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I went for a GTT test today and have had a phonecall from the hospital saying my blood sugar is a little high. I am not overweight and before pregnancy exercised regularly. My father has late onset type 2 diabetes (obesity related). I am a little shell shocked. They have transferred my care from midwife lead at the local surgery to a doctor at the hospital. Does this mean I can't have the home birth I was planning?

Dear Amanda,

 Thanks you for contacting the NCT.  We can't give individual health advice, so you will need to discuss with your midwife and/or consultant the possible implications for you and your baby of your raised blood sugar level.  Whilst they may advise you to give birth in hospital it is entirely your decision whether or not to go ahead with your planned homebirth.  As the Nursing and Midwifery Council has stated  "It is a midwife's duty to make all options and choices clear and to respect the choices a woman makes."

It is not uncommon for women who have not previously had any symptoms of diabetes to develop what is known as "gestational diabetes".  This can often be controlled through diet and exercise during pregnancy, and usually settles down once the baby is born.  Occasionally if the mother's blood sugar level is not well-controlled this can lead to the baby growing very large.

You may find it helpful when weighing up the risks and benefits in your own case to take a look at the website www.homebirth.org.uk where under the section "Diabetes and Homebirth" you will find a number of links to relevant information plus stories from mothers who have found themselves in a similar situation to you.

If you do decide not to have a homebirth, it is worth thinking about what you can do to make the hospital surroundings as home-like as possible - for example having the bed moved to one side and a mat or mattress on the floor; using a birthball or bean-bag to support you in comfortable upright positions, taking in your own music and some familiar items from home.

I hope these suggestions are helpful. 

With best wishes for the rest of your pregnancy and the birth.

My school has had one confirmed case of Swine flu. I am 32 weeks pregnant. They have said that a risk assessment has been done by the HPU and i am to return to work, however my GP has said he will give me a certificate to stay off. I am really confused about the conflicting advice. What should i do?

Dear Crystal,

Thank you for contacting NCT.

The NCT has set up several pages of information on swine flu, and how it may affect pregnancy, the baby, and plans for labour and birth, and they also link to government advice: http://www.nct.org.uk/press-office/press-releases/view/154

The decision on whether to return to work has to be yours. I am afraid we at NCT are not medically trained and cannot advise on a particular course of action.  It seems as if both options are available to you - in that your GP has provided the means to remain away from work if you feel this is the right option for you.

I hope the information pages help, and hope you will be able to enjoy the remaining weeks of your pregnancy,

kind regards

Barbara, NCT Antenatal teacher

My baby is 17 weks and i exclusively breast feed. Although i wake him at 11pm for a night feed, he is still waking once in the night hungry for a full feed. Would introducing a hungry baby formula feed at 11pm help him sleep through? Or is the formula so much more filling than breast milk, that he could have this at 7pm and possibly sleep 12 hours without being woken for a 11pm feed?

Hi. Emily. Thanks for posting. I hope we can help.

 

You're describing normal behaviour in a 17 week old, and few babies of this age sleep through the night without waking to feed or to have comfort. Hungry baby formula milk does not hae more calories than breastmilk, and while it is marketed as a product for 'hungry' babies there's no real evidence that babies go longer between feeds. The theory is that because the proteins in it are casein-dominant and are slower to digest than whey-dominant formulas, the baby should feel 'fuller' for longer, but there is no research that actually tests the manufacturers' claims. 

 

If you are keen to continue breastfeeding 12 hours without a breastfeed, or even longer than this if you give him a bottle at 7 pm instead of a breastfeed is going to do two things - the first is certain, that you will be uncomfortable in the short term,very full and engorged. In the medium term, and this is less certain, you will have an impact on your breastmilk supply (because long gaps between feeds reduce the supply) and you might find you make insufficient for his other needs.  So you would need to guage these risks before you decided what to do. 

 

The other option is to think of ways you can meet his normal needs in the night with the least possible disturbance in the night - co-sleeping is the obvious one, or bringing him into bed with you to feed and keeping him there. There are ways to ensure the safety of this, and your HV should help you check these. 

 

I hope this gives you some ideas and information, Emily. 

 

all best wishes

 

Heather Neil

breastfeeding counsellor

Hi there. I have been breastfeeding my baby for 14 months now, and I want to stop and get him to drink cow's milk, but he refuses to have any. I even tried Aptamil formula because it is said to be sweeter than cow's milk, but he has refused that too. He is having 200ml of cow's milk with his cereal in the morning, but he can't taste it obviously. I am currently only giving him the breast at night, but I would now like to stop. I just feel so guilty because he won't drink any other milk. How do I get him to drink cow's milk? He was never given a bottle, and he can drink his water just fine from a cup, but neither bottle nor cup worked with cow's milk. Can you help?

Marianne,  your baby never has to drink cow's milk if he doesn't like it.  It is a complete myth that cow's milk is the best or only way to meet his nutritional needs.  He can drink water and eat cheese, yoghurt or fromage frais, broccoli, all of which are calcium-rich.  Cow's milk has been heavily marketed for years as an absolute necessity but it really isn't.  If he likes milky foods then put them into your food planning for him - rice or other milk puddings or cheese sauces on vegetables/meat are ways of adding calcium without having to try to force something on him that he doesn't like.

I hope this helps,

Best wishes

Jenny Lesley - Breastfeeding Counsellor

when I last breastfed 30 yrs ago there was a spray which numbed and disinfect- ed the nipple making the first weeks easier Is something similar around?

Hi, Nicky....I think you mean Rotorsept. It was discontinued for breastfeeding many years ago - there were concerns about the baby ingesting it, the fact that it tasted and smelled and might disguise the taste and smell of the breast and the milk, and because nipples don't need to be numbed or disinfected.  The mother may need some help and support to ensure her baby is comfortably attached, or to position herself so the baby can self-attach. I don't know if this all applies to someone you know or not, but she can get help from our breastfeeding line if she would like to call - 0300 330 0770.

 

all best wishes

 

Heather Neil

I am currently talking to my employer with regards to maternity leave/pay and as they only offer a statutory maternity package, they have offered as an alternative for me to work from home on an ad-hoc timesheet basis during my maternity leave (in addition to the 10 KIT days)and pay me for any time worked. There is no commitment needed from me in terms of hours so I can be as flexible as I want.

My HR Manager has advised that any time worked would be taken off the end of the maternity leave period and the period of maternity pay (i.e. if I did 4 weeks this would shorten my total maternity leave by 4 weeks to 48 weeks instead of 52 weeks and my pay from 39 weeks to 35 weeks.

I was unsure as to if this would constitute being back at work and no longer on maternity leave.

Could you please help?

Hi Caroline,

Thanks for contacting NCT.

If you work any additional days over the KIT days allowance, this does constitute returning to work.

This system is explained fully on this webpage :

http://www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Expectingorbringingupchildren/DG_10018741

It seems that your employer may be offering you a more flexible arrangement than the statutory package - so it would be best to discuss the exact details with your HR department.

I hope this helps,

Kirstie, Antenatal Techer

My 10 month old baby is very tall for his age, above the 99.6th percentile on the growth chart. His weight is still increasing steeply but has not reached the same percentile as the height. There are very tall genes in the family so I would expect him to be tall. My question is, could his weight be on the same percentile as the height and him still not be overweight? ie. is it body mass index that matters or simply weight? He can eat for England, is full of energy, and very healthy. My second question is, because he is so very energetic, could I be feeding him too much, or is it simply that he loves life and loves to be active? Hope you can help.

Hello Gill. It sounds as if you have a strapping young lad on the way up. If I’ve understood correctly he’s both tall and big, but he’s not quite as big as he’s tall. You seem to be unconcerned about his height – it seems to be as it should be in your family But it seems that if his weight matches his height you would be concerned that he’d be overweight.

The thing is, it’s a bit difficult to say whether BMI is more important than weight or not. You see every child has their weight plotted on charts so that’s the measurement that is measured most frequently. But it is only one measurement among many that could be done; for instance, height or BMI are rarely charted, and there is less research done on those measurements.

I’m really not sure why you think you might be feeding him too much. Is his energy a problem? At 10 months, he’s probably just about ready to explore the world outside his mother’s arms, and he will probably show as much interest in the wrapping appear as the toy. Everything in the world is new to him and worthy of exploration. It is a wonderful learning experience for him, and an era of non-stop vigilance for you the parent.  Would feeding quantities alter this? I don’t know. Would you want this altered? If it’s causing a problem you will probably have to invest in stair gates, safety locks, etc.

If you meet other mothers in your local NCT or toddler group, you will see what their babies are doing now.

I am not sure i I have answered what you were asking Gill, but best wishes for you and your young son.

 

Eithne Murray, breastfeeding counsellor

We are desperate for help. Our baby girl was born in March 6 weeks early. She is now just over 9 weeks old. She has been 'colicky' from quite early on in that she has been very fussy at tea times. However, we didn't know the meaning of the word 'colic' until two weeks ago. She now spend the evenings thrashing around in pain and is inconsolable screaming so hard she can barely breath. It is vertually impossible to feed her during the evening as she can only latch onto the breast for a few seconds at a time and then screams. It is usually over by 10.30pm but on one occasion she suffered all night. She has also had colicky periods during some days. We have tried Infocol and are now trying Colief - neither of which has made a difference. I have also cut out caffeine, spicy foods and have cut down on brocoli and cabbage. Is there anything our doctor should be able to do (we have been to see them twice)? We just cannot imagine potentially our baby going through another 3 weeks of this. Also - as our baby was 6 weeks early could the colic go on for an extra 6 weeks??

Any help and advice would be greatly appreciated - thank you!

Lou, I'm so sorry to hear what an unhappy time you and your family are having.  No-one really knows what colic is or whether there is any "cure".  It is normal for most babies to have a fussy, cranky time usually during the evening where they are on/off feeding for a period of hours sometimes.  No-one has successfully proved why this happens or one way of dealing with it.   If she feeding well during the day and then in the evening is wanting to feed but seemingly not able to latch on then some mothers try giving expressed milk at this time of day.  Others are advocates of cranial osteopathy although the evidence on this is limited.

 It is almost certainly NOT anything you ate nor anything wrong with your breastfeeding, particularly if she is happy and settled at other times of the day.  Do speak to your GP/health visitor but it is a known feature of premature babies that they have a tendancy to be more "colicky" . It may be that the only thing you can do is pat yourselves on the back for doing everything you can and find support for yourselves and ways of coping with her behaviour.  You might find the book "Babycalming" helpful and the Cry-Sis website has some other suggestions you might find useful. 

You could also talk to a local breastfeeding counsellor - the NCT breastfeeding line will be able to look up the nearest one to you.  

I hope this helps and that your evenings become calmer soon.

Best wishes,

 

Jenny Lesley - Breastfeeding Counsellor

 

 

 

Hi there,

I am currently breast feeding my 3 week old baby. He has recently taken to spitting out my nipple and getting really excited before wildly trying to latch back on. Is there anything I can do to prevent this as it seems to disturb his feeding particularly in the evening. Thanks, Rachel

Hello Rachel. Congratulations on the birth of your baby. I get the impression that the breastfeeding has gone very well until now. If so, that’s great. It means that glitches like this will probably be easier to get around.

Without knowing a little more Rachel I’m not sure I could say what might prevent it. I’m not clear if the ‘spitting out’ happens at the start or the middle or end of a feed, and that might make a difference.

You would probably find it more helpful to talk to one of us in person and see if you can identify any factors which might be contributing to this situation. Our number is 0300 330 0771

Meanwhile, since your baby is still quite young, he might probably respond better if you tried breastfeeding him lying back like in these pictures. When the baby is on top of the mother like that, his reflexes are kick-started and so are the mother’s, so it might ease things for a while for you.

Best wishes Rachel.

I hope the issue sorts itself out for you.

 

Eithne Murray, breastfeeding counsellor

I developed a thrombosis 3 days post delivery and was treated with warfarin. Consequently was unable to breastfeed due to medication.
However, I have now stopped all medication and would love to be able to breastfeed.
I fed the baby for the first 3 days before had to stop and he is now 9 weeks old.
Is relactation possible at this stage and if so any advice would be very much appreciated.
Thank you

Hi, Pauline. Thanks for your post and I hope we can help.

 

I am surprised that you were told to not breastfeed because of warfarin. If you check for yourself here

http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

 

and  here

http://www.breastfeedingnetwork.org.uk/drugs-in-breastmilk-information-and-factsheets.html

(see the anticoagulants factsheet) you will see there is nornally no concern about the effects on breastfeeding at all, or the safety of breastfeeding.  Both these websites are referenced, and you can share them with your doctor or health visitor, and perhaps find out why the advice was different for you, or else report your concern to them if it turns out you could have breastfed safely after all. 

 

Yes, it is possible to start breastfeeding again, but it's realistic to accept that it could be a real challenge, you will need patience and motivation, and support from people around you...there is nothing at all to stop you putting the baby to the breast and seeing what happens as a first step! Getting milk back will depend on having a co-operative baby,  and  frequent expressing too (so a good pump is helpful).

Some women in your position, when there has been some time since they breastfed, do not get a full supply back, but they are able to retrieve some breastfeeding, and this, they feel is well worth it.

 

You can call our breastfeeding line 0300 330 0771 and/or post again here for further info,and feel free to report back when you have had time to think about your options.

 

I hope things work out for you, Pauline. 

 

 

 

 

  Heather Neil

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