Expecting your first baby? Your questions answered

Expecting your first baby? Your questions answered

by Myriam Panard, International Board-Certified Lactation Consultant (IBCLC) for Lansinoh France

Firstly, congratulations on your first pregnancy! Whether you’re completely new to the baby scene or you’ve been around your friends’ babies a lot in the last few years, you’re bound to have lots of questions and a range of emotions. You’re facing a massive change in your life and it’s normal to feel all kinds of things. It can be quite overwhelming, so be patient with yourself. You have a lot of new things to experience and learn and even if it feels like a lot, you will be ready when the big day arrives.

Over the next few months your body, emotions and relationships will undergo some major upheavals. Lower energy levels combined with high levels of hormones can make for an emotional roller-coaster. Having the right support will help you get through these periods, so make sure you talk to your partner, mum, or friends for reassurance.

What are the early signs of pregnancy?

Some signs of early pregnancy are unmistakable, even if not all women experience them in the same way.

Nausea during pregnancy

Feelings of nausea – and, yes, actual vomiting – begin for many women four to six weeks after their last period. For most women, this peaks at around 8 to 12 weeks and usually disappears between 15 and 17 weeks.

Fatigue during pregnancy

Fatigue is a common symptom,[1] as are firmer and more sensitive breasts that increase in size – both band and cup measurements. This is because as early as week 4 of your pregnancy, your breasts are growing milk duct cells and lactocytes (milk-producing cells), within the glands of your breasts, preparing your body to feed your baby.[2]

These physical changes are often accompanied by questions and concerns about the prospect of becoming a mother. Try to surround yourself with family and friends who offer a positive attitude, celebrating your pregnancy and providing you with the support you need to help you deal with any difficult symptoms.

When can I feel my baby move?

In the second trimester of pregnancy (weeks 13 to 27), you’ll feel baby movements in your belly for the first time – a magical moment that opens up a special connection as your baby grows and develops. With many of the more challenging physical symptoms of early pregnancy gone by now, you blossom! You start to picture your future, your mood is more peaceful, you feel more connected with your baby, and you have more energy.

In the third trimester of pregnancy (weeks 28 to 40), backache and blood-flow issues, such as high blood pressure or pre-eclampsia, become troublesome for some women. You might have difficulties falling asleep, or find your sleep disturbed by heartburn, leg cramps or pressure on your bladder. You may feel some anxiety as the birth date approaches and start thinking more about your birth plans.

Pregnancy skin care

Throughout pregnancy, your body is expanding and stretching to accommodate your growing baby. Although skin elasticity differs from one woman to another, taking good care of your skin can help relieve any dryness and itchiness associated with stretching. Apply a moisturising body lotion or oil every day, especially on the tummy, breasts, hips and buttocks as there’s some (limited) evidence that this may also reduce your chances of developing stretch marks.[3] If you do get stretch marks, remember they are harmless and very common, affecting around eight in ten pregnant women.[4]

Taking time out to do things you enjoy during pregnancy is good for you. Why not indulge and relax with a massage given by your partner or a professional who specialises in pregnancy massage? Just make sure they use products that moisturise effectively and are safe for pregnant women.

Regular exercise in pregnancy is great for your physical health and can boost your spirits, ease low moods, and help you sleep better. Activities that are gentle, promote blood flow and reduce tension – such as swimming, prenatal yoga, tai chi, qi gong, and walking – are ideal. It’s a good idea to speak to your healthcare professional to get the go-ahead before trying a new form of exercise during pregnancy.

Pace yourself – some days you will have more energy than others so don’t give yourself a hard time about your fitness regime. Avoid stressful situations and learn to relax. Some women find techniques such as pregnancy meditation or breathing exercises that can help to calm them. They’re also useful preparation for labour and birth.

Sex during pregnancy

Many women question whether it’s safe to have sex during pregnancy – the answer is, it is perfectly safe to have sex whilst pregnant unless your healthcare professional tells you not to. It is normal for your sex drive to change during pregnancy. Some women may experience increased levels of sexual arousal for their partner. Some women simply don’t want to have sex – it’s all due to hormones. The most important thing is to talk about your feelings with your partner and remember that there are many ways to be close to each other.

Pain management during pregnancy

About 70% of pregnant women experience back or pelvic pain during pregnancy[5]. It’s very common! If you have back or pelvic pain, digestive discomfort, or any other disorder that disrupts your daily life, speak with your healthcare provider, and consider consulting a physiotherapist, osteopath, or chiropractor as well to help relieve your symptoms. Choose someone who has experience working with expectant mothers and always follow your primary healthcare provider’s advice.

Increasing numbers of future parents are choosing a holistic approach to preparing for the arrival of their baby. Prenatal singing, sophrology (a relaxation technique based on yoga), hypnosis, haptonomy (connecting with your unborn baby through touch), aquatic preparation (such as aquatherapy and aquanatal exercise) and hypnobirthing are all gaining in popularity, so give them a try if they appeal to you.

Pregnancy diet

It is recommended to eat and drink well during pregnancy without the need to go on a diet as your baby will need the right nutrients to grow. However, there are a few foods and drinks that you should avoid.

Alcohol and pregnancy

When it comes to your diet in pregnancy, only one item is truly not allowed: alcohol. So, how does alcohol affect pregnancy? Even in low doses, it can have harmful effects on foetal brain development. Alcohol passes from your blood into the baby’s placenta and too much can be extremely harmful to their development. It’s safer to avoid it completely.

Foods to avoid during pregnancy

As far as all other foods are concerned, enjoy yourself while being cautious and ensuring good hygiene. Avoid foods that increase your risk of contracting listeriosis or toxoplasmosis, as these infections can have serious adverse effects on the developing foetus. The greatest risks come from raw or undercooked meat, raw fish and seafood, unpasteurised milk, raw eggs, deli meats, soft cheeses, and raw milk cheeses.

What to eat during pregnancy?

Aim to eat a balanced diet with plenty of fruit and vegetables, protein, and carbohydrates. If you think you’re not getting sufficient vitamins from your diet, your health professional may recommend special dietary supplements for pregnant women. If you’re a strict vegetarian, and especially if you’re vegan, you need to take a vitamin B12 supplement. This vitamin, found only in animal proteins, is vital for the development of your baby’s brain and nervous system.[6]

Vitamin supplements in pregnancy

Another essential vitamin is B9, or folate, which helps prevent serious neural tube defects including spina bifida. Ensure you get enough by taking a 400-microgram tablet of folic acid every day for at least the first three months of your pregnancy (and ideally beforehand too) as well as by eating folate-rich foods such as leafy green vegetables, beans and fortified cereals.[7]

Vitamin D regulates the amount of calcium and phosphate in your body to support the healthy development of bones, teeth, and muscles. Although you get some vitamin D from sunlight and foods such as eggs, oily fish, and red meat, most people don’t get enough in their day-to-day lives so all pregnant and breastfeeding women are advised to take a daily supplement of 10 micrograms of vitamin D.[8]

Stocking up on iron during pregnancy

Almost 25% of pregnant women in developed countries have anaemia, which can cause a range of problems including fatigue, increased pressure on the cardiovascular system, and a higher risk of premature birth or low birth weight.[9] Avoid anaemia by eating iron-rich foods, for example, red meat, beans, nuts, whole grains, dried fruit and leafy green vegetables. Your routine pregnancy blood-tests should indicate whether you are anaemic and need to take an iron supplement. If you have any concerns, ask your health professional for advice.

Caffeine during pregnancy

Some studies have linked a high intake of caffeine during pregnancy with an increased risk of miscarriage[10] and delayed foetal growth,[11] so it’s best to steer clear of strong coffee and caffeinated energy drinks.

How much weight do you gain during pregnancy?

Weight gain during pregnancy varies considerably from woman to woman. If you feel nauseous or suffer from vomiting in the first trimester, you may lose weight before putting it back on in the following two trimesters. If you are already overweight or are diagnosed with gestational diabetes, your health professional will recommend close monitoring of your diet.

Smoking during pregnancy

Smoking while pregnant is strongly connected with a higher chance of miscarriage and reduced infant birth weight, as well as birth defects and increased risk of cot death,[12] so avoid it in all forms.

Medical checks

Depending on whether your pregnancy is straightforward or high risk, you may be monitored by a general practitioner, gynaecologist, obstetrician, or midwife. They will prescribe a range of blood and urine tests over the course of your pregnancy to check for any potential complications. Your partner may also be offered a health check.

During your first trimester, you’ll have an early prenatal interview with your healthcare professional. They’ll discuss the key moments of your pregnancy and explain current medical recommendations. You’ll receive follow up appointments for later in your pregnancy.

Ultrasound scans during pregnancy

You’ll typically be offered pregnancy ultrasound scans at the following intervals:

  1. Between 11 and 14 weeks after your last period, to confirm your due date, find out if it’s a single or multiple pregnancy, and detect certain health conditions.
  2. Between 20 and 25 weeks to check your baby is growing healthily and screen for a wider range of medical conditions.
  3. Between 30 and 35 weeks to determine the location of the placenta, the position of your baby in the womb, and the likely birthweight (although this can’t always be predicted reliably).

Prenatal consultations take place once a month starting from the third month, with additional examinations if necessary.

For your own health and that of your baby, you should follow any guidance you’re given by qualified medical professionals during pregnancy. Don’t be tempted to self-medicate.

Preparing for childbirth

Will you give birth in a hospital, birth centre or at home? Your choice will depend on where you live and the risk level of your pregnancy, as well as your personal preferences and knowledge of the establishment and medical team.

Normal Care: normal newborn care is delivered by a mother with the support and guidance of her midwife, either on a labour ward, a postnatal ward or at home.

Transitional care: neonatal transitional care (NTC) is care additional to normal infant care, provided in a postnatal clinical environment by the mother or an alternative resident carer, supported by appropriately trained healthcare professionals.

Special care: care provided for babies who require additional care delivered by the neonatal service but do not require either intensive or high dependency care

High dependency care: care provided for babies who require highly skilled staff but where the ratio of nurse to patient is less than intensive care

Intensive care: care provided for babies who are the most unwell or unstable and have the greatest needs

Most parents-to-be are offered antenatal classes to prepare for childbirth. These may be run individually or collectively at an independent midwifery practice or your local maternity unit. It’s helpful if the baby’s father or another birth partner attends with you.

These sessions give you information and aim to reassure you about the legitimate concerns you may have about giving birth and caring for a newborn (for example pain, tearing or episiotomy, caesarean section, postpartum recovery, and infant feeding). Some hospitals provide sessions specifically aimed at future fathers and birth partners as they may have their own fears about the birth and care of their first child.

As well as being informative, these sessions and discussions often create a bond between participants. They can be a useful way of finding a support network, and even long-term friendships, reducing the feelings of isolation frequently experienced by new parents.

Mother’s breast milk

Do you plan to breastfeed? There are lots of myths and misunderstandings about breastfeeding, so make an informed choice by getting information from reliable sources. Seek support from other women too, so you can learn from them, share your experiences and support one other.

For the first few days following the birth, your breasts will produce small amounts of colostrum, a thick, yellowish fluid quite different to mature breastmilk. Colostrum is high in protein and growth factors, and it is particularly rich in antibodies that defend against stomach bugs and other infections.[13] Most expectant mums start to produce colostrum in pregnancy so don’t worry if you notice your breasts leaking in the shower or bath or inside your bra. It’s normal! You might want to buy some disposable or reusable breast pads to put inside your bra. Even if you are unsure about breastfeeding long term, ensuring your baby has your colostrum will help give them a healthy start in life. Breastfeeding also supports the bonding process by stimulating the release of oxytocin (the ‘love hormone’) in both you and your baby.[14]

Benefits of breastfeeding

Breastmilk is full of live cells and bioactive ingredients that protect your baby against sickness and diarrhoea, colds and chest infections, ear infections and even sudden infant death syndrome. In the long term, babies who were breastfed are less likely to become obese or to develop type 1 or type 2 diabetes or leukaemia as they grow up.[15] By breastfeeding you’ll also lower your own lifelong risk of developing breast and ovarian cancers, cardiovascular disease, and type 2 diabetes.[16] And the longer you continue, the greater the benefits for both of you.

If you’re planning to breastfeed you’ll want to invest in some nursing bras, breast padsnipple cream and maybe some breastfeeding tops or dresses and a breast pump too. It’s also worth having the contact details of a lactation consultant or breastfeeding counsellor handy in case you need support. (One US study found that 92% of breastfeeding mums have concerns by day three.[17]) You might not feel as if you’re saving money when you’re spending out on this equipment, but experts have calculated that exclusive breastfeeding saves a family £880 to £1,500 during their baby’s first year.[18]

Breastfeeding is also the most environmentally friendly way to feed your baby. Your breastmilk needs no intensive dairy farming, factory emissions, transportation, or packaging!

A strong support network

Bearing a child, giving birth, and breastfeeding are all wonderful experiences to treasure. Yes, there are times when you’ll feel anxiety, exhaustion, discomfort, even pain, but becoming a parent is also one of the most precious and fulfilling of human experiences.

Ensure you feel confident and supported through this unique period in your life by creating strong, rewarding relationships with:

  • Your partner, family members or close friends whose help and encouragement you can call on when needed
  • A trusted health professional who can refer you if necessary, to other professionals in their network (lactation consultant, physiotherapist, osteopath, chiropractor)
  • Other pregnant women or mothers who will comfort you and with whom you can share your experiences of motherhood

Your journey from newly pregnant to new mother is both exciting and demanding. By looking after yourself throughout and having good support networks around you, you’ll be best able to nourish and nurture your baby from the womb to the outside world.

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References

[1] www.ncbi.nlm.nih.gov/pmc/articles/PMC5096665/

[2] https://opentextbc.ca/anatomyandphysiology/chapter/28-6-lactation/

[3]  www.ncbi.nlm.nih.gov/pmc/articles/PMC5782435/

[4]  www.nhs.uk/conditions/pregnancy-and-baby/stretch-marks-pregnant/

[5] Kesikburun, S., Güzelküçük, Ü., Fidan, U., Demir, Y., Ergün, A., & Tan, A. K. (2018). Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Therapeutic advances in musculoskeletal disease, 10(12), 229–234. doi:10.1177/1759720X18812449

[6]  https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/

[7] https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/

[8]  https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-minerals-supplements-pregnant/

[9]  www.ncbi.nlm.nih.gov/pmc/articles/PMC5779562/

[10]  www.ncbi.nlm.nih.gov/pubmed/26026343

[11] www.bmj.com/content/337/bmj.a2332

[12] www.ncbi.nlm.nih.gov/pmc/articles/PMC3881126/

[13] www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/

[14]  www.ncbi.nlm.nih.gov/pmc/articles/PMC6096620/

[15] www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/; www.ncbi.nlm.nih.gov/pmc/articles/PMC3508512/

[16] www.ncbi.nlm.nih.gov/pmc/articles/PMC3508512/

[17]  www.ncbi.nlm.nih.gov/pmc/articles/PMC3784292/

[18] https://www.hhs.gov/surgeongeneral/reports-and-publications/breastfeeding/factsheet/index.html

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