosomal defects, in particular Trisomy 21. However the age related risk for these conditions still remains low up until the age of 40.

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Is it safe to fly whilst pregnant?

Most airline companies permit pregnant patients to fly up to 32 weeks. However, some airline companies have specific requirements and it is worth checking these prior to your booking air travel. Long distance flights in pregnancy are associated with a risk of thrombosis (clots) developing in the legs and lungs. Flight stockings, hydration and leg exercise during the flight minimises this risk. Occasionally, it is necessary to take medication also. If you are planning flights during pregnancy, please discuss with your midwife and obstetrician.

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I plan to breastfeed my baby. Is there anything I need to do during pregnancy to prepare my breasts and nipples?

Extra physical preparation of the breasts and nipples is unnecessary. The breast prepares automatically by growing and developing during pregnancy. A good correct fitting support bra may be helpful. The best preparation is, to learn as much as you can about breastfeeding. Ask the Hospital/Clinic for appropriate leaflets/booklets. Drop in on a local Breastfeeding Support Group – see babies happily breastfeeding. Make contact with your Public Health Nurse/Health Centre, before baby is born find out what support services are available. Keep contact phone numbers handy.

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I have developed pre-eclampsia during my pregnancy. Will it go after the birth of my baby?

Pre-eclampsia is a fairly common (10%) complication of a first pregnancy. Although there are many theories nobody knows exactly why women develop it. The most effective way of dealing with pre-eclampsia is to deliver the baby and if the pregnancy is well advanced this solution poses no difficulty for the mother and baby. It may however pose problems if the baby is very premature. Pre-eclampsia almost invariably settles within the first six weeks of giving birth and usually will not re-occur. If it does re-occur in subsequent pregnancies there is a possibility that the mother has underlying kidney disease and may well have a tendency to develop high blood pressure later in life.

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Questions About Ultrasound/Fetal Assessment

What is ultrasound?

In ultrasound scanning during pregnancy, high frequency sound waves are used to produce a picture of the uterus (womb), baby and placenta (afterbirth). This usually enables the examiner to demonstrate the particular structures of interest in a requested examination. All ultrasound examinations should be for a specific reason/indication (Council Directive 97/43/Euratom of June 1997). Ultrasound has limitations in that the sound waves are absorbed by excess tissue (fat) or bone, which when present make some examinations difficult and the pictures sub-optimal.

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Why should I have a scan?

A scan is a medical test and therefore it needs to be ordered by a doctor who will fill out an ultrasound request form. Most scans are performed for specific medical indications although some experts argue the all women should have one 'routine' examination during pregnancy. In general this examination is best performed before 22 weeks of pregnancy although the optimal time for any ultrasound scan depends on the specific information being sought. The commonest reason for performing an ultrasound examination is to determine when the baby is due. Scans have a limited ability to detect abnormalities although in general the greater the abnormality the more likely it is to be detected by scan. A scan will not diagnose Down Syndrome, Cystic Fibrosis or Cerebral Palsy. Pain or/and bleeding in early pregnancy are other common indications for a scan, or if you have a medical/obstetric history of previous problems, a scan may be indicated. Sometimes at a pre delivery visit, the doctor/midwife gains the impression that the baby may be smaller/larger than expected and an ultrasound examination may then be advised to check the baby’s weight. A fetal assessment is a series of examinations, including a scan, which helps determine if the baby is healthy. This may also be performed in the Perinatal Day Centre. The size, position, fetal activity and/or blood flow may need to be assessed. An ultrasound examination will not be advised for gender determination or pictures. In gynaecology if bleeding, pain or some specific symptom or history causes concern, this may require transvaginal ultrasound assessment of the womb, ovaries and other pelvic organs. Being unable to conceive a pregnancy over a period of time may be an indication for an outpatient test of patency of the fallopian tubes. This test is called an Hystero-Contrast-Sonography(HyCoSy) and is an investigative technique provided in the Coombe Women & Infants University Hospital. There are other indications why your doctor may consider it appropriate for you to have a scan.

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Will it hurt?

An abdominal scan is rarely painful in normal pregnancy. Pre-heated gelly is used in the ultrasound department and only gentle pressure on the tummy is required to make the pictures. With a transvaginal assessment, it is described as being similar to inserting a tampon and moving it around or as being similar to a smear test.

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When would I have one?

The timing really depends on the indication/reason for ultrasound scan but it can safely be performed at any stage in pregnancy. The 'routine' scan is most often performed at 20 to 22 weeks.

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What does it tell me?

In early pregnancy (from five weeks), a pregnancy sac should be apparent in a woman with a very regular menstrual cycle and definite menstrual dates. The presence of fetal heart pulsations, the number of sacs and dating of the pregnancy can be carried out with ultrasound. In the 20-22 week ultrasound the baby’s anatomy can be checked and the placenta located. During any scan it may or may not be possible to determine the sex of the baby, it depends on the circumstances and the position and size of the baby. In a gynaecology ultrasound assessment the normalcy of the womb, ovaries and pelvis is determined. There are many variations of normal as this is dependent on the patient's age, medical treatment received and the day of the menstral cycle.

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How safe is it?

Most experts consider ultrasound to be safe but this can never be proven. In the Coombe Women & Infants University Hospital we limit the exposure of the baby to ultrasound energy to a level that is ‘As Low As Reasonably Achievable’ (ALARA) consistent with obtaining the information required by the doctor/midwife. For this reason scans are only performed when requested where the benefits clearly outweigh any possible adverse effect. Expert bodies and organisations that regulate and control Ultrasound staff state that ‘No known side effects have been reported under the current Food and Drug Administration (FDA) power output regulations in the USA, which date from 1976 to April 1999. Using the 'ALARA' principle, the intensity output of the equipment is kept as low as will allow the most information to be gained (AIUM 1997)’.

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Who organizes it?

When attending the emergency room (following referral by the general practitioner), the attending doctor will arrange it. Otherwise your obstetrician/midwife/gynaecologist will request you to organise it with the relevant staff, if it is deemed appropriate. For patients attending General Practitioners in the South Inner City GP Group Scheme, their doctors can arrange gynaecology ultrasound examinations for a limited number of patients. For external referrals from consultant doctors for the Hystero-Contrast-Sonography (HyCoSy) investigation of tubal patency, the department can be phoned direct at (01)4085243 with relevant details.

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Why would a repeat assessment be advised?

A repeat assessment may be advised due to sub-optimal views, which can be due to any number of factors. A more detailed examination of some babies may be necessary and in the event of a problem, it is important to consider all options. The growth of the baby or change in intrauterine conditions may need to be regularly assessed over a certain time frame. With a gynaecology ultrasound, a different day of the cycle may be more appropriate for the requested examination. Follow up of particular ultrasound findings may be necessary for variation in size of cysts, for example.

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How do I prepare for the assessment?

The doctor will determine whether a transvaginal or transabdominal examination is more appropriate. For transabdominal assessment a full bladder may be necessary and a warm gel is spread over and back across the abdomen. In transvaginal ultrasound an empty bladder is necessary and a tampon like transducer is placed in the vagina to demonstrate the pelvic structures in their normal environment.

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How long does it usually take?

Time taken depends on the examination requested but it usually requires 10-20 minutes. An image may be taken at some point during the assessment and given as a keepsake, but extra time will not be spent scanning for an image.

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How long do results take?

An overall impression will be given following the examination. The referring doctor will then give a detailed result.

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Who provides the service?

The ultrasound department is staffed by specially trained Midwife-Sonographers and Doctors who will have considerable experience at ultrasound scanning. Sometimes, a second opinion may be sought from a consultant with a particular skill in a specific aspect of scanning. Frequently, more than one scan may be necessary to arrive at a diagnosis.

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Questions on Labuor and Childbirth

I’m terrified of the pain I will feel during labour. How can I plan my pain relief before I start labour?

A lot of women who have gone through labour will classify the pain as being very severe. There certainly is a fortunate minority who can cope very well with very little or no analgesia. However the majority of women undergoing labour, particularly first labour, do find it a painful event. There are many options available to pregnant mothers and all of the options work better if the woman feels well supported by her partner and those that are looking after her. The commonly used methods of analgesia would be Pethidine, gas and oxygen (Entonox), TENS and an epidural. Whilst second and subsequent labours may be fairly quick, this tends to be unusual in first labour. Consequently different types of analgesia suit first time mothers better. In a first time labour, if the mother is feeling a substantial amount of pain it is very difficult to approach anything like the satisfactory pain relief that is given by an epidural.  On balance, the majority of  women in labour for the first time when making a free choice would be very happy to have their pain substantially eliminated by an epidural rather than not have one.

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What are the symptoms that labour has begun?

There are three symptoms that labour has begun. The first and the most obvious is the onset of regular, painful, uterine contractions. Whilst not one hundred per cent reliable, this is the single most common way that women know that they are in labour. The other symptom which may indicate that labour will begin shortly is a 'show’ which is the mixture of mucous and blood that comes from the cervix prior to the onset of labour. Usually after a show is seen labour will start within the next 24 to 48 hours. The third common symptom is when the waters go and once ruptured (assuming that the baby is due) labour, if it does not start on its own, will usually be induced within 48 hours.

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What happens if the umbilical cord is wrapped around the baby’s neck?

It is not at all infrequent that the umbilical cord is wrapped around the baby’s neck and usually this causes no difficulty whatsoever. Very occasionally if the cord is short or if the cord is wrapped around the baby’s neck several times it can cause problems by making it difficult for blood to get from the placenta to the baby. If this is going to be a problem it usually does not occur until labour is underway when it will best be detected by picking the signs that the foetus is beginning to get distressed. These signs usually are characteristic decelerations of the baby’s heart rate which are picked up either by the midwife listening to the foetal heart or by the monitor which is counting the baby’s heart rate. The vast majority of babies that are born with the cord around the neck suffer absolutely no problems as a result of this.

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Questions on Early Parenting

My baby cries every evening for about an hour and my friends say that this is colic.

Colic is a loose term used to describe crying/unsettled fussing behaviour which occurs in some infants on a repetitive basis. This is most common in the evenings and peaks at around six to eight weeks of age. There is more normal crying at six weeks of age than either before or after, with 30 per cent of infants at this age crying for more than three hours per day and this decreasing to 10 per cent of infants crying for more than three hours per day by three months of age. Colic is generally defined as unsettled fussing/crying behaviour for more than three days per week on a consecutive basis. The infants often draw their legs up, cry intensely and look as if they are in pain with or without the passage of flatus. These episodes settle and the infant feeds and thrives normally and a variety of medicines, many of which are sedatives, are prescribed without much evidence to back up the effectiveness of the most commonly used medications, including lactose drops. There is no evidence that lactose intolerance, milk allergy, excess wind or many of the other commonly held theories, are the cause of colic which is a normal developmental phase in some infants.

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My new baby is now two months old and my three year old seems to resent her taking any of my attention.

This is a normal behavioural adaptation which toddlers make and it takes varying lengths of time for them to adapt to a new baby. The important thing is that they are always included, and not excluded from sharing in the new infant’s care and also that they do not feel excluded from parental attention. The best way to reassure the older child is by continuing to ensure that they have some specific time each day where they have a one-to-one relationship with their primary care-giver.

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I have been exhausted since I came home with my first baby. I am so tired and wish she would not cry every three hours. What can I do?

It is extremely hard work looking after infants especially after the stresses and strains of pregnancy, labour and delivery. It can be exhausting and this is compounded by lack of sleep. If you feel excessively tired then ask for help, ask somebody else to take the baby for a particular feed, ask your relatives for some help and accept and recognise your own limitations, particularly in the area of sleep deprivation. The early infant period with lack of sleep does not last forever and most babies will be sleeping overnight by six to seven weeks of age. The main thing is that if you feel you cannot cope then ask for help. Being unable to cope is a presenting sign for significant post-natal depression, which is said to occur in 10 per cent of Irish mothers but is often unrecognised.

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When my baby wakens up at night for a feed we usually take her into bed with us. Is this okay to do?

Many studies in the western world including studies in Ireland, the UK, Scotland, Norway, Australia and New Zealand have shown that if a baby is brought into bed to sleep for the entire duration of the night, this is a significant risk factor for sudden infant death syndrome. Consequently this is not recommended practice. However, most of the increased risk of sudden infant death is accounted for by parents who smoke or drink alcohol on the designated night, so both of these practices should be avoided if the baby is being brought into bed, and this practice should also be avoided if the parents are excessively tired. The safest parenting practice for small infants is to have the baby lying on their back in a cot beside their parents’ bed, to bring them in for a feed and to put them back into their own cot when the feed is finished.

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My baby seems content after a feed but I am told I should wind him by putting him over my shoulder and tapping his back?

This is an old-fashioned belief and is an old wives’ tale as there is no evidence that putting a baby over your shoulder and tapping his/her back gets rid of wind. Babies will not retain anything in their stomach under pressure because most babies have free reflux from their stomach, which is a normal event in all babies. Consequently, wind which is in the baby’s stomach will be belched effortlessly, irrespective of how the baby is placed and this occurs when they are lying on their back asleep, propped up or however. Most of the wind in the baby’s abdomen is in their intestines and has to be passed as flatus and there is no amount of patting or rubbing on the back which encourages flatus production. This point seems to be overlooked by most people who are quite happy to give advice on getting rid of wind which is not based on any evidence.

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How often should baby have a dirty nappy and is it different for bottle or breast-fed babies?

Bottle and breast-fed babies have a very different stool pattern. Bottle-fed babies usually having a dirty nappy every day or at least every second day. Breast-fed babies on the other hand most frequently have a dirty nappy each time they feed.

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My baby seems to sleep a lot, and I have to wake him up for his feeds. Is he just lazy or is there a problem?

Babies need a lot of sleep because they grow during sleep and babies are growing incredibly quickly, usually at a rate ten to twelve times faster than adolescents. A baby of about six weeks of age will usually be two and a half inches taller/longer than they were at birth. Sleep is necessary for growth because you shut down all your energy requirements and put all your efforts into growth and growth hormone is produced during sleep for this specific reason, but baby also needs sleep to recover and to rest. Sleeping is not usually a problem provided baby is waking up and drinking sufficiently to have a normal urinary output (3-4 nappies per 24 hours) and a normal weight gain.

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Should he feed from both breasts? My baby only takes one breast at each feed. Is this alright?

This is alright, provided baby has normal wet and dirty nappies and is gaining weight. However, most babies need to feed from both breasts, particularly until the milk supply is established, and during periods of growth spurts.

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What is colic?

Colic is a periodic behaviour characterised by unexplained, persistent, apparent distress, fussing, crying, diminished soothability, excess activity and restlessness. It may escalate in the first 6 weeks and occurs at the end of the day in 10-20% of otherwise healthy infants during the first three months of life. It is important to ensure that there is no underlying reason for the symptoms described above. Unfortunately there is no effective cure for colic, however, factors are often identified which alleviate it.

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My baby was weighed today and has lost weight. Is this normal?

During the first week of life there is an acceptable weight loss which should not exceed 10% of the birth weight. Between day 10 and day 14, it is expected that baby will be on or above the birth weight. Failure to achieve this warrants evaluation by your Midwife, Public Health Nurse or Doctor. It is important to weigh baby regularly for the first few weeks. After 2 weeks, babies are expected to gain an average of 180 grams or more per week.

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My baby’s bowel motions are greenish-black. Is there something wrong?

Following birth babies pass a greenish-black bowel motion called meconium. There is a transition to a more regular bowel motion by the end of the first week. The normal bowel motion for a breastfed baby is yellow-orange in colour and may be seedy.

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Coombe Women & Infants University Hospital
Cork St.
Dublin 8.

Tel: +353-1-408 5200
Fax: +353-1-453 6033
email: info@coombe.ie

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