Your pregnancy, your midwife, your choice

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14 Jun

One to One Midwives: June is breastfeeding awareness month

June is breastfeeding awareness month and we are celebrating the great benefits of breast milk for you and your baby.

As well as being convenient and perfectly designed for your baby, breast milk also protects your baby from infections and diseases. Breastfeeding can build a strong emotional bond between you and your baby and also provides health benefits for you too.

Here at One to One we have dedicated midwife and mothers assistants (MaMAs) on hand to offer advice on breastfeeding before your baby arrives and for six weeks after as part of our unique post-natal care, as well as your dedicated midwife who is with you throughout your pregnancy.

Two of our MaMAs, Julie and Sarah, have given us their top tips for breastfeeding:

Research and speak to a MaMa before you have your baby – ask your midwife
Understand how small your baby’s tummy is: http://www.ameda.com/breastfeeding/the-first-12-months
Get off to a good start, eat well and keep hydrated
Take a vitamin supplement that contains vitamin D
Understand when growth spurts stages are and why your baby is doing them: http://kellymom.com/bf/normal/growth-spurts/
Good positioning and attachment
Sleep when baby sleeps
Know about feeding cues and being baby lead
Effective sucking/supply and demand: http://youtu.be/Zln0LTkejIs
Ask for support: One to One Mama support/breastfeeding groups.

Breastfeeding reduces the risk of:

• Infections, with fewer visits to hospital as a result 
• Diarrhoea and vomiting, with fewer visits to hospital as a result 
• Sudden infant death syndrome (SIDS) 
• Childhood leukaemia 
• Type 2 diabetes 
• Obesity 
• Cardiovascular disease in adulthood

For mums breastfeeding and making breast milk also has health benefits. Breastfeeding lowers your risk of:

• Breast cancer 
• Ovarian cancer 
• Osteoporosis (weak bones) 
• Cardiovascular disease 
• Obesity

One to One breastfeeding facts and figures:

Initiation rate for all women: One to One: 79% England: 73.9% 
Initiation rate for homebirth: One to One: 91% 
Still breastfeeding at 14 days: One to One (All Women): 69% England: NA 
Still breastfeeding at 14 days home birth: One to One: 81% 
Still breastfeeding on discharge (6weeks): One to One: 57% England: 47.2%
Still breastfeeding for home birth: One to One: 67%

* Figures taken from One to One’s Quality Report 2014/2015
** Breastfeeding information taken from www.NHS.uk

The Liverpool One to One Team will be joining the Breastfeeding Celebration Parade on Monday, June 20, to celebrate Breastfeeding Feeding Awareness Week. The Parade will assemble at St Georges Hall at 11:30AM and will officially start at 12:00PM. It will end at Chavasse Park close to 12:30pm. There will then be a picnic in Chavasse Park (weather permitting) and if it rains we would love to see you at John Lewis Café for cake and coffee! Midwife Lorna and Mama Michelle will be there.

To find details of Wirral breastfeeding events please visit: http://www.wirralct.nhs.uk/news-campaigns/news/latest-news/celebrate-breastfeeding-awareness-month-with-us

11 Aug

The Newborn and Infant Physical Examination (NIPE)

Shortly after birth, your baby will be offered a number of tests and examinations to screen for any health conditions that may be present. The Newborn and Infant Physical Examination (NIPE) is one of the tests offered and as the name suggests, consists of a physical examination of your baby. It will be offered to you within 72 hours of birth and again between 6-8 weeks of age.

The main purpose of the NIPE is to identify babies born with heart, hip and eye problems so that any necessary treatment can be started quickly. For baby boys, it also screens for problems with the testes. In addition, the health professional carrying out the examination will be looking for anything unusual about your baby’s general appearance and wellbeing that may indicate an underlying problem.

Before the start of the examination, you will be asked a few questions around your pregnancy, your own health and any medical conditions that may be present in any of your baby’s immediate family members. You will also be asked about your baby’s behaviour and feeding pattern since birth and should be given the opportunity to discuss any concerns you may have about your baby’s health and behaviour. Your baby will need to be undressed for part of the examination and although your baby may cry, the examination is not painful for your baby. You will be told the results of the examination immediately. If a problem has been found, a referral to a specialist may be necessary for further investigations and to confirm a diagnosis.

Although it is recommended that every newborn baby has a NIPE examination, you have the right to decline it, or part of it. If you have any worries or concerns about the examination then please speak to your midwife or other health professional. It is also important to know that not every condition will be identified during the NIPE, as some conditions don’t develop or show symptoms immediately. If you notice anything about your baby that you are worried about, you should therefore speak to your midwife, health visitor or a doctor without delay.

Post by Jo, One to One midwife

11 Jun

One to One Midwives supporting Tommys

Charlie was born in September with a wonderful One to One experience. Labour was quick at only 2 hours 40 minutes, getting used to being a mum to a new born again happened pretty quickly too and he is just growing up too fast!

The one thing that is taking far too long however, is me getting my body back into shape! Now I have never been slim (I love chocolate far too much) but pre-baby, I was healthy and enjoyed exercise.

With my first son (now 5 years old) I was straight back to Buggyfit for my 6 week post natal check. This time, the desire to exercise didn't return so easily! It is now 8 months on and while I have lost 'some' of the baby weight, this has been down to a “healthy-ish” diet and certainly not because of any exercise. I do not however feel any pressure to return to my 'normal' body size but I do feel some exercise with baby would improve my motivation, get the blood pumping and perhaps meet some other mums along the way.

So back to Buggyfit I go (once I have dug out my trainers from under the bed). The fresh air, adrenaline and opportunity to mix with other local mums is actually really enjoyable!

It was at my first session back this week that I heard about the 'Baby Race' being run by BuggyFit instructors across the country in aid of the fantastic Tommy's charity (www.Tommys.org/babyrace).

Anyone can participate in the Baby Race and it can be completed at your own pace. The event will be held in the park (I'll be going to the Cheshire Baby Race in Northwich) and it will be a great event to meet other mums, dads and carers, have some fun and support a great cause. Tommy's are hoping to invest the sponsorship raised to open a new research centre dedicated to preventing miscarriage, which affects 1 in 4 parents.

So I've signed up and now have no excuses! Charlie and I will be crossing the finish line (hopefully without the rain) with a full heart, great satisfaction and a renewed enthusiasm for exercise.

One to One Midwives will be at the Cheshire event to cheer us all on and offer their support to Tommy's with a donated raffle prize.

I urge everyone reading this to sign up to the Baby Race and join 'Team One to One'; it is a great opportunity to have some fun, exercise (without the pressure), meet some new friends and have a feel good factor for helping such a great charity that is close to our hearts.

Can we expect to see you there?

Post by Lucy Hughes, Marketing Supervisor and Brand Ambassador

01 Apr

Monitoring fetal heart rate in labour during a home birth

Your midwife has a choice of ways to listen to your baby's heart during labour. The most common is via a sonicaid, which is a handheld Doppler and you may be familiar with this method, as your midwife may have used this to monitor the baby throughout your antenatal period. Most sonicaids can also be used under water and so if you are planning a home birth with a pool, you won’t need to worry about keeping moving in order for your midwife to listen to the baby, she can work around you!

The benefits of the hand held Doppler are that you are able to hear your baby's heartbeat as well as your midwife, however some women prefer not to have a sonicaid to listen to their baby, so instead your midwife can use a Pinards stethoscope. This is a trumpet shaped, wooden, plastic or metal item and is placed onto your abdomen with the widest part of the Pinards and the flat part with a hole in the centre is where your midwife will place her ear in order to listen to the heartbeat. This is one of the oldest methods used to listen to the fetal heart. Your midwife should be trained to use this as sometimes sonicaids can break down!

There is another device, which is sometimes used and this is called a fetoscope. It is a little like the stethoscope your midwife uses to check your blood pressure but has an extra attachment shaped like a bar which your midwife places against her forehead and rests this against your abdomen and then listens to the fetal heart via the stethoscope.

The normal heart rate for a baby is between 120 bpm and 160 bpm, although there can be variations such as accelerations above 160 bpm or decelerations below 120 bpm which are normal.

In labour the midwives will listen to the fetal heart rate every 15 minutes whilst you are in established labour, for at least 1 minute after a surge/contraction. This is so we can determine how baby is coping with the labour and most babies cope very well. Sometimes babies become a little distressed and your midwife then needs to evaluate the situation. This will also depend on other factors, such as how far along in labour you are, position of baby, etc. This may present as the fetal heart having decelerations, especially if they are unprovoked, e.g. not caused by cord compression or could present as a Fetal tachycardia where the heart rate is above 160 bpm for a prolonged length of time. Your midwife is trained to evaluate the situation and to act as necessary. This may mean a trip into hospital to evaluate further.

In the last part of your labour, the expulsion phase where baby is being born, midwives listen to the fetal heart rate every 5 minutes, again to evaluate how baby is coping.

Some women like to use their own hand held Doppler’s to listen to the heartbeat themselves, but please be aware that you may not hear the true heartbeat as sometimes your own maternal pulse can be picked up and also you can sometimes hear the cord pulsating rather than the heartbeat.

If you are concerned at all about your baby please contact your midwife.

Post by Debbie Hibbs, One to One Midwife

20 Oct

Nub Theory

What is nub theory?

Is it true about the angle of the dangle?

Can you really find out your babies sex at 12 weeks?

Any best guess would be only slightly better than 50/50 and would have to be confirmed again at the anomaly scan at around 20 weeks. The honest truth is that it is very difficult for a sonographer to see clearly all the structures at dating scan and the genitalia of a fetus at this stage is very unclear and looks very very similar for both male and female foetuses.

'The correct visualization of any fetal part depends on many factors such as fetal position, amount of amniotic fluid and thickness of the abdominal wall. Establishing gender can sometimes be very difficult.'

The theory is as follows:

The following images are from 12-14 weeks.

Image 1: Supposed male fetus in development. With the male fetus, the genital tubercle usually creates an angle of greater than 30° with the lower part of the spine.

Image 2: Supposed female fetus in early development. In the female fetuses, the genital tubercle protrudes in the same direction as the lower portion of the spine with an angle of less than 30° relative to the backbone.

Various studies have supposedly been done to test this theory.

Studies have been conducted in Brazil, London (2studies) and Israel. Out of a total of 1619 pregnancies; gender was assigned and confirmed in 1424.

The results when combined together found that genre was accurately predicted at:

11 weeks 68%
12 weeks 88%
13 weeks 94%
14 weeks 98%

From: http://baby2see.com/gender/study_ultrasound.html#Brazil

I must highlight that I have searched one of the biggest online journal forums on the internet (which has never failed me when it comes to medical research) and I couldn't find any of these supposed studies!!

You must also remember ladies that not all sonographers will be trained to recognise and capture images like the ones here. This is not something we usually look at so early on.

I personally and professionally am not convinced. You may believe what ever you like though and I would LOVE to see the original articles and research if anyone has any links to them then please post them below.

Post by Sally Barnes, One to One Midwife

08 Oct

How to make bath times an enjoyable experience

How to make bath times an enjoyable experience

Bath time is one of the most enjoyable experiences to have with your baby, and if you plan, your baby will love their bath times. I would recommend that you ensure the room you plan to bath your baby in is warm and that you have everything you need ready in advance, including – your bath filled with warm water, a warm towel, toiletries, clean nappy, and clothes.

To ensure the water used is at the correct temperature (36-38 oC), put cold water in the bath first, and then hot. This reduces the chance of scalds. Test the water with your elbow (as hands can bear very high temperatures) before you put your baby in. It should feel comfortably warm. Your baby will enjoy bath time more if she is not hungry or overtired.

You can either bath your baby in their own baby bath tub or co-bath with your baby in your family bath. Either way try these simple steps to make it a pleasant experience.

Once you are ready;

• Undress your baby on a safe surface.
• Wrap your baby in a warm towel, keeping her head exposed.
• Cradle your baby firmly under your arm- supporting her head.
• Gently wash your baby’s head over the bath by using your free hand to cup the water and apply the water using your hand. Using a pea size amount of mild baby shampoo, gently massage it through and rinse. Be careful not to get the soap/shampoo in your baby's eyes - stinging eyes can put babies off bath time. • Place your baby back on the surface and gently pat dry her hair.
• Lower your baby feet first into the water, supporting her head and neck at all times.
If you choose to co-bath- rest your baby against your chest keeping their head exposed and out of the water and their body submerged in the warm water- just be sure the water is at the safe temperature for them. 
• With your free hand, gently splash water over your baby's body.
• Keep talking to your baby for reassurance and to let her know she is safe.
• When you have finished, take your baby out, wrap her in a warm towel and then apply a nappy and dress her. 
Please Note- It is not safe to leave a baby or toddler alone in water, not even for a second. 
Newborns do not require daily baths because they do not get dirty, and their skin is very delicate. Bathing once a week is more than enough for the first few months to protect your baby’s skin from becoming dry. As your baby gets older however, bath time can become part of your evening routine. Evidence-based guidelines recommend bathing a baby with warm water only for the first two-four weeks of life and the use of creams and lotions for dry skin should be avoided (Walker et al, 2005) 
Top and tailing is an alternative to bathing for your very young baby. This is a quick way to cleanse your baby and you can do this once a day.
• Undress your baby but leave the nappy on.
• Wipe your baby's face, neck and ears with some damp cotton wool you have wet in a bowl of warm water, and dry with cotton wool or soft warm towel.
• Cleanse your baby’s eyes using a dampened cotton wool ball dipped in cooled down boiled water-wipe from the inner to the outer eye, and discard the cotton wool-repeat of the other side with a fresh piece of cotton wool.
• Wipe your baby's hands and under her arms in the same way.
• With a newborn, wash any discharge from the cord stump with a dampened cotton wool ball dipped in cooled down boiled water.
• Remove her nappy.
• Wash her bottom and genitals well (wipe girls from front to back to avoid spreading germs from the bottom to the vagina) and dry.
• Put on a clean nappy, and replace your baby's clothes.

Reference Walker, L., Downe, S., Gomez, L. 2005. Skin care in the well term newborn; two systematic reviews. Birth. 32 (3); 224-228.


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