Breastfeeding Programs an Infant's Metabolism

Breastfeeding is universally recommended as the superior method for feeding infants because it's linked to long-term prevention of various illnesses including asthma, diabetes and obesity. A study released Monday puts more emphasis on breastfeeding by showing it may have a lasting impact on metabolism.

French researchers analyzed three years of data following 234 children and how they were fed after birth. One group of children received only breast milk for the first four months of life. The other two groups were randomized to receive either a low-protein formula or a high-protein formula. Both of the formula types contained protein amounts that are within recommendations.

The study showed that children who received breast milk for the first four months had a specific pattern of growth and metabolic profile that differed from the formula-fed babies. Even at 15 days of life, the breast-fed infants had blood insulin levels that were lower than the formula-fed infants.

By 3 years of age, many of the metabolic and growth differences between the breast-fed and formula-fed infants had disappeared. However, blood pressure readings were higher in the infants who had been fed the high-protein formula compared with breast-fed infants. The blood pressure rates were still within the normal range.

The study suggests that if breast-feeding is not possible, infants should be fed formula that has a metabolic profile as close to human breast milk as possible.

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Breastfeeding Linked to Better Behaviour

Babies who are breastfed for several months develop fewer behavioural problems in early childhood than those who are bottle-fed, researchers have said.

The British study which involved around 10,000 mothers and their babies found that breastfeeding for at least four months lowered the risk of behavioural problems in children aged five by one third.

Researchers say the findings, published in the journal Archives of Disease in Childhood, add to a wealth of existing evidence on the benefits of breastfeeding.

Children raised on bottled milk formula tended to show more signs of anxiety, hyperactivity or lying and stealing, researchers found.

"We're not necessarily talking about tearaway, unmanageable five-year-old kids," said Maria Quigley from Oxford University, who led the research.

"It might be unusual anxiousness, restlessness, inability to socialise with other children or play fully in groups."

Scientists said the results could be explained either by the fatty acids in breast milk which aid brain development or the bonding between mother and child, which may affect learned behaviour.

Researchers from the Universities of Oxford, Essex, York and University College London analyzed data from a survey of 10,037 infants born in the UK between 2000 and 2001, who took part in the the wider Millennium Cohort Study.

Mothers were asked to assess the behaviour of their children by the age of five, giving scores for different behaviours, such as clinginess and restlessness.

Raw figures showed that only six percent of breastfed children were given abnormal scores indicating behavioural problems, compared with 16 percent of formula-fed children.

However, mothers who breastfed tend to be older, better educated and from a higher socio-economic background than those who don't, the study said.

Researchers therefore adjusted the figures to take those factors into account, concluding that there was a 30 percent greater risk of behavioural problems among formula-fed children.

"Our results provide even more evidence for the benefits of breastfeeding," Quigley added.

"Mothers who want to breastfeed should be given all the support they need."

Janet Fyle, from the Royal College of Midwives, agreed that the study backed evidence that breastfeeding is best for babies but warned against victimizing women who choose not to.

"We need to be careful to keep a balance when interpreting the results, so that we do not send a negative message to mothers that they have failed or make them feel guilty because they bottle-fed their babies," she said.

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Basic Infant Care - Clothing

Clothing

Unless the temperature is hot (over 75 degrees Fahrenheit [23.88 degrees Celsius]), your newborn will need several layers of clothing to keep her warm. It's generally best to dress her in an undershirt and diapers, covered with pajamas or a dressing gown, and then wrap her in a receiving blanket. If your baby is premature, sh may need still another layer of clothing until her weight reaches that of a full-term baby and her body is better able to adjust to changes in temperature. In hot weather you can reduce her clothing to a single layer. A good rule of a thumb is to dress the baby in one more layer of clothing than you are wearing to be comfortable in the same environment.

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A word of caution regarding sleep-trainers

There is evidence to suggest  that sleep-trainers may be  a dangerous solution to a frequently waking baby. Encouraging a baby to sleep too deeply, too long, too soon, may interfere with the natural developmental and survival mechanisms that the baby is armed with.  Sleep researchers have found that blood flow to the brain is almost doubled during light sleep and believe this is indicative of a more active brain during these periods.  They believe important development takes place during light sleep.  Training a baby to spend more time in a deeper sleep may therefore be damaging to the baby.

Source: lullaby

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Crying it out

There is a theory that advises you not to respond to a baby’s cries during the night because it will teach him to comfort himself back to sleep and therefore, he won’t bother you as much.  I have to say, this is the worst advice I have ever come across.  A baby in the early stage of growth is very vulnerable and it is the parents’ biological duty to satisfy every need of their offspring.  Letting him  ‘cry it out’ can be very psychologically and physically damaging to the child in the early stages of development.  There does come a point in development when baby will reach the stage where he does need to learn to comfort himself on his own.  However, as far as the right and safest way to look  after your newborn is concerned, give him everything he needs, and yes that obviously means some sleepless nights in the beginning.   

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Understanding the stages of sleep

When an adult falls asleep, her higher brain functions decelerate which allows her to enter the phase known as deep sleep.  During this time her body hardly moves, breathing is slow and regular, and her muscles become relaxed and loose.  After around an hour and a half later and her brain becomes more active and she enters into a period called light sleep.  It is during this time when she may slip into REM (rapid-eye-movement) sleep where most dreams occur.  These deep/light  cycles continue throughout the night, at around two hours intervals, so that the average adult spends around 6 hours in deep sleep 

and 2 in light sleep. 

Babies need to be parented to sleep because, unlike adults, they only go into a deep sleep after an initial period of light sleep.  Let’s see how many of you can relate to this: Imagine you’re performing your bedtime ritual with your baby:  you’re rocking, walking, nursing etc until she falls asleep in your arms.  Her eyes  are completely closed, her eyelids may be fluttering and she may be twitching or showing momentary smiles (called sleep grins).  Just as you think it’s safe to place your baby in her crib and sneak away, she wakes and starts crying! Why does this happen?  It’s because she wasn’t properly asleep and only in a state of light  sleep.  Next time you attempt  your bedtime ritual, carry on past this first stage of sleep (usually takes around 20 minutes).  Wait until the twitching and smiling cease, the breathing becomes more regular and the muscles relax so that her limbs dangle weightlessly.  These are the tell-tale signs that the baby is in the deep stage of sleep and your chances of being able to put her down and sneak away successfully are dramatically improved.    

Like adults, babies’ sleep cycles continually change from light to deep throughout the night.  However, their cycles are significantly shorter than those of adults.  They will enter into a period of light sleep every hour or so.  During this time the baby is prone to awakening easily if an uncomfortable stimulus occurs, such as hunger. Some new parents will often spend time just watching their baby sleep.  If you do this, you may notice the tell tale signs that she is about to awaken.  You may be able to get your baby through this period of light sleep, without waking, if you place your hand on your baby’s tummy, whisper a comforting word  or play her favorite lullaby quietly. Sometimes letting baby know that you’re there will comfort her enough to enter back into deep sleep without waking.  Fathers may have more luck with this technique if the baby is breast fed because often the baby will pick up on the scent of breast milk and will automatically awaken for a feed.  In a chapter 2.3 we will discuss the advantages of playing comforting music in more detail.   

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Understanding why babies wake during the night ?

It is important that you understand the reasons why newborn babies wake in the night. In the first few months they have many essential needs, yet their ability to communicate is extremely low.  For example, their minuscule tummies digest milk extremely quickly and if the stimulus for hunger does not wake the baby, he  will not get the level of nourishment needed at that vulnerable age (Sears 2006). Likewise, babies are still learning to regulate temperature and it’s an important survival mechanism that they awaken if they are too cold or hot during the night.  The same applies to many stimuli that also have the potential to wake the baby.  Therefore, these mechanisms are not there just to annoy the parents, but to ensure the well-being of the baby!  As you are next dragging yourself out of bed to tend to your baby, you should take comfort in the fact that his innate, built-in defence-mechanisms are evidently working just fine!  

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Cleaning Baby's Ears Safely

How To Safely Clean Your Baby's Ears

Safe and proper ear cleaning is one of the most commonly misunderstood aspects of personal hygiene. For parents, the issue of whether to clean the baby's ears is often fraught with confusion. One the one hand, earwax buildup can be acutely uncomfortable; on the other, cleaning the ear risks causing infection or damaging the baby's delicate eardrum.

Earwax is actually beneficial

Cerumen, the substance commonly known as earwax, is a combination of several chemicals (including cholesterol) that's secreted by many of the same glands that help keep the body's skin moist and hydrated. It's manufactured in the outer ear canal but carried towards the ear's edge by the movement of the jaw, taking dirt, dust and other harmful agents along with it.
Earwax varies among different ethnic groups. Among Asians and Native Americans, earwax is flaky and gray. Caucasian and Afrocentric peoples typically have earwax that is damp and honey- or brown-colored.

Cleaning baby's delicate ears

Parents are strongly encouraged to let their baby's doctors clean the child's ears during routine wellness visits. They'll use special instrumentation that won't prove a danger to puncturing or scratching the eardrum.

If you notice that waxy buildup is covering the eardrum, however, you may wish to remove the wax yourself. Excessive earwax around the ear canal can put pressure on baby's eardrum, resulting in balance problems and severe discomfort.

Never insert a cotton swab, your finger, or any other cleaning implement into your child's ear canal. Even light contact is enough to scratch the eardrum. Moreover, cotton swabs can pack the dirt, dust, and other harmful particulate matter closer to the eardrum, actually increasing the risk of infection.

Some health care item manufacturers promote special bell-shaped swabs for cleaning the baby's outer ear. While these are safety-tested to present no danger to the child's inner ear, parents should still use them with caution.

Preventing waxy buildup

Earwax buildup can be slowed simply by keeping the child's ear and neck area clean. Parents can even use a cotton swab or ball dipped in warm water or peroxide around the ear bud and neck area for maximum cleanliness. Just make sure that none gets inside the ear canal.

When the child gets older

The child can begin cleaning its own ears as soon as it can understand the safe use of cotton swabs. Parents can introduce safe ear cleaning about the same time they teach the correct way to wash hair and trim fingernails and toenails.

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Working Mom Or STAHM?

Working Mom or SAHM: Does It Really Matter for Baby's Development?

For babies whose mothers work outside the home, the positives may outweigh the negatives.

The Scoop

The latest wrinkle in the Mommy Wars? Babies raised by working mothers may receive more positive benefits than negative ones, according to data from one of the most comprehensive childcare studies to date.

As highlighted in a July 31, 2010, Washington Post piece, researchers from Columbia University followed more than 1,000 children from 10 geographic areas through first grade, tracking their development and family characteristics. The study found that infants raised by mothers with full-time jobs scored, on average, somewhat lower on cognitive tests, deficits that persisted into first grade. But this negative was offset by three strong positives. As researchers note that working mothers had higher incomes, they were more likely to seek high-quality childcare, and they displayed greater "maternal sensitivity," or responsiveness toward their children, compared to stay-at-home mothers.

"We can say now, from this study, what we couldn't say before: There's a slight risk [for cognitive delays], and here's the three things that you, Mom, can do to make a difference," says Jeanne Brooks-Gunn, the study's lead author, in an interview with the Washington Post.

According to researchers, the study also reaffirmed that part-time employment had no negative effect, nor did it seem to matter for a child's cognitive development whether a mother worked full time after the first year.

For Baby

The link between cognitive development and working outside the home? Researchers believe that mothers with full-time jobs find it more challenging to provide an infant with "the kinds of intensive interaction that babies require," says Brooks-Gunn. High-quality childcare appears to offset this, but according to Brooks-Gun, high-quality childcare, too, is hard to find for an infant.

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Baby's First Smile

Baby's First Smile

Out of all the first milestones with your baby, the first "real" smile is one of the most anticipated.

In that instant, all the work (sleepless nights, endless diaper changes) over the past several weeks seems well rewarded because your little angel finally flashes you that pink, gummy grin. And then for the next several days, we parents try our best to re-create that smile, for family, friends, the garbage man—basically anyone who will pay attention. So when can you expect this first real smile—and how can you tell it from a reflex smile?

Reflex Smiles

Babies give fleeting smiles as early as birth and even smile in their sleep. But, according to experts, this is a reflex action or survival instinct similar to other newborn reflexes like rooting and sucking. These first reflex smiles are innate and are believed to make newborns more appealing to keep them safer.

"I can't say that I remember the very first smile, because in the beginning so many of the little smirks were questionable," says Christine Schmid, an Arizona mother of 5-month-old Sydney. "We couldn't tell if she was smiling, if she had gas or if she was just uncomfortable. I was one of those moms that read too much and learned that in the early weeks of life a child smiles for survival reasons. If they can win the love of everyone in the room, they're likely to be fed and cared for. However, even knowing this, the first smiles were the greatest."

Expect these reflex smiles to start sometime around birth to 3 days and to last until approximately 2 months.

Baby's First Real Smile

Sometime around your baby's 6th to 8th week (although some parents say as early as 4 weeks), the smiles become a reaction to stimuli or a "learned" smile. The grin lasts a bit longer and you can even see expression in her eyes. Babies learn to smile because they see your reaction. The joy in your face and the smiles and laughter she gets from you makes her want to repeat it, again and again.

It's hard to distinguish between what is a real smile and a reflex smile, but generally, your baby will use her whole face, including her eyes, when she is smiling to please you or in response to your overjoyed reaction. But don't worry if you haven't seen that real smile by week 8. Babies develop at different stages, and some very happy babies will wait up to 12 weeks before flashing the first real smile.

According to Dr. Martha Heineman Pieper and Dr. William Joseph Pieper, authors of Smart Love, the first social smile could appear around 6 weeks, but is not likely to stick around on a regular basis until 12 weeks. And by 6 months, most babies smile happily and readily at the people they know best.

"Ashley smiled from the day she was born, and she was always smiling in her sleep," says Amanda Tabscott, an Indiana mother of two. "It wasn't until she was about 5 months old, when she would wake up and really smile especially for me, happy to see me in the morning."

"In the beginning, I felt like everything I was doing must be wrong," Schmid says. "Sydney wasn't sleeping and she seemed to always be crying for food. Although this is completely normal, I guess being a new mom, I didn't know it at the time. So after weeks of giving this little girl all my love, attention, and energy, she gave me smiles that told me 'Life is good, Mom! You're doing a good job, and it's going to be all right.'"

Games to Make Baby Smile

• Peek-a-boo: One of the all-time favorite games for babies, peek-a-boo can simply be played with a blanket, burp cloth, or even a napkin. Cover your face to hide from Baby and then remove the napkin and say "peek-a-boo!"
• Upsy Daisy: While your baby is on her back, let her grasp her hands around your thumbs. Slowly pull her up to sitting position and say, "upsy daisy!"
• Bubbles: Use liquid bubbles and blow them toward your baby's face or on her neck or belly. She will get a kick out of the mysterious bubbles, especially when they pop.
• Kisses: Tickle your baby by kissing her on the neck or blowing on her face or belly to make her show that toothless grin.
• This Little Piggy: Babies are infatuated with their toes, and even love to put them in their mouths! Recite the popular rhyme as you play with their toes: "This little piggy went to market, this little piggy stayed home, this little piggy had pizza, this little piggy had none. This little piggy went WEE WEE WEE all the way home!"
  
  

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Benefits of Breastfeeding



Breast Feeding

What are the benefits of breastfeeding?

Breastfeeding has many benefits for both you and your baby. It's a lovely way for you to feel close to each other. Best of all, though, your breastmilk gives your baby everything she needs to thrive for the first six months of her life.

And once your baby starts solids at around six months, you can carry on breastfeeding her. Breastmilk is full of nutrients that will continue to do your baby good.

Breastfeeding also helps your baby to fight infections in the first few months of her life. Breastmilk contains antibodies which help protect your baby against illnesses such as tummy bugs (gastroenteritis), colds, urinary infections and ear infections.

Breastmilk also reduces the risk of your baby getting allergic conditions such as asthma and eczema. It can even help to protect your baby against serious illnesses, such as childhood diabetes and leukemia.

As well as antibodies already in your breastmilk, your body will make new antibodies as soon as you are exposed to an infection. These antibodies then transfer to your milk, ready for your baby to receive as soon as she next has a breastfeed.

Breastmilk has long-chain polyunsaturated fatty acids, which are essential for helping your baby's brain develop. Exclusively breastfeeding for the first few months can improve your baby's cognitive development. In theory, this means breastfeeding your baby could make her more intelligent.

Breastfeeding is the healthiest choice for you, too. It reduces your risk later in life of pre-menopausal breast cancer, ovarian cancer, and bone fractures from osteoporosis.

On the practical side, a big benefit of breastfeeding is how convenient it is. You have nothing to wash, sterilise or prepare. You and your baby will enjoy it, and you will feel a real sense of achievement to see her growing and developing. And it's all your own work!

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Nausea (natural remedies)

• Why it happens
• Which therapies can help?
• Self-help suggestions
• Breakfast for morning sickness

Why it happens

Nausea, also known as 'morning sickness', and mild vomiting are common symptoms in early pregnancy. You may experience feelings of nausea accompanied by tiredness and lethargy at different times of the day, but usually the symptoms will clear up by the end of the first three months. Occasionally, symptoms can continue throughout pregnancy, and may be more likely to do so if you are expecting twins. Severe vomiting that does not stop (hyperemesis) requires urgent medical attention.

Although the causes of nausea in pregnancy are not yet known, the following have been suggested as contributing factors: low blood sugar, low blood pressure, hormonal changes, emotional ambivalence about the pregnancy, food deficiency (in particular of vitamin B6 and iron), an excess of refined, spicy, or greasy foods, and pressure on the stomach from the growing uterus in the last few weeks of pregnancy.

Which therapies can help?

• Homeopathy. There are several remedies that can be effective, so consultation with a homeopath is recommended. (To find a registered practitioner, visit our complementary therapies A-Z.)
• Acupuncture, psychotherapy, and cranial osteopathy. These therapies may all be effective in relieving nausea.
• Herbalism. Consultation with a herbalist is recommended since there is such a wide range of herbs that may be useful. Chamomile and wild yam root, for example, aid digestion and have a sedative effect, while balm and meadowsweet are soothing.
• Shiatsu. Applying pressure to the stomach meridian may alleviate symptoms.
• Aromatherapy. Use essential oils of lavender, chamomile, and rose (either singly or combined) mixed with a base oil, as a massage oil. You can also put a drop or two of one of these on a tissue and carry it with you.

Self-help suggestions

Listed below are some useful tips and natural remedies that may be helpful for nausea. If one remedy doesn't work, experiment with another:
• Practice deep breathing, meditation, and yoga and try to take an hour's walk in the fresh air every day.
• Consider possible emotional causes and seek professional help if need be, or discuss your feelings with someone understanding.
• A protein-rich snack eaten half an hour before you go to bed in the evening will help to ensure that your blood sugar level doesn't fall too low during the night.
• Try to remember to get up slowly out of bed and take your time in the morning. You may find a teaspoon of cider vinegar in a cup of warm water helpful first thing.
• An infusion of grated ginger root may bring relief if drunk while you are feeling nauseous.
• Increase the iron-rich foods in your diet, such as beef, sardines, eggs, dried fruit and green leafy vegetables.
• If you have no appetite, take 10-20g of vitamin B6 as a daily supplement.
• Try an audio-therapy CD. Similar to those developed for travel-sickness, CDs are now available to ease the symptoms of morning sickness. Frequencies and pulses, disguised by music, interrupt signals from your brain to your gut telling your body to be sick.

Breakfast for morning sickness

Stay in bed for half an hour after waking and sip a digestive herbal tea, such as peppermint, fennel or chamomile, or a glass of mineral water with a few dry crackers. Rise slowly, have some fresh fruit or fruit juice and breathe deeply in the open air. Half an hour later have a slice of wholegrain toast with yeast extract and a second cup of herbal tea.

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You After Birth

You after the birth

• How will I feel as soon as my baby's born?
• What changes in my body will I notice?
• How long will it take to lose weight?
• How will I feel in few months' time?

How will I feel as soon as my baby's born?

Giving birth is an amazing achievement, and every mom responds in her own way. You may feel alert and happy - physically, mentally, and emotionally satisfied. Or you may feel bruised and battered, exhausted, disappointed and even depressed. You may be in pain if you've had a tear or cut (episiotomy). You may experience any of these feelings and emotions, or none of them.

However you feel, remember that you are recovering from a huge physical upheaval. If you had a caesarean, you will have had major abdominal surgery. Be kind to yourself and your body, and allow yourself time to get your strength back. With plenty of rest and support, you should recover quickly.

What changes in my body will I notice?

Your body has spent months nurturing and growing your baby. All the changes that helped to bring your baby into the world are now abruptly reversed.

You will have a bloody discharge from your vagina called lochia. This will be the case whether you've had a vaginal or a caesarean birth.

At first, the lochia is red, then it becomes brownish and, finally, yellowish white. For about 10 days it will be like a heavy period, and it can continue for up to six weeks in dribs and drabs. The more you rest, the lighter the lochia will be.

All the while, your uterus (womb) is shrinking back to its normal size and position. You may have afterpains as it contracts down. Afterpains feel rather like mild labour contractions.

They often happen while you are breastfeeding. This is because the hormone oxytocin, which encourages your uterus to contract, is released while you're feeding. It also can cause redder or heavier blood loss.

Your vagina will gradually regain much of its former tone. And your pelvic floor, although stretched, will return to near its usual position. You can help speed up this process by doing regular pelvic floor exercises as soon as possible after your baby's birth (Lee and Thomas 2009, Guy's & St Thomas's 2006).

If you feel bruised and battered, don't worry, you will feel better. Grazes and small tears to your cervix, your vagina and the area between your vagina and back passage (perineum) heal quickly. An episiotomy may take longer to heal. And stitches may be painful for a few days or even weeks (Andrews et al 2008, Macarthur and Macarthur 2004).

Doing your pelvic floor exercises may help to reduce swelling and speed up healing around your perineum. If you're at all worried about how you are healing, ask your midwife or nurse for advice.

After birth your breasts will be soft, as they only contain a little colostrum. This is the rich, creamy first milk full of antibodies that help to protect your baby from infection. After a few days your breasts will begin to make milk. This is often called your milk coming in, and your breasts may feel hot, swollen and tender.

At first, your nipples may feel very sensitive, and the first 10 to 20 seconds of each feed may be uncomfortable. This usually begins to ease off after about the fifth day. If it doesn't, you may need some help with latching your baby on to your breast. Talk to your midwife or a lactation consultant.

Your tummy may be flabby and wrinkly, and your waistline will still be non-existent. You won't have lost all the weight you gained in pregnancy yet. You can start gently exercising your tummy muscles as soon as you feel up to it. Starting these exercises soon after your baby's birth will help you to get back into shape and lower your chances of developing back pain (DH 2009a, Lee and Thomas 2009).

You may have a few niggles that take a little longer to fade:

• You may have hemorrhoids, but they should gradually disappear.
• You may be left with stretchmarks on your breasts, tummy and thighs, especially if you gained a lot of weight quickly during pregnancy.
• Your ankles may be swollen for a week or so, as your body starts to move and lose the extra fluid you retained.
• Some of your hair may start falling out. During pregnancy, your hair became thicker and more luxuriant, because hormones prevented normal hair loss. Once those hormones drop, you may start to lose the hair that you held onto during pregnancy. Don't worry, your hair will return to what it was.
• If you have had a caesarean birth, you're bound to be sore. You'll find it uncomfortable to move much at first. However, it's a good idea to get mobile as soon as possible, to speed your recovery.

The good news is that as the level of the hormone progesterone in your body drops, the tone of smooth muscle throughout your body improves.

How long will it take to lose weight?

In the first few days after you give birth, you will lose weight quickly as you shed fluid. The extra water you carried during late pregnancy is passed out in your urine and sweat. You will lose more weight as the amount of circulating blood returns to normal levels and your uterus gets smaller. But after this the weight loss tends to slow down.

Don't be disappointed if your body doesn't snap back to its pre-pregnancy shape as soon as you've had your baby. Unfortunately, this just doesn't happen. Your body has been through the major process of pregnancy and labour, and will need time to recover. Extra fat may linger, as nature intends this to be a store of energy for breastfeeding.

Try not to let it get you down. Don't forget, it took you nine months of pregnancy to get to where you are. So it's only fair to allow your body the same amount of time to recover its shape. Healthy eating, particularly if it's combined with exercise, can help you shed the weight (Amorim et al 2007). In time, you should be able to get your body back!

How will I feel in few months' time?

You'll be offered a postnatal check-up with your doctor or midwife about six to eight weeks after you've had your baby. Your doctor or midwife will talk to you about how you are feeling in mind and body, and will make sure you're recovering well (DH 2009a, NICE 2006). If you have any problems, such as soreness from stitches, or discomfort during sex, don't suffer in silence. Ask your doctor for help.

With a bit of attention to your posture and some gentle exercise, stretched tummy muscles should regain their tone. It's a good idea to keep doing exercises to strengthen your tummy muscles for at least three months after you've given birth (Lee and Thomas 2009).

It's recommended you breastfeed your baby for at least six months, to give her the best start in life. Once you stop breastfeeding, your breasts will return to almost their pre-pregnancy shape and size. However, larger breasts may not be as self-supporting as they were before and smaller breasts may not be as perky. It's pregnancy changes, rather than breastfeeding, that make this happen.

If you choose not to breastfeed, the levels of the milk production hormone, prolactin, will fall. Your breasts will stop making milk and will, over several months, go more or less back to their pre-pregnancy size.

Your body will have changed after pregnancy and childbirth and may have matured into a more womanly shape. Be proud of your body. It's done a wonderful job of bringing your baby into the world.

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Top 10 signs of pregnancy

If you're extremely tuned in to your body's rhythms, you may begin to suspect you're pregnant soon after conception. But most women won't experience any early pregnancy symptoms until the fertilized egg attaches itself to the uterine wall, several days after conception. Others may notice no signs of pregnancy for weeks and begin to wonder "Am I pregnant?" only when they miss a period. Below is a list of some of the first signs of impending motherhood. You may experience all, some, or none of these symptoms of pregnancy:

1. Food cravings. Yes, it's a cliché, but food cravings sometimes can be a sign of pregnancy. Don't rely on them as a sure symptom (it may be all in your head, or even a sign that your body is low on a particular nutrient), but if cravings are accompanied by some of the other symptoms on this list, start counting the days from your last period.

2. Darkening of your areolas. If the skin around your nipples gets darker, you may have successfully conceived, though this may also signal a hormonal imbalance unrelated to pregnancy or be a leftover effect from a previous pregnancy.

3. Implantation bleeding or cramping. About eight days after ovulation, you may experience implantation spotting, a slight staining of a pink or brown colour, as well as some cramping. You might also see some spotting around the time you expect your period; this is caused by the egg burrowing into the endometrial lining.

4. Frequent urination. Once the embryo implants and begins producing the hormone human chorionic gonadotropin (hCG), you may find yourself going to the bathroom more often.

5. Fatigue. Feeling tired? No, make that exhausted. High levels of the hormone progesterone can make you feel as if you've run a marathon when all you've done is put in a day at the office. Fatigue is a hallmark of early pregnancy, though probably not a surefire symptom on its own.

6. Tender, swollen breasts. If you're pregnant, your breasts will probably become increasingly tender to the touch, similar to the way they feel before your period, only more so. Once your body grows accustomed to the hormone surge, the pain will subside.

7. Altered sense of taste. You may notice that your sense of taste changes. Some women say they have a metallic taste in their mouth, others that they cannot stand the taste of coffee, tea, or a food they usually like.

8. Morning sickness. If you're lucky, morning sickness won't hit you until a few weeks after conception. (A lucky few escape it altogether.) But as early as a couple of days following conception, you may begin feeling nauseated and queasy. And not just in the morning, either -- pregnancy-related nausea can be a problem morning, noon, or night.

9. A missed period. If you're usually pretty regular and your period is late, it's worth trying a pregnancy test. A missed period is the surest sign of pregnancy in a woman of childbearing age who usually has regular periods.

And finally ...

10. A positive home pregnancy test. If you've waited to test until at least the first day of a missed period and a blue line appears in the test window, you're most likely to be in the family way. Make an appointment with your doctor to confirm the good news

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Planning Pregnancy

Planning Pregnancy

Start Your Healthy Pregnancy Now

The choices you make now, before you become pregnant, are important to your baby's health.
One of those choices should be to start taking a prenatal multivitamin containing folic acid even before you are pregnant.

Why Prenatal Multivitamins Are Important

If a woman doesn't get enough folic acid, her baby has a higher risk of developing a type of birth defect called a neural tube defect (NTD).
What are NTDs? NTDs are birth defects that occur very early on in pregnancy and can lead to abnormalities of the skull, brain, and spinal cord. In Canada, the most common of these abnormalities is spinal - a condition known as spina bifida.
These conditions can occur as early as the first three to four weeks of the baby's development, a time when many women don't even realize that they are pregnant.
One way to help prevent NTDs is to make sure you get enough folic acid. While folic acid can be found in some of the foods you eat, most Canadian women don't get their recommended daily allowance, much less the extra folic acid they need during pregnancy.
Did you know Health Canada recommends that all women who could become pregnant-as well as those who are pregnant or breastfeeding - take a multivitamin containing 0.4mg of folic acid every day? As well the Society of Obstetricians and Gynaecologists of Canada, also recommends women with no personal health risks take a daily multivitamin with 0.4 mg to 1.0 mg of folic acid at least 12 weeks prior to conception, throughout pregnancy and 4 to 6 weeks postpartum or as long as breastfeeding continues. Women with increased health risks such as epilepsy, insulin dependent diabetes and family history of neural tube defects may require a higher dose of folic acid and should consult their doctor.
It is important to choose a multivitamin especially formulated for use during pregnancy.
There is recent evidence that taking a prenatal multivitamin before you become pregnant can also help prevent other conditions in your baby, such as leukemia and childhood tumors.

When to Start

Women should begin taking a prenatal multivitamin at least twelve weeks before becoming pregnant. Since about half of all pregnancies are unplanned, starting a prenatal multivitamin now may be one of the best things you can do for your future child.
Your baby's good health starts with you.

Folic Acid or a Multivitamin?

There are many good reasons for taking a prenatal multivitamin instead of just a folic acid supplement.

Folic Acid Supplements

• help prevent neural tube defects

Prenatal Multivitamins

• help prevent neural tube defects
• help prevent low birth weight and prematurity
• help prevent iron deficiency anemia
• help maintain maternal bone health
• help prevent vitamin D deficiency

Studies have shown that Canadian women who increased their intake of folic acid reduce the rate of NTDs in their children by more than half. Because of this, Health Canada recommends that all women who could become pregnant take a daily multivitamin containing folic acid.
In addition, researchers at Toronto's Hospital for Sick Children found that women taking a multivitamin with folic acid before pregnancy helped to protect their babies from some of the most common types of childhood leukemia and tumors.
What you do today can help keep your baby healthy tomorrow.

The vitamins and minerals you need during ALL stages of pregnancy and breastfeeding

Starting prenatal vitamins before you get pregnant prepares your body for your future pregnancy.

Before Pregnancy

The extra folic acid in Centrum® Materna® helps to prevent birth defects involving your baby's skull and brain. Since many of these defects occur before a woman even knows she is pregnant, women who are thinking about having a baby should start taking a prenatal multivitamin like Centrum Materna at least twelve weeks before conception.

During Pregnancy

During pregnancy, a woman's need for many essential nutrients increases. For example, her body needs extra iron to help maintain a healthy placenta for her baby. Women who don't get the extra iron they need are at risk of developing iron deficiency. Each Centrum Materna tablet contains 27 mg of iron, the recommended daily allowance of iron for pregnancy, in a convenient once-daily dosage.
Some women experience stomach upset when taking prenatal vitamins that include iron. Some other simple things you can do to make it easier to take the pill include taking it with food or taking it just before bed.
Some women also have difficulty swallowing tablets. Breaking the tablet in half or crushing it and then mixing the powder into a drink should make it easier.

After Pregnancy

After pregnancy, Centrum Materna provides both calcium and vitamin D to help meet a breastfeeding woman's needs.
Centrum Materna has the extra vitamins and minerals your body needs before, during, and after pregnancy.
One pill for all stages of pregnancy: Centrum  Materna, complete from A to Zinc

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