After The Birth (Postnatal)

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Breastfeeding

Breastfeeding gives your child the very best start in life, but it is not always easy, especially when you are doing it for the first time. I sometimes feel that breast-feeding represents a greater challenge to new mothers than the birth itself, especially the first time. Latching and settling are the main challenges. The midwives looking after you will help you with attachment and feeding. You may receive quite contradictory advice on techniques and strategy. That simply reflects the fact that there are many different ways of doing things. My advice is to try everything and see what works for you, and ask for help. There is a lot of help available, including in your home, if needed.

Silverettes nursing caps are the new way to promote soothing and healing of nursing nipples. Hydro-gel pads and Lansinoh cream are generally less encouraged, because of possible links to mastitis, but they do work well for some women. Nipple shields, under midwifery care, can help some women. I can prescribe Motilium for you if your milk supply needs to be increased. Some women experience vasospasm of the nipple when feeding, which can be very painful, and cause your nipples to go white or blue. Nifedipine and some ‘natural’ therapies can be effective treatments for vasospasm.

If you are breast feeding for the second time you may experience intense cramping “after pains” with feeding, that you did not have the first time. These will usually settle after a few days. Taking pain relief tablets, such as Panadol and anti-inflammatory medication, just before feeds, can be a real help.

I am also mindful that not all mothers are able to or want to breast feed, so if you have had a bad experience with feeding previously or you do not want to breast feed then please let me know. I can prescribe Dostinex to suppress your milk supply, if necessary. A firm bra and cabbage leaves also help.

Please contact my midwife team by text, before you leave hospital. They will usually arrange to do a post-natal consultation. Please contact the team by at other times if you need their help or advice. Text message is best. They provide an exceptional service, that has been of tremendous benefit to many women, especially those who have experienced difficulty with feeding or settling. They provide a single telehealth home check, and are not contactable on some days, but can find help for you if needed.

Please remember the team cannot provide an emergency service. In an emergency antenatally or postnatally please ring delivery suite at your hospital. Do not delay.

In addition to the support from my team you may need assistance from a lactation consultant or mothercraft nurse. The drop-in classes at the hospital stopped during COVID-19 but are resuming.

For extra support at home I recommend the following:

Lactation Consultants	Rochelle Levinson 0432 180 899 or rochelle@themothershub.com.au
–	Cathy Short 0420 790 073
–	Cara Suttner 0425 371 725
–	Jeannie Thomas 0415 662 991
Inner West	Maddie O’Connor 0412 524 848
Coogee Beach Doctors	Ellen Gulson 0403 684 365
Parenting Support	Debra Cross: 0415 381 671 (also provides a doula service)
–	Jennifer Hazi 0490 045 416

Expressing Colostrum from 36-37 Weeks

Some babies may experience difficulties with feeding or maintaining their blood sugar levels during the first few days after birth and therefore require supplementary feeds. Expressing colostrum before birth, may decrease the need of your baby requiring or being given infant formula after birth.

Colostrum can be safely stored in the freezer and given to the baby soon after birth once defrosted. It is recommended to express by hand into a syringe rather than using an electric pump because colostrum is too thick to be collected by a pump.

A study including 635 women demonstrated that here is no harm in advising women with diabetes in pregnancy at low risk of complications to express breastmilk from 36 weeks' gestation. (DAME study)
Please refer to a hand expressing video: breastfeeding.asn.au or globalhealthmedia.org

Without Prejudice. Copies of this letter are not to be released without prior permission. This letter is intended for the exclusive use of the person or persons to whom it is addressed and may contain sensitive information or information that, by law, is privileged or confidential.

Generally you may commence expressing at 36-37 weeks gestation. Begin with 5 to 10 minutes of expressing on each breast; once or twice a day. If it is comfortable you can do longer and more often. Please use a fresh syringe each time. Sometimes expressing can initiate contractions. If so it may be advisable to stop and continue when you feel ready to go into labour.

Syringes and red caps are available from Dr Sen’s secretaries. Ring 9363 9474 to confirm availability.

Expressing must be comfortable; seek assistance from a health professional if you experience any discomfort. If you require additional support, please text Michele (or Chantelle) on 0417 821 438

Collecting and storing your colostrum

Wash hands and sit comfortably. You may want to place a warm (not hot) cloth over your breast
Make a C with your hand and cup your breast with the thumb uppermost and 4 fingers under breast away from areola.
Press gently back toward your chest then squeeze the breast with your thumb and fingers.
You may not see anything coming out straight away it might take a bit of practice.
When colostrum is pearling up or dripping easily, collect the colostrum directly into the syringe.
When milk ceases to flow, rotate the position of your fingers and thumb around the areola (imagine a clock face) and repeat the expressing process.
Swap to the other breast when the flow slows down or after two to three minutes.
Use each breast twice during each expressing session.
Colostrum can be collected in the same syringe for both breasts.
Seal the syringe with the red cap, Place colostrum straight into the freezer after expressing. Place the syringe into a zip-lock bag before putting into the freezer.
Label the syringe and bag (separately) with a sticker detailing the date and time you expressed. If you are bringing it to the hospital make sure you check the ID details and initial it.
The frozen colostrum can be stored for up to three months in the freezer

Transporting colostrum to the hospital

Your expressed colostrum (fresh or frozen) must be transported to hospital in a cooler pack with ice bricks to maintain the temperature. The midwives will show you where to place the colostrum into the hospital freezer. Frozen colostrum will defrost in the refrigerator and once fully defrosted must be used within four hours or discarded. Once defrosted, colostrum cannot be re-frozen.

What happens after the birth of my baby?

You will be encouraged to have skin to skin contact with your baby in the first one to two hours following birth, including caesarean births, if possible.
Breastfeeding is encouraged and should be unrestricted.
If your baby is experiencing difficulties or is uninterested in breastfeeding at this time you will be encouraged (and assisted if necessary) to express some colostrum to give to your baby. You may. also use any colostrum you have brought into hospital with you.
Should your baby continue to experience challenges with feeding at the breast or their blood sugar levels are low, your Paediatrician will advise you on further treatment and feeding.

Breastfeeding – Tips for New Mothers

Breastfeeding and breastmilk are very important. They benefit the health and well-being of mothers and babies, their families, society and the environment. Not breastfeeding increases the risk of a number of illnesses and health conditions. Breastmilk alone is perfectly suited for babies for the first six months after which appropriate family foods are introduced. Breastmilk continues to be the main food for the first twelve months. Cow’s milk is suitable from twelve months of age. Mothers will slowly stop breastfeeding when they are ready, many continue well into baby’s second year.

The Early Days

Skin to skin contact as soon as possible after birth is very important for your baby. It helps your baby know who you are and encourages breastfeeding behaviours.
Offer the breast as soon as your baby looks interested. Newborns are very alert and will seek the breast in the first few hours.
After an early good feed some babies are very sleepy; this helps mum recover from the birth.
The small amounts of colostrum available at this stage are important for baby’s immune system.
Within a couple of days most babies will start to get hungry and breastfeed between eight and twelve times in a 24 hour period: many of those feeds at night.
Breasts can become very firm and lumpy for a few days. Feed regularly and change your baby’s position at the breast. Expressing milk softens the areola and helps with attachment.
If breasts are uncomfortable, use cold compresses, gentle massage and pain relief according to the pharmaceutical manufacturer’s directions.
Ask your midwife to sit with you and talk through a feed as correct positioning and correct attachment will prevent problems.
It will take time and patience to learn this new skill.
Keeping baby close day and night will increase your confidence and understanding of their hunger and tired signs.
If your baby is not with you because he/she needs to be in the neonatal or special care nursery, ask for help with learning how to express. This will stimulate your supply and provide milk for your baby. Information on expressing and storing breastmilk is also important. Whenever possible try to have skin to skin contact (kangaroo care) with your baby.

Hunger Signs (cues)

Stirring from sleep with yawning and stretching.
Mouthing and licking lips.
Bringing hands to mouth.
Crying is a sign of distress and will occur if response to other signals is slow.

Which Breast and How Long

Alternate the breast you start with at each feed.
In the first few days try to keep the stimulation even for both breasts. Once the supply increases aim to drain one breast well at each feed.
Offer the second side if the baby looks interested.
Most babies will come off themselves when ready; there is no need to time feeds.
As baby gets older and more efficient the feeds will shorten.

Positioning

Wash your hands.
Get comfortable, support your back.
Unwrap your baby for closer contact.
Turn your baby on his or her side facing you.
With your hand support your baby’s neck and shoulders rather than the head.
Use your forearm to keep your baby close to your body.
Baby’s chin needs to be touching the areola and the nose in line with the nipple.

Attachment

Wait for baby to open his/her mouth very wide. You may need to stroke baby’s lips with your nipple or express a little milk into baby’s mouth.
Direct your nipple to the roof of your baby’s mouth. Keep your fingers as far back as possible to be sure your baby takes in plenty of breast tissue and not just the nipple.
The first sucking is rapid, followed by a slower suck/swallow pattern with regular pauses.
Nipple shape should not be distorted when your baby comes off – if it is, there may be an attachment problem.
Nipple tenderness can be normal in the first few days, but continuous nipple pain, cracks and bleeding are not – ask for help.

First Breastmilk: colostrum

Produced from around 16 weeks of pregnancy it can be clear to yellow or orange in colour. It has little fat, sugar or water.
The high levels of immune defence factors stimulate the baby’s immature immune system.
It satisfies baby’s hunger and thirst, there can be a few drops or as much as 5–15 mls.
It is a natural laxative to help your baby pass meconium and reduce the chances of developing jaundice.

Mature Breastmilk

Milk volume increases (or ‘comes in’) from three to five days, and matures over two to four weeks. Your full firm breasts will soon settle.
Milk at the start of the feed can look a ‘watery’ whitish blue colour – it satisfies baby’s thirst.
Towards the end of the feed it looks creamy as the fat concentration increases. These extra calories will satisfy baby’s hunger.

Night Feeding

Many babies in the first few months will naturally sleep more during the day become wakeful in the late afternoon/evening and want to catch up on their breastfeeds.
Most babies will always have at least one or two breastfeeds overnight to maintain adequate growth and their mother’s milk supply.

Some Issues to Consider

Most women make plenty of milk for their baby if they feed according to baby’s needs rather than a schedule.
Breastmilk is digested very quickly and babies have small stomachs. There is generally no recognisable pattern at first.
Avoid giving a bottle feed of formula to help an “unsettled” baby or help establish a “routine”. This may have unwanted side effects.
Trying to alter a baby’s natural pattern or substituting breastfeeds with formula can lead to engorged breasts, mastitis or a reduction in milk supply. There is also a risk of the baby developing allergies or other health issues.
Some babies will not breastfeed effectively because of the differences in the sucking action required for a teat or dummy.
If you have any concerns about your breastfeeding it is important to talk to a health professional skilled in breastfeeding or an Australian Breastfeeding Association Counsellor.

Adapted from NSW Health Brochure. Reference: www.seslhd.nsw.gov.au

Early Childhood Centre Nurse

You will be given the phone number of your local Early Childhood Centre and advised to call and make an appointment for a visit for your child with the family health nurse. Generally first visits are either done in your home or at the centre a few weeks after your baby’s birth. There is often a long wait, so please ring to book your visit as soon as possible after the birth.

After that all visits are in the early childhood centre. The nurse will be able to advise you regarding all aspects of care of your baby. They will also provide comprehensive assessments of your child’s growth and development and offer support to parents who are experiencing difficulties with parenting. The nurse will encourage you to attend the centre regularly, so you can access the information sessions and the parents’ groups (mothers’ groups).

Remember to take your baby’s blue book, so that your baby’s weight and progress can be recorded.

Circumcision

If you have a son and would like him to be circumcised then this can easily be arranged. It is now no longer done immediately after birth, but can be done soon after discharge from hospital. From a medical perspective the risks and benefits of circumcision are evenly balanced in Australia. In countries with very high rates of HIV there is a theory that male circumcision may reduce HIV transmission.

The main benefit for performing circumcision is for religious or cultural reasons. Most little boys would like to look like and be like their dads and their brothers. They may feel self-conscious if they look different from other boys at school. This remains a rather controversial topic, both on medical grounds and legal grounds, with passionate advocates for and against circumcision. You might like to read the American Academy of Pediatrics’ statement and the discussion that follows:
www.pediatrics.aappublications.org/content/130/3/585

If you are planning circumcision purely as a medical procedure I can recommend two paediatric surgeons, who will perform the procedure either soon after the birth under local anaesthetic, or after 12 months of age under general anaesthetic:

Dr Gideon Sandler, Suite 704, Level 7, 3 Waverley Street, Bondi Junction. Tel: 02 8307 0977

Dr Anthony Dilley and Dr Carolyn Russell, Gymea and Randwick. Tel: 02 9540 4409

If you would like to have your son circumcised as part of the Bris then you may have your own Mohel. I recommend Dr Gideon Sandler or Dr Haddon Suttner on 0401 074 586, whose wife, Cara, is also lactation consultant.

Breastfeeding in the first week: A general guide. Remember: Every mum & baby is different

Babies need 150mls x weight/kg No of feeds/day eg: 150 x 4kg= 75mls 8 feeds/day	First 24 hrs	Day 2 24-48hrs	Day 3 48-72 hrs You may feel teary today! Day 3 blues!	Day 4 over 72 hrs You might feel teary today too	Day 4-6	Day 7 & next 5 weeks or so
Breasts	Soft	Soft	Becoming fuller and firmer. Veins may appear more prominent	Full and firm. May leak between feeds	Full, will soften with feeds. Leaking is common	Full, will soften with feeds. Leaking is common
Milk	Colostrum – small volume, highly nutritious, thick clear yellow or orange colour. Approx ½ tsp/feed	Colostrum about 1 tsp/feed	Increasing in volume, whiter colour.	Increasing in volume, whiter colour. Thinner, more watery consistency	Thinner and whiter in colour.	Thin, white. Flows freely during a feed
Baby Remember babies have their own routine for many months: feed-play-sleep	First feed occurs within first hour after birth when baby is alert. After the first feed baby may sleep for a long time or be wakeful and feed often.	Baby usually more alert and wakeful. Can be unsettled during the night, more settled when held & cuddled.	Some continue to be wakeful and feed frequently especially at night. Others sleep for longer periods between feeds.	Some continue to be wakeful and feed frequently Others sleep for longer periods between feeds	Frequent night feeds are common. Babies tend to sleep more during the day.	Generally more settled during the day has longer periods of sleep. Becomes unsettled (may be awake for long periods) in the evenings more alert and wakeful at night. Settles better when cuddled and fed.
Breastfeeds	At least 6-8 feeds. Offer both breasts	Feeds more often to stimulate breast milk supply. At least 6-8 feeds	At least 6-8, maybe more. May hear suck-swallow. Offer 2nd breasts in response to baby’s cues. May feed a lot overnight ie: hourly	At least 6-8 feeds/day maybe as many as 10! May feed a lot overnight	At least 6-8 feeds. You should hear suck and swallow. Feed from 1 breast till empty before offering 2nd from now on	Varies, average 6-10 feeds up to 12 feeds is normal! Let baby drain 1 breast before offering 2nd. Cluster feeds in the afternoon till late evening are common
Nappies Urine Baby girls may pass a spot of blood from their vagina for a day or two - it’s called pseudomenstruation	At least 1 wet nappy.	At least 2 wet nappies. Urates - a pinky/orange stain in the nappy is common	At least 3 wet nappies.	At least 3-4 pale or colourless wet nappies	At least 4-6 pale or colourless wet nappies	At least 6 pale or colourless wet nappies You might notice the baby’s cord bleeding slightly & it will go black & smelly just before it falls off
Stools	At least 1 meconium nappy-thick, sticky black/green stool	At least 2 meconium nappies	At least 3-softer, green/brown colour	Softer or runny, brown/yellow colour	Frequent. Runny or pasty yellow with little lumps (curds)	Frequent, runny or pasty yellow with little lumps (curds)

Adapted from RHW postnatal services March 2012
Acknowledgement: NSCCAHS booklet “Breastfeeding: Information for parents and their families”

Settling techniques: newborn – 12 months

Learning how to self-settle and go to sleep is a skill babies usually gain during the first year of life. Like most skills, it takes time and occurs at an individual rate. In the early months of life, a baby has a need to be physically connected to their parents. They are in a normal state of adjustment where erratic feeding and sleeping patterns, periods of crying and of unsettled behaviour are common. During this phase there is a gradual development of a routine as babies adapt to their environment and develop their own rhythms

Tired sign/cues

Tired signs are the individual signals your baby gives to let you know they are getting tired and need to sleep. These may include: facial grimacing, yawning, grizzling, frowning, sucking, staring, minimal movement or activity, turning head away, jerky movements or becoming more active, clenching fists, rubbing eyes, squirming crying/ fussiness

Responding quickly to your baby's tired signs can stop your baby becoming overtired and distressed. This quick response helps your baby learn to self-settle and prevents your baby getting into a state of distress that requires lots of effort to calm.

How much sleep does my baby need?

All babies are different which means that some babies will sleep more and some will sleep less. Most newborns 0-6 weeks will become tired after 1 hour of up time they should ideally sleep for 1½ -3 hours. By the end of the first month the infant sleeps approximately 13-14 hours per day spread across day and night. As your baby matures the sleep requirement of 13-14 hours remains much the same with the length of time your baby sleeps at night increasing. During the day your baby will have longer wake times and up to 2-3 day sleeps. If your baby wakes up happy your baby probably has had enough sleep.

Sleep cycles

Babies are not born with a day/night rhythm. It takes time to develop their 24 hour internal clock that controls the sleep-wake cycle. The sleep-wake cycle, is the time spent going through both deep (quiet) and light (active) stages of sleep. From birth a sleep cycle is about 40 – 60 minutes with 20 - 30 minutes deep sleep within the cycle. The periods of deep sleep in each cycle, and the time to move to deep sleep, increases with age. Between each sleep –wake cycle, babies rouse/wake briefly then resettle to sleep - sometimes you may need to help your baby to resettle, this need for assistance should decrease as your baby becomes older.

ROUTINES are generally structured around three main activities: feed, play and sleep. These are regular events that occur throughout the day.

After a feed and /or play (depending on day or night) you may use a range of activities that signal to your baby that bedtime is approaching, helping your baby move to a calm state in preparation for sleep. These activities may include a quiet story, a particular song, cuddles, certain verbal phrases, bath-time and a goodnight kiss.

Settling Options

Most babies will take time to settle and consistency with choice of options is important in helping your baby establish good sleep habits. Remember babies may protest as they learn new ways to settle.

Settling in arms (the early weeks)

Hold your baby in your arms until they fall asleep. You can use gentle rhythmic patting, rocking, stroking, talking, or softly singing prior to putting your baby into the cot. If your baby wakes after a sleep cycle you may need to resettle (as above) to ensure adequate sleep.

Hands-on settling

When you see your baby's tired signs (cues), prepare your baby for sleep

Check your baby's nappy
Wrap your baby in a light cotton sheet (optional) – taking care not to overheat
Talk quietly and cuddle your baby to encourage a state of calm
Position your baby on their back in the cot awake [calm/drowsy]. Ensure cot sides are up and secure
Comfort your baby by: gentle ssshhh sounds, gentle rhythmic patting or rocking, or stroking staying until calm or asleep
If your baby remains distressed you may need to pick your baby up for a cuddle until calm. Once calm repeat steps 4 and 5.

The length of time it takes to calm your baby will lesson as your baby learns to self settle

Comfort settling (over 6 months)

Comfort settling provides your baby with reassurance and support while also providing an opportunity for your baby to discover their own way of going to sleep.

Use the first 5 steps above (Hands on Settling)

As your baby calms, move away from the cot or leave the room

Listen to your baby's level of distress (intensity of cry)
If your baby remains distressed, calm your baby again and move away or leave the room
You may have to repeat this several times before the baby responds
If your baby does not respond, pick your baby up and cuddle until calm then either
- reattempt comfort settling
- use hands on settling until baby is asleep
- get baby up and try again later

Parental presence (over 6 months)

You may prefer this option if your baby is over 6 months of age and has not been separated from you at sleep time.

Prepare your baby for sleep as per steps 1 to 5
Once calm lie down or sit beside the cot within sight of your baby and pretend to be asleep
If your baby remains awake, give a little cough or quietly ‘ssshhh time to sleep' signalling you are still in the room
If your baby becomes distressed respond with the minimal action required to calm your baby and then repeat steps 4 and 5
Stay in the room until your baby is asleep during the day and sleep in the same room as your baby throughout the night
This continues for at least 1 week or until your baby has 3 consecutive nights of relatively uninterrupted sleep.
You can now begin to leave the room before your baby is asleep.

Unsettled periods

Crying is part of normal behaviour (your baby's way of communicating) and can be due to:

hunger, thirst, being hot or cold, a wet or soiled nappy;
being overtired, excited or frightened;
a need for comfort (to soothe your baby back into a calm state)

Your baby may have unsettled periods where they are fussing and crying for no apparent reason. If your baby is otherwise well you can consider other options. For example: offer a 'top up' breastfeed within 30 minutes of the last feed (babies up to 3 months); cuddle; rhythmical movement, walk using pram, sling; play some music; offer dummy; offer cooled boiled water (babies over 6 months) baby massage; or deep relaxation bath.

If your baby still finds it hard to settle a wrap may help. It is thought a wrap lessens baby's involuntary movements giving a sense of security and promoting a state of calm. Use a light material [usually cotton] ensuring arms are above waist level and hip movement is not restricted. It is important to choose options that are safe and suit you and your baby. If your baby does not calm [during the day] after an attempt to settle and becomes too distressed, get your baby up and continue your daily routine. If your baby remains unsettled ask for help from family, friends, the Child and Family Health Nurse or local doctor.

Prevention of Sudden Infant Death Syndrome (SIDS)

For safety ensure the cot sides are completely raised whenever the baby is left unattended in it There are three main ways to reduce the risk of SIDS:

Put your baby on their back to sleep, from birth.
Make sure your baby's head remains uncovered during sleep.
Keep your baby smoke free, before birth and after.

More information on how to reduce the risk of SIDS and sleeping your baby safely can be obtained from the SIDS and Kids website or by contacting SIDS and Kids by telephone on 1300 308 307.
© Tresillian 2000–2013

Vaccinations

Three vaccinations that are recommended in pregnancy are the Influenza (Flu) vaccine, the Pertussis (whooping cough) booster and the COVID-19 vaccine or booster. I strongly recommend the Flu vaccine if you will be pregnant or have a young baby during winter. The best time for vaccine is usually May/June each year and covers the latest Influenza strains. It is supplied free to pregnant women by the government, and is available through your family doctor. It can be given safely in any trimester of pregnancy. You should consider it if travelling overseas in summer.

I also recommend vaccination for Pertussis (whooping cough) for you, your partner and all the baby’s close contacts, including grandparents. Whooping cough can be a very serious infection for newborn babies and infants. It is given together with Tetanus and Diphtheria. I recommend having the booster at 28 weeks in every pregnancy. I also recommend keeping up to date with COVID-19 vaccination, which can protect both you and your baby.

Breastfeeding advice

Australian Breastfeeding Association. Tel: 1800 686 268 or www.breastfeeding.asn.au

ABA is a free 24/7 telephone service run by trained volunteers who all have experience at breastfeeding. They can give practical advice regarding any aspect of breastfeeding. You can join the Association to receive updated information on breastfeeding and baby products. They also have regular get-togethers and welcome new mums.

Prince of Wales Private Hospital Breastfeeding

NB POWPH Drop in clinics have been suspended during COVID-19

Breastfeeding help & advice from lactation consultants, who see you on a one-on-one basis When drop-in classes resume. For new mums who have birthed at POWPH.

Monday–Friday 12.30–2pm. Appointment preferable – call 9650 4443

Antenatal & postnatal breastfeeding talks

Mon, Wed, & Fri 10.30–12pm drop in no appointment needed

Royal Hospital for Women Breastfeeding Support Unit

For women who have birthed at RHW and are experiencing breastfeeding difficulties.

There is a drop-in clinic Monday-Friday 1pm-4pm for inpatients and their babies

The Unit is staffed by lactation consultants, who can make an appointment to see you.

Monday–Friday BY APPOINTMENT ONLY call switch on 9382 6111 or call direct on 9382 6341

Local Breastfeeding support groups – Drop-in, no appointment needed

Bondi Beach early childhood centre breastfeeding drop in Tuesdays 9-11am; 9130 2838

Cnr Brighton Boulevarde and Wairoa Avenue, Bondi.

Eastgardens early childhood centre breastfeeding drop in Mondays 9-11am; 9382 0933

Eastgardens Suite 510, Level 4, Westfield, Pagewood

Kings Cross early childhood centre breastfeeding drop in Wednesdays 9-11am: Tel 8374 6311

19 Greenknowe Avenue, Potts Point NSW 2011

Waverley early childhood centre breastfeeding drop in Thursdays 9-11am; 9387 1981

25 Ebley Street, Bondi Junction NSW 2022

Karitane lactation support clinic: 9399 6999

146 Avoca Street, Randwick – by referral only

Breast pump hire

Australian Breastfeeding Association call Holly Goodwin: 0423 684 216

Comino Chemist, 149 Avoca Street, Randwick. Tel: 02 9399 3025

Online: www.Breastpumphire.com.au or www.Medirent.com

Postnatal Yoga / Mums and Bubs Yoga at Royal Hospital for Women

A great opportunity to connect with other new Mums whilst improving your fitness, rebuilding core and pelvic floor strength and gaining more energy and vitality. Learn invaluable breathing & relaxation techniques to stay more centered & grounded in early parenting.

Mondays 1.30 – 2.30pm, (except Public Holidays), in Seminar Rooms 1&2.

Booking essential: www.karmamama.com.au Cost: $18 per session. Please check in 15 mins prior. https://www.trybooking.com/195115

Parenting advice

Karitane Early Parenting Store: free consultation. Level 5, next to Target, Westfield Bondi Junction. Self referral, or call 02 9101 2488

Karitane 1300 CARING (1300 227 464) TTY 02 9794 1848 or www.karitane.com.au

A free 24/7 advice line for parents and carers. Information regarding all aspects of parenting babies, toddlers and under 5’s, can be accessed, including breastfeeding, sleep and settling.

Parent baby day unit, 9399 6999 Karitane Family Care Cottage, 146 Avoca Street, Randwick Parents can spend the day at the cottage and receive support and expert advice on sleep, settling breastfeeding and parenting. Referral from healthcare professional required.

Tresillian Family Care Centres & Parenting Line 1800 637 357 or 9787 0855 www.tresillian.net/

A similar set up to Karitane. A 24/7 advice line with residential and outreach programmes. Parents are referred to Tresillian whose babies have settling difficulties or parents who have postnatal depression. Referral from healthcare professional required.

Health Direct, 24/7 medical advice line: 1800 022 222

Pregnancy, birth & baby helpline: 1800 882 436 or www.healthdirect.gov.au

Helpful websites: www.raisingchildren.net.au, www.Tresillian.net, www.Karitane.com.au and www.Australianbreastfeedingassociation.com.au websites have great information and factsheets on babies and breastfeeding.

Sleep/settling advice app: rockabub

Outline of baby’s development and milestones apps:

The wonderweeks
Love, talk, sing read, play

Contraception information: www.fpnsw.org.au/

Domestic Violence hotline 1800 65 64 63

Services for postnatal depression/anxiety

If you or your partner is feeling anxious or depressed there is a lot of support for you. Please discuss your concerns and feelings with me, with your family doctor or with my midwife

I recommend the Cloudberry Clinic team: 1300 553 722 or admin@cloudberryclinic.com.au

Justine Adler from Maternal Connections: 0416 088 742 or justine@maternalconnections.com.au

Mellanie Rollans 0437 864 232 is a Clinical Nurse Specialist, with a special interest in mental health

Emergency departments at public hospitals, such as Prince of Wales Hospital, provide assessment and support for anyone experiencing acute anxiety, depression or psychosis, especially if you or your partner have any thoughts of harming yourself or harming your baby.

Alternatively urgent assistance or advice can be obtained by contacting the Crisis or Acute Care team on 1800 011 511.

St John of God Hospital, Burwood provides a comprehensive range of services for both inpatients and outpatients, including the highly respected Circle of Security programme.

Perinatal depression line 1300 726 306 or www.panda.org.au

Mum for Mum is a service for new mothers having difficulty coping with motherhood, who don’t have their family support around. Support is given free of charge by older women in your home.

contact@mumformum.org.au or 9363 0257

Immunisation

The immunisation schedule is on the back pages of your baby’s blue book. Your GP provides immunisation commencing when your baby is 2 months old. It is important to find a GP you feel comfortable with. Feeding or cuddling your baby during immunisation will provide comfort for your baby. The Hepatitis B vaccine is usually given in hospital, just after your baby is born.

Some parents apply EMLA cream onto the baby’s thigh to numb the injection site an hour prior to immunisation (ask your chemist). It may be wise to have baby Panadol on hand in case of common reactions like pain and fever. Again please remember to take your baby’s blue book.

Formula feeding advice

For advice on formula feeding there is a website: http://www.bottlebabies.org, and a Facebook page: https://www.facebook.com/bottlebabies/

Parents Groups

MUMSENSE at Royal Hospital for Women. A weekly parenting group for all new parents who have babies aged 0-4 months:
No need to book – Every Thursday 10.30–12.30. Call 9362 6700 for more information

Mumsociety – holds regular brunches to bring mums together at Centennial Park Restaurant, with guest speakers: www.mumsociety.com.au

Early childhood centres run their own groups: www.sch.edu.au/departments/child_family_health

Australian Breastfeeding Association have regular meetings and welcome new parents

Movie sessions especially for parents with babies and children under age of 4 –
Participating cinemas: Randwick Ritz, Greater Union and Hoyts

PLAYGROUP: look up playgroupassociation.com to find your local playgroup. All parents and children under 5yrs welcome.

Your local council website lists all children’s services (including childcare) available in your local area.
Childcare information: www.mychild.gov.au

Help for Dads

Mensline: 1300 78 99 78 – A 24/7 counselling line for men, or visit www.mensline.org.au a great website with on line forums and helpful information

Ryan Kaplan, Psychologist, Suite 402, 9-13 Bronte Rd, Bondi Junction 9158 6714

South east local neighbourhood centre runs Mens Shed – A fathers’ group for dads and babies: familysupport@senc.org.au or www.facebook.com/thebabyshed

Cheers to Childbirth by Lucy Perry – A dads’ guide to childbirth support

Sms4Dads – a free sms service or facebook page, for support up to first birthday

Additional Reading Material

Your experience of pregnancy and childbirth is unique. However, you may find other peoples’ experiences, opinions and advice helpful. Here is some additional material you may want to read:

Your Pregnancy Bible by Dr Anne Deans – A contemporary approach without being too heavy

Up the Duff by Kaz Cooke – A light-hearted look at pregnancy but still quite practical and helpful

Preparing for Birth by Jane Palmer and Andrea Robertson

Baby Love by Robyn Barker – A practical and reassuring guide to caring for your baby

Eating for Pregnancy: An Essential Guide to Nutrition by Catherine Jones – Very useful information on healthy eating, which contains some easy to use recipes

Physiotherapy and Pilates

It is quite common to experience joint aches and pains in pregnancy, especially as your body changes to accommodate the growing baby and you release the hormone, Relaxin. Learning good techniques for standing, lying and lifting can help, as can breathing and stretching exercises and Pilates.

Women in Focus Physiotherapy, 40 Ebley Street, Bondi Junction 2022. Tel: 9288 9093.
www.womeninfocusphysio.com.au

The Physiotherapy Clinic, 904/3 Waverley Street, Bondi Junction 2022. Tel: 9387 1011

Fix Programme 503/71 York Street, Sydney NSW 2000. 02 9264 0077

Sherin Jarvis, Pelvic Floor Physiotherapist, Bathurst Street: 1300 722 206. www.whria.com.au

Body Love, Pilates in Woollahra and the CBD. 9326 2006. https://bodylove-pilates.com/studios

Acupuncture, Yoga and Massage

Houng Lau, Eastern Therapies, 2nd Floor Suite 4, 106 Ebley Street, Bondi Junction 0400 331 321 www.bondi-acupuncture.com.au

Naomi Abeshouse, The Red Tent, Suite 2/81 Curlewis Street, Bondi Beach 1800 733 836

Rebecca Mar Young, The Red Tent, Level 1/17 Randle Street, Surry Hills 9211 3811
www.redtent.com.au

Brooke Canning & Nicola Marishel, Acupuncture East, 130 Edgecliff Rd, Woollahra: 02 9388 9669.
www.acupunctureeast.com.au

Pregnancy Yoga, RHW, Mondays & Wednesdays 6pm

Sage Beauty & Massage – 292 Campbell Parade, North Bondi: 9130 7064

Stay well. Stay safe. See you at 6-8 weeks.

Rahul Sen

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