newsletter Feb06

The newsletter, July 2008

Travelling whilst pregnant

Going on holiday or on a short trip can, or rather must be an enthusiastic adventure even when you are pregnant. During these nine months, however, it is important to take some precautions to prevent fatigue and allow you to fully enjoy the trip.

Whether you travel by car, plane, ship or train, there is one basis rule: avoid staying still for long periods of time. Prolonged immobility slows the circulation of the blood, that tends to thicken and clot, especially during pregnancy when the hormones normally make the blood thicker. Try therefore to walk as much as possible. If you travel by ship there is no problem, if you travel by plane or train, and the journey is long, try to walk up and down the corridor, making sure you have your partner or a friend with you, who you can “grab” onto if the vehicle jolts suddenly. If you are travelling by car, try to make some short stops now and again at motorway rest areas to stretch your legs. Another tip is to keep moving your feet during the trip: move your feet up and down, extend your legs, rotate your ankles as this will help circulation. If you are travelling by plane, inform the hostesses of your condition, they are always most helpful.

The second rule which is applicable everywhere is: always choose comfortable, wide fitting clothes that do not force you to sit upright, use breathable materials (like cotton and linen), as perspiration increases during pregnancy. Take a light sweater with you to wear when you enter air conditions rooms on planes and ships, as the temperature is often a good few degrees lower than outside. Remember to wear comfy shoes, which are wide and with a 3 or 4 cm heel to encourage circulation. Take as less luggage as possible, without forgetting all your exam and scan results and the reports issued by your physician or gynaecologist. They often come in handy.

Generally speaking, airlines do not allow pregnant women to fly after the 32th week, but recently some allow women to fly up to the 36th week, on the condition they are in perfect health and their gynaecologist issues a statement that there is not risk of a premature birth. Discuss this with your physician and, if there are any problems, assess the possibility of using another means of transport. Airline staff are trained to deal with all possible emergencies, but it is better not to take any risks.

Remember to take a good supply of cool mineral water (especially on planes where the air is very dry) and some portions of dry savoury food, such as crackers or bread sticks. They are ideal for "filling" the hole in your stomach if it is a long trip and, above all they are useful against nausea which is common during pregnancy. Try to avoid, if possible, taking any anti-nausea medicines.

You have gone back to work, or you have started going out with your partner again but you don't want baby to miss out on any of the benefits of maternal milk.

We have the solution: you can simply extract it and store it, so that baby can drink it from a baby bottle when you are not there.

Storing your milk, which can sometimes be more than baby actually needs, means you have a practical extra supply for those moments when you produce less yourself, something totally natural.

You can also deliver extra milk to the Mill Banks which some Italian hospitals have set up to provide maternal milk to newborn babies who, for a variety of reasons, need it as their own mothers are not able to provide it.

Unfortunately this service is only up and running in a few cities, and your local hospital will be able to give you more details.

Milk can be extracted manually, but this procedure requires a little experience; we recommend you ask your midwife for some practical demonstrations on how to do this properly.

It is quicker and easier if you use a manual or electric breast pump, that gently sucks out the milk which collects in a container that you can store for future use.

If you intend to store the milk, always use special clean and sterilised containers, and fill them with enough milk for one feed; then close the top firmly and write the date on the container.

In cool weather, milk can be stored at room temperature for up to 8 hours without losing its nourishing values. It can be stored in the fridge for up to 72 hours, in the freezer for up to 3 months and in the deep-freeze at -18°C for no more than 6 months.

To thaw the milk move it from the freezer to the refrigerator, or allow it to thaw gradually at room temperature.

When it has thawed completely, you can give it to baby after heating it up using a bain marie pan, bottle warmer or the microwave.

Soft, smooth, and above all delicate: this is how we can describe a baby's skin, which normally needs care and attention, but even more so in summer, when the heat can cause sweating and contact with nappies can cause nappy rash and irritation. A few hygiene tips can keep this situation under control.

One of the most frequent disturbances in summer is called sudamina, it causes small blisters to form on the surface of the skin and they make it red and rough to the touch. They are caused by profuse sweating, that does not evaporate and remains trapped in the skin pores, which causes itching and makes the baby irritable. To soothe this disorder, bathe the baby in the evening in a little lukewarm water and add a spoon of bicarbonate of soda or rice starch, which decrease the skin's pH level. Cleanse the areas where your baby sweats the most: his chest, neck, the folds at the top of his legs and the genital area. Gently pat the skin dry using a soft towel. During the day, try not to use too much waterproof sunscreen as this also obstructs the pores.

Another common disorder in summer is nappy dermatitis, more commonly known as ‘nappy-rash', which is caused by contact with the urine which stagnates in the waterproof material. To prevent this disorder, or calm it when it exists, try to change baby more often when it is hot and as soon as you realize that it is "full" of pee. Also try to change him more often during the night. Cleanse baby's skin using a delicate milk or a light non-soap cleanser, and always apply some protective zinc oxide cream all over his bottom and genitals. You can also wait before putting a new nappy on baby, but make sure baby's genitals do not come into contact with sand or dust that can cause infections and irritation. Always lay out a towel sheet on the beach or lawn for baby to move around on.

The choice of clothing is also important to prevent heat irritations. During the summer, you can remove his bodysuit and dress the baby with a cool cotton t-shirt, that allows the skin to breathe and keep it fresh. You can leave his legs uncovered, and also his feet. If you really want to dress baby up, choose a pair of light cotton shorts that do not restrict his movements. Choose light colours that reflect the light and heat, and avoid dark colours such as navy blue, which attract the sun and increase body heat.

A grazed knee whilst running, a fall off a bike, a scratch by next door's cat after too much cuddling. Children love to play and be adventurous, which will naturally lead to small accidents now and again. Leave them to enjoy themselves and don't' worry too much. Normally they will just need some medication by grown-ups.

The classical "grazed knees" after falling off a bike or when roller skating, that bleed a little need to be rinsed under running drinkable water and, possibly, with a little soap to eliminate all traces of dirt and germs. Disinfect the area with a non-alcohol content liquid and protect the area with a sterile gauze kept in place with a bandaid or a bandage.

If the child is injured by a splinter of glass, a knife or bitten by a dog or a cat, follow the instructions above, then visit the local hospital to check if the child needs a tetanus, booster or anti-rabies injection.

In the case of burns caused by a fire, hot water, an iron or chemical substances, the first thing to do is remove the garments that have come into contact with the burnt area. Then place the burnt area under fresh running water for at least ten minutes, to calm the pain and cool the skin. Then disinfect the skin with a cream that prevents infections and helps the skin recover. If necessary, protect the area with a sterile gauze held in place by a bandaid. Don't puncture any blisters that may form, and don't resort to any "old wives' remedies", such as the application of olive oil or potatoes.

If the child takes a blow, disinfect the area as indicated above, and then apply an ice pack to decrease the swelling (leave it on for ten minutes, then remove it for a while and replace it again); try to assess how harsh the blow was. If the child took a blow to the head, but was not knocked out, immediately cries and is as lively as normal, it generally means that the blow was not serious. It is recommended however to observe the child's behaviour over the 48 hours following the accident: if the child loses consciousness, or looks drowsy at "abnormal" times of the day or vomits, you should go immediately to the local casualty department. If the child received a "blow" to another part of the body - an arm, a leg or a hand - it is important to check that the pain progressively decreases, the swelling goes down and that he starts to use the limb normally again. If the symptoms persist, you should go to casualty to check there are no fractures.

Is an only child, a spoilt child?

There are children with one or more brothers or sisters, who are unbearably ill-mannered. And there are only children who are lovable and very well behaved. In short, it is normal that when children – by choice, by chance or by obligation - grow up without a brother or sister, the attention of their parents and relatives is all on them; this does not however necessarily mean that only children are spoilt.

What really matters is being able to create the right conditions for children to grow up without a brother or sister in a happy and well-balanced atmosphere. To start with it is vital to look at your roles as parents, to overcome any senses of guilt that often fathers, and above all mothers, have in the case of only children: the fact that you have not given your child a brother or sister is not a crime or anything to be ashamed of. Happy, smiling parents, convinced of their choices, are the best educators for children.

Secondly, it is essential to learn how to say no from the very beginning. When children start school, they are all treated equally, and those are used to being the centre of attention may find it more difficult to fit in and socialise. Try to avoid making you only child the centre of your universe and don't give in to every single request. This is a useful exercise for future life: knowing how to accept and to manage refusals makes people stronger in their job, in their friendships and their sentimental choices.

Try not to project your own expectations on your child, by encouraging him to imitate you and take up you own hobbies and interests. It is positive to be role model for your child, but you must respect his own personality, and not try to make him into your little clone, and above all you must not feel disappointed when this doesn't happen. You have to maintain your parental role: give you child all the love in the world, be his reference point, someone who deserves attention and respect, without however trying to be the brother or sister the child doesn't have.

Allow your child to mature his or her own socialization instincts by playing with other children, not just infant school friends, but also cousins, the children of friends and those you meet at the park. Your child will learn to get along with children he doesn't' know and feel at ease, be just one of many, and he will get used to handling his desires and wishes within a context where he is not alone. Don't be afraid he will ‘hurt himself' when he is playing with the others: it is much worse for him to spend too much time with his grandmother or a nanny, however loving they are.

Finally, give him a few daily rules, so that he does not get used to feeling like a little prince. It doesn't take much: ask him to tidy up his toys after play time, or to put his clothes away when he gets ready for bed and make sure he waits for his turn to speak; these are not impossible feats for a child but easy exercises that have the precise objective of teaching him how to cohabitate in a civil manner. Small gestures which will be important for his future.