Hectic

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What can I say…I can’t believe the last two weeks have gone by so quickly. I’ve gone back to work after maternity leave and I honestly feel that being in work is the easy bit. It’s the behind-the-scenes part that’s a bit tricky,the getting yourself ready, the packing your work bag, packing the nursery bag,organising nursery pick ups and well just leaving the house on time that’s the hard part. And in only part-time! Also I can’t believe that before Liliya was born I used to take it for granted that I would get a full-nights sleep before a day at work! The luxury! But not to sound miserable, everything is getting easier, it’s good to be back at work and good for Liliya to be in nursery…her immune system has had a barrage of bugs to deal with too and she seems to poorly all the time…but it will pass and am sure I’ll will feel like a pro in no time..well there’s a first time for everything!

Here is a link to Catherine’s post about going back to work!

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Guest blogger…Dr Catherine Heaney

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Apologies for lack of blogging,I blame this on going back to work and finding time to do everything else,new found respect for working mummy’s everywhere it’s hard work!A full blog will follow, in the meantime here is a great post from our lovely guest blogger Catherine on an important subject we don’t always like to talk about it….postnatal depression,see u soon xx

Gwyneth Paltrow, Brooke Shields and Elle MacPherson. What do these three all have in common?

They’ve all suffered from postnatal depression. Brooke even wrote a whole book about it!

It’s a sad side of motherhood that is often overlooked. But there are many treatment options available so it’s really important to recognise the problem, talk about it and get help.

It’s very common to feel a bit down after giving birth – up to half of all women experience “baby blues” a few days after giving birth. This results in mood swings, irritability, tearfulness and anxiety but the feelings normally improve within two weeks.

Some women end up with more severe symptoms though which turn into postnatal depression. Typical signs of postnatal depression include:

– Feelings of hopelessness
– Sleeplessness
– Appetite changes
– Not being able to enjoy anything
– Anxiety
– Loss of interest in the baby
These feelings last for longer than two weeks and mean that sufferers find it difficult to look after themselves and their babies. Postnatal depression often occurs for no obvious reason but some women may be more susceptible to it, such as those who have had previous mental health problems or those who lack close support from family or friends. It can happen with a second baby, even if there were no problems with the firstborn.

If you think you might have postnatal depression, see your GP or health visitor who can offer you help. Treatment options include counselling and antidepressant medication. Counselling or “talking therapy” can help you understanding why you are experiencing certain feelings and help you change the way in which you think about and deal with depression. Antidepressants can be used for more serious depression, they can take a couple of weeks to start to work and usually need to be taken for at least six months. Breastfeeding is still possible whilst on antidepressants but some medications may not be suitable so it is important to tell your GP if you are breastfeeding.

Rarely (about 1 in 1000 women) a more severe form of depression called puerperal psychosis develops. The woman experiences hallucinations and delusions and may show manic behaviour. Treatment in hospital is often needed, ideally in a specialised mother and baby unit

The Royal College of Psychiatrists also has some really good information on mental health around childbirth, follow this link to a leaflet which has some practical tips on how you can help yourself if you have postnatal depression: http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/postnatalmentalhealth/postnataldepression.aspx

The Association for Postnatal Illness (http://apni.org/) is a charity that runs a telephone helpline and also has some helpful information leaflets.

So make sure if you’re struggling that you get help, for both your sake and you baby’s sake.

Cruel mummy

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A new phase this week is being scared of most things…namely loud noises, a big green exercise ball, anybody knocking on the door and as it now appears nursery too. I don’t know whether starting nursery has set this all off or if it was bound to happen at some stage but it seems Liliya has a great time there when I’m away..however greets me with a horrible cry when I arrive with a look that says ‘I can’t believe you left me!’ Oh my word it is so so hard but I know it must be done and yes I know it’s for the best blah blah it still feels like I’m being a very cruel mummy..though I suspect that like everything else this too shall pass…I have also joined Dad’s ranking and am now the best thing since yogurt and she tends to cling to me alot more when we are together,coincidence? Of course I secretly love it but it also confirms in my head that nursery is the way to go..on a funny note we attended church this morning to try and get things organised for Liliya’s christening. Though we tried to look as though we were regulars we were quickly given away when we found out about Liliya’s latest fear…the church organ. We had to leave early in the end as she bawled each time it was played!! She was terrified! Sweet but odd too! And no one has ever searched for this on google! X

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Nursery part 2

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Well drama over and the first settling in day at nursery actually went quite well…a bit too well in fact,Liliya absolutely loved the toys and attention and I felt quite mean having to take her away! She liked it so much she was cuddling the staff within about 15mins! So much for separation anxiety…!I acted all cool bit was secretly a bit jealous…but at least this is better than tears and tantrums. Roll on day 2 next week when she is going to be left for a bit longer…all alone..and so the drama (created in my head) continues!x

First day at Nursery

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I am a mature person. I will not cry. I will be cool and laid back…and I will not cry! Feel like such a saddo,it’s Liliya’s first day at nursery tomorrow,not even a proper day but one of these ‘settling in’ days that the nursery offers, I presume for the child to get used to it as well as for me! I’m sure it will all be absolutely fine, it doesn’t do children any harm to socialise and experience all of these new and exciting games ad toys that nursery has to offer…but will it do me any good I wonder?! I guess only time will tell, will keep you posted…wish me luck ;( ( oh and I guess to Liliya too but something tells me she will be absolutely fine!)

The Bad Egg

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So we have recently had our suspicions confirmed and Liliya is officially allergic to eggs. Rubbish as eggs seem to be in everything but also on the plus side it is one of the ‘better’ allergies as most children will grow out of it by the age of 5…felt so awful as the first thing I thought of was ‘how will I bake her birthday cake?!’ but my fears can be dismissed…

The facts:

Egg allergy is one of the most common food allergies in children and affects 1 in 50 children in Britain.

Reactions can present with a rash, vomiting,abdominal pain or facial swelling.

Most children will outgrow the egg allergy by age 5.

Diagnosis is made by history and skin prick testing.

There is no treatment for egg allergy aside from avoidance of food containing eggs and in if advised so by your child’s doctor to introduce eggs gradually once your child is older.

As well as foods certain vaccines contain egg protein and may cause a reaction if given. This includes the flu vaccine and yellow fever. MMR can now be given to individuals who are egg allergic.

There is hope for cakes! Health food shops sell egg alternatives to use in baking which will not cause a reaction..

As always for further information speak to your doctor. A good link below;

http://foodallergies.about.com/od/eggallergies/p/eggallergies.htm

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Guest Blogger Dr Chris Ward

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antenatal care

Testing for HIV in Pregnancy

 

This post is a follow-up from a previous blog, here

Hello, Chris again. I’m a sexual health doctor, meaning I spend a lot of time talking to people about HIV testing. However a lot of young mothers haven’t been to sexual health clinics before and thus haven’t had the opportunity to discuss HIV testing. I thought I’d write about the dreaded blood test everyone worries about during their appointment and try and share some information or dispel some myths about what happens and why we do it.

 

What are HIV and AIDS?

 

HIV stands for the Human Immunodeficiency Virus and is the virus that can cause AIDS. It is commonly acquired from unprotected sex with an HIV-positive person, or transmitted through bodily fluids like blood, semen and breast milk. HIV infection in heterosexual people is becoming more common in theUKand the number of heterosexually infected people is now higher than the number of gay people with the infection. If you are HIV-positive, it can be passed onto your unborn baby through pregnancy. HIV gradually damages the immune system and, without treatment, can lead to the development of serious infections and disability.

AIDS stands for Acquired Immune Deficiency Syndrome and is a term used for HIV-positive people whose immune system is severely impaired by the HIV virus. Most people with HIV don’t have any symptoms and feel very well so often the only way of picking up the infection is by having a blood test.

There is about a 20-30% risk of transmitting HIV from mother to baby during pregnancy and birth if no treatment is given. There is then a further risk of about 5-20% of transmission through breastfeeding. This can be significantly reduced to less than 1% by identifying the infection and starting treatment during pregnancy. Once the baby is born they are often given a short course of anti-HIV medication to further reduce their risk. The baby will then have blood tests to ensure they haven’t been infected but these may take several months and several repeated tests to be 100% certain. One in five HIV-infected babies develops AIDS or dies within the first year of life, so it’s important to reduce the risk of transmission.

Test considerations

Before having the HIV test it is important to consider a couple of things:

  • HIV is treatable, life expectancy is now into the mid 70s if diagnosed young and early diagnosis improves outcome of HIV infection
  • Modern drugs are effective at helping the immune system stay healthy, and delay the development of AIDS
  • Treatment can help prevent passing the virus on to your baby

However

  • A positive HIV diagnosis may cause concerns about relationships with your partner or friends
  • Travel to certain countries may be restricted
  • There may be employment issues if working for the health service
  • It may be more expensive to take out some insurance policies or mortgages

You have the right to decline the HIV test at antenatal booking and, if so, your care will not be any different from any other expectant mother. You are also able to take time to think about the test in more detail if you wish and have the test at a later date, however the earlier the infection is picked up the better.

What does the test involve?

If you agree to the test your midwife will gain your consent and take a small sample of blood from your arm to send away to the lab for testing followed by a short wait of a few days to a week for the result. Your midwife will liaise with you how best to deliver the results. If the test is negative then it is very unlikely that you have the infection. Like syphilis, there can be a 3 month period after infection before the test becomes positive so repeat tests may be indicated if you have had recent exposure that you are concerned about. Again your midwife will be able to give you more information on this if necessary.

HIV and pregnancy care

If the test comes back positive you’ll be offered specialist care and regular follow up during your pregnancy. This is likely to involve the commencement of anti-HIV medication that has been shown to be safe in pregnancy and regular blood test monitoring. If the medication works as the doctor expects, then you can often still have a natural vaginal birth. If there is still circulating virus in the blood at delivery then a caesarean section is safest to prevent transmission during labour. This is best discussed with your obstetrician and will be decided closer to delivery. After birth, your baby will need a course of anti-HIV medication for a few weeks and you will be advised to bottle-feed, not breastfeed. 

If you think that you’re at risk of getting HIV or you know that you’re HIV positive, talk to your midwife or doctor about HIV testing and counselling. Support can be obtained from the following organisations and websites:

The Terence Higgins Trust

http://www.tht.org.uk/

PositivelyUK

http://www.positivelyuk.org/

Facts and figures

Finally, I’d like to provide some facts and figures to hopefully put your mind at ease:

  • National uptake of antenatal screening in 2010 for hepatitis B and HIV was 96% and for syphilis was 97%
  • 0.43% of pregnant women screened in 2010 were positive for hepatitis B
  • 0.15% of pregnant women screened in 2010 were positive for syphilis
  • 0.17% of pregnant women screened in 2010 were positive for HIV

So overall the risk is very low, and well worth considering testing to protect your own health and the health of your baby.

If you have any questions, just check with you midwife or your friendly local GP prior to taking the test. If you aren’t pregnant and want to have a test for any sexually-transmitted infections, it is probably best to arrange an appointment at you local sexual health clinic where they can offer individual advice.

Remember, there is no such thing as a “stupid” or “embarrassing” question to people in our profession and everything you disclose to your midwife or doctor will be kept strictly confidential.

Chris

Further advice can be found at:

http://i-base.info/guides/pregnancy

http://www.avert.org/hiv-testing-pregnancy.htm

Facts and figures can be found at:

http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1245581538007

http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1296683688485