Having a new baby is one of the most stressful things that will happen in our life. There are so many things to worry about and you might start to feel as though you aren’t coping as well as you think you should. You may have the “baby blues” for a few days or you may have more severe feelings of depression.

It is said that there are roughly 10-20 percent of mother in Australia that suffer from postnatal depression. It is also estimated that 10 percent of first time fathers suffer from postnatal depression. Although they don't have the hormonal changes normally associated with postnatal depression, you must remember that father's lives are turned upside down when a baby arrives as well.

Postnatal depression is a serious mental illness that a lot of mothers (and fathers) suffer from, many silently, as they don’t want to admit that there is a problem.

After giving birth at your six week checkup, your doctor or early childhood nurse may give you a “test” to see how you’re going, this questionnaire is called the Edinburgh Postnatal Depression Scale. It was developed for the British Journal of Psychiatry in 1987 and is still used today as a guide to whether a mother may need some help for postnatal depression.

Below is the Edinburgh Postnatal Depression Scale for you to use on your own. Please remember that scores provide only a rough guide as to whether a woman has postnatal depression. For a full diagnosis, it is important to see your doctor.

To complete the questionnaire, circle the response that answers most accurately how you have been feeling in the past seven days.

1. I have been able to laugh and see the funny side of things.
• 0 As much as I always could
• 1 Not quite so much now
• 2 Definitely not so much now
• 3 Not at all

2. I have looked forward with enjoyment to things.
• 0 As much as I ever did
• 1 Rather less than I used to
• 2 Definitely less than I used to
• 3 Hardly at all

3. I have blamed myself unnecessarily when things went wrong.
• 3 Yes, most of the time
• 2 Yes, some of the time
• 1 Not very often
• 0 No, never

4. I have been anxious or worried for no good reason.
• 0 No, not at all
• 1 Hardly ever
• 2 Yes, sometimes
• 3 Yes, very often

5. I have felt scared or panicky for no very good reason.
• 3 Yes, quite a lot
• 2 Yes, sometimes
• 1 No, not much
• 0 No, not at all

6. Things have been getting on top of me.
• 3 Yes, most of the time I haven't been able to cope at all
• 2 Yes, sometimes I haven't been coping as well as usual
• 1 No, most of the time I have coped quite well
• 0 No, I have been coping as well as ever

7. I have been so unhappy that I have had difficulty sleeping.
• 3 Yes, most of the time
• 2 Yes, sometimes
• 1 Not very often
• 0 No, not at all

8. I have felt sad or miserable.
• 3 Yes, most of the time
• 2 Yes, quite often
• 1 Not very often
• 0 No, not at all

9. I have been so unhappy that I have been crying.
• 3 Yes, most of the time
• 2 Yes, quite often
• 1 Only occasionally
• 0 No, never

10. The thought of harming myself has occurred to me.
• 3 Yes, quite often
• 2 Sometimes
• 1 Hardly ever
• 0 Never

Add up the numbers or your circled answers. The higher your score, the more likely it is that you are distressed and may be suffering from postnatal depression. If you score is high, or even if it is low but you feel depressed, please consult your doctor as soon as possible.

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How will your baby catch whooping cough?

The main source of infection of whooping cough for you baby will come from you and your family members.

You may have it and not know it; in adults it is hard to tell if what you think is just a chest infection is actually whooping cough.

What can you do about it?

The government immunisation program has three vaccinations against whooping cough for your baby, providing full protection by the time baby is six months old.

But until then baby is open to the risk of catching whooping cough. It is important that you, your partner, and any other adults, like grandparents, who will be in contact with your baby are vaccinated against whooping cough.

You can have the vaccination straight after you give birth. It is safe to have while you are breastfeeding.

Your partner should be vaccinated before baby arrives.

Grandparents might think they are protected since they were vaccinated against whooping cough when they were kids. This protection may have faded so a booster is necessary.

How do you get vaccinated?

Your family members should head to their local GP or community health immunisation centres. You can ask your maternity hospital for a vaccination.

NSW and NT have been the most progressive in understanding the importance of the whole family around a newborn baby being immunised against whooping cough. Since 2009 the vaccine has been, and continues to be, free to parents and close family members in these states.

QLD has now also recognised the importance of this; grandparents as well as any other adults living in a household with a baby under six months old are also eligible for a free vaccination. However, it is only for a limited time.

In VIC and WA until 30 June 2011 the vaccine is free only to parents, adoptive parents and foster parents of newborn babies.

Unfortunately, there are no free vaccines in 2011 in SA, ACT, and TAS.

So, don’t be shy to hassle all adults who will be a part of your baby’s early months to make sure they are vaccinated before the joyous arrival; even if they have to pay for it.

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The World Health Organisation (WHO) suggests that there is no safe level of drinking alcohol during pregnancy and that abstaining is the safest approach. A recent report in the United States supports the WHO recommendation and advises that all pregnant women should avoid alcohol completely.

The attitude towards alcohol consumption varies largely from country to country with recommendations being less stringent in the UK and Europe. Experts in Australia have not yet arrived at a consensus on what is considered a safe level of alcohol consumption during pregnancy.

However, professionals agree that there is no particular period during pregnancy when drinking is considered to be one hundred per cent safe. As a result, the Australian Drug Foundation (ADF) recommends that pregnant women limit their alcohol consumption to small, infrequent amounts.

The Effects

Many pregnant women admit to drinking alcohol during pregnancy, particularly before realising that they have conceived, and their babies have been born healthy. Although research is still being carried out into the long-term side effects, it is generally thought that a few drinks is unlikely to seriously harm the developing baby.

What must be taken into account is the fact that everybody metabolises alcohol at varying rates and what affects one person may affect another quite differently.

It is known that the detrimental effects of alcohol are compounded if you smoke, have nutritional imbalances, consume high levels of caffeine or take certain types of medication. It is these "unknown" factors that often prompt women to avoid alcohol altogether.

In the same way that women respond differently to alcohol, babies also respond in different ways. The effects of alcohol on the unborn child can vary considerably. The effects may be influenced by:

• the quantity of alcohol consumed
• the type of alcohol consumed
• whether or not the alcohol was consumed over a period of time or during a drinking binge
• the developmental stage of the pregnancy

Babies born to women who have been heavily dependent on alcohol during pregnancy may suffer from withdrawal after birth. Symptoms of this reaction may include a bloated abdomen, irritability and tremors and fits.

Foetal Alcohol Syndrome

Heavy drinking during pregnancy is of great concern and can cause Foetal Alcohol Syndrome (FAS), a condition that is known to produce the following:

• Damage to the baby's central nervous system causing mental retardation or severe learning disabilities
• Low birthweight and severely reduced weight gain following birth
• Facial deformities, including eye problems
• Other deformities, including spinal curvature, abnormally-formed toes and fingers
• Defects of the organs

Heavy drinking during the final three months of pregnancy may increase the risk of still-birth, thought to be caused by a reduction in the amount of oxygen being delivered to the developing baby.

Foetal Alcohol Effect

Some babies who are born to mothers who are heavy drinkers escape FAS but are born with the less serious condition of Foetal Alcohol Effect (FAE). Babies with FAE may be born with low birthweight, have difficulties sleeping and feeding, and may experience problems with their hearing and vision. It is also thought that some behavioural and emotional problems are linked to FAE.

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According to the World Health Organisation (WHO) more than 300 million people in the world are obese due to poor nutrition and a lack of exercise.

Obesity is increasing at an alarming rate globally causing serious health repercussions including female reproductive problems and infertility.

According to the World Health Organisation (WHO) more than 300 million people in the world are obese due to poor nutrition and a lack of exercise.

In Australia the prevalence of excess weight and its extreme obesity, has more than doubled in the past 20 years. Experts are linking the rise to sedentary lifestyles and a lack of education.

A recent Australian Diabetes, Obesity and Lifestyle Study found that almost 60% of men and women were considered overweight or obese as defined by body or waist circumference.

By measuring waist circumference, the prevalence of obesity was found to be higher in women than men.

In the United Kingdom, an epidemic of child obesity is tipped to cause a drop in life expectancy for the first time in a century. Obesity is being identified in children as young as three years.

One in forty UK women are now "morbidly obese" meaning their health is severely at risk from excess weight. In fact it is estimated that two thirds of the UK population needs to shed pounds - the exact opposite of a century ago when the same proportion of population was underweight due to malnutrition.

In the United States the prevalence of obesity alone rose from 15.0% to 30.9% between 1980 and 2000 and continues to increase. Poor nutrition and physical inactivity now accounts for some 300,000 premature deaths each year.

Studies have found that excessive weight can cause fertility problems due to menstrual irregularities and irregular ovulation, and greatly increases the risk of pregnancy complications such as gestational diabetes and pre-eclampsia.

With obesity comes metabolic changes which human physiology was never designed to withstand. Blood pressure rises as do cholesterol and insulin resistance, the latter leading to an increase in the prevalence of diabetes.

In the space of a single generation in the UK heart problems, diabetes, cancer and respiratory illnesses (non-communicable diseases) now account for more deaths each year than infections such as HIV and malaria.

Yet obesity is not confined to those living in developed nations. In Thailand 15% children obese – up from 12% two years ago. In cities in China one in five adults is obese and there are more than 20 million diabetics.

In Greece, a nation celebrated for its abundance of fresh olive oil and salads, there are high rates of obesity in children.

Foods high in saturated fats, salt and sugar are recognised as the major contributor to obesity and overweight. In other words it is the consumption of highly-processed junk food found on supermarket shelves and served up by the fast food industry that is making our population larger figured. As a result food giants and advertisers have come under fire by action groups and health organisations.

Children have become the target of advertising campaigns by high profile multi-national companies with the use of sporting heroes and celebrities to endorse a plethora of junk food.

Furthermore, the use of computers both at work and play, watching television and other home entertainment has all added to a more sedentary life style. The WHO believes that more than half of the world’s population fails to do 30 minutes of moderate activity a day.

To find out how excess weight and obesity effect fertility and pregnancy click here.

DID YOU KNOW?

• It takes 90 minutes of running to burn off the calories of a Mars Bar.
• Coca Cola increased sales by 7 % in 2001 when it teamed up with Warner to promote the movie Harry Potter The Philosopher’s Stone.
• In the UK £452 million is spent on food advertising. The fast food chain McDonalds accounts for £42 million of this amount.
• A boy aged eight is the ideal consumer for soft drink companies and the like as he has 65 years consumption ahead of him.

THE SURVEY

The Australian Diabetes, Obesity and Lifestyle Study carried out between 1999 and 2000 to measure the prevalence of overweight and obesity in adults involved participants aged 25 years and over from 42 randomly selected districts throughout Australia. Guidelines of Body Mass Index or BMI (a formula that identifies the percentage of body tissue that is actually fat by taking your weight in kilograms and dividing it by the square of your height in metres) and waist circumference were used to determine overweight and/or obesity as follows:

• A Body Mass Index greater than or equal to 25.0kg/m(2) for both men and women
• A waist circumference greater than 80cm for women
• A waist circumference greater than or equal to 94.0cm for men

Of 20,347 eligible people who completed a household interview, 11,247 attended the physical examination at local survey sites providing a 55% response rate.

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It will be news to some that an accepted way of treating women with high-risk pregnancies isn’t necessarily as helpful across the board as previously thought. New research shows to much bedrest with certain people can effect birth weight and lead to other complications.

Bed rest is a standard prescription for mothers-to-be with threatening prematurity of term and other complications. In some cases it still may be recommended but current research is seeking further trials to determine just when ‘lying down on the job’ is NOT helpful.

The biggest no-no seems to be that bed rest contributes to a woman’s weight loss in the later stages of pregnancy when putting on weight is so important. This is bad for mother and child and can result in a newborn with lower-than-ideal birthweight.

A study reported in Biological Research for Nursing also found

bed-resting mothers suffer from more aches and pains; headaches,

backaches, soreness, muscle shrinkage and also depression.

Researchists recommend further studies comparing high-risk pregnant mums who get about as usual with those resting up more in bed in order to determine when bed rest is advisable and when it isn’t.

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Louise and Tim were both smokers. In fact Tim (24) described Louise (25) as a "hard-core smoker" as it wasn’t unusual for her to smoke a packet of cigarettes in one night, particularly if they were out meeting friends in a bar.

When Louise became pregnant, they both decided to quit cigarettes for their baby Will. Louise was so determined to kick her 10-year habit that she stopped within three days of finding out that she was pregnant.

"There really has been a significant shift in identity for me, not only becoming a mother but a non-smoker," says Louise, having smoked since she was 15 years old. "For me having a baby and giving up smoking was an enormous lifestyle change."

So how did she do it?
"At times during my pregnancy I became nostalgic for the old me," she admits.

This is her story:

Why I Quit

Before my pregnancy I smoked about 15 cigarettes a day and often as much as a packet when I went out socially. I decided to quit smoking because I didn’t want to harm our baby in any way. I also knew that if I didn’t quit I would subject myself to the disapproving eyes of judgmental onlookers.

Money was also a big incentive for giving up smoking. We knew we wouldn’t have much money after our baby was born. When I was smoking I would spend up to $60.00 a week on cigarettes. I wanted to spend this money on Will’s future and our lives together.

Some people, mostly smokers, believed that it would be more stressful for the baby if I gave up smoking during pregnancy. But I thought bulls**t.

How I Quit

I gave up within three days of discovering that I was pregnant. It was easier than I had thought it would be. I decided to completely abstain from coffee and alcohol in the first trimester and this really helped me to quit due to the association I had between drinking coffee or alcohol and having a cigarette. I also experienced morning sickness during the first trimester and as a consequence my cravings were significantly reduced. Sometimes if was around people who were smoking I would feel really sick, particularly early on during the first trimester.

I had tried to quit heaps of times before but without success. I had always told myself that I would give up if I became pregnant so there was a significant psychological factor driving my motivation. Having a baby was the best motivation.

How I Felt

Once I quit smoking I felt sh*t but ongoing morning sickness was also contributing to my sense of well-being. I was very emotional and very snappy. Once the morning sickness abated I encountered moments where I felt like having a cigarette. On occasions I gave into my resolve, but only ever in a social context and usually when I was having a glass of alcohol. At about 20 weeks I felt our baby kicking really hard after I had had a cigarette or two. Our baby was clearly distressed from the cigarette smoke I had inhaled. This incident was significant in strengthening my resolve not to smoke.

How I Coped

If I felt like a cigarette I would just think about our baby and that would normally be enough to stop me from having one. Sometimes I would have something nice to eat and that would take my mind off wanting a cigarette.

At times I resented not being able to smoke especially if I went to a party where my friends were smoking and drinking. I felt left out. Previous to my pregnancy I was smoking and drinking a lot and out having fun. For me having a baby and giving up smoking was an enormous lifestyle change. At times during my pregnancy I became nostalgic for the old me.

On those odd occasions when I did have a cigarette I received dagger looks from the people who were around me and felt publicly scrutinised. I felt particularly offended and upset when friends criticised me especially when I had been trying so hard to give up completely. I resented feeling like public property and people passing judgement on me, especially my friends.

How I Regard Smoking Now

I don’t want to be a smoker, but sometimes I still feel like having a cigarette when I have a glass of alcohol, usually when I go out. It is difficult because so many of my friends and family smoke.

Smoking the occasional cigarette whilst breastfeeding hasn’t seemed to affect Will. He’s a very healthy and robust baby.

The new policy on restricting smoking in restaurants has been fantastic. We now can go out to the pub and have a meal or meet friends and not have to worry about Will being exposed to passive smoking. We’re very careful about exposing Will to cigarette smoke and take every precaution we can.

How I Feel Now

My complexion is much clearer, my energy levels, vitality and respiratory fitness have increased. I am also much more inclined to participate in exercise than I did prior to becoming pregnant.

There really has been a significant shift in identity for me, not only becoming a mother but a non-smoker. Sometimes throughout my pregnancy I felt lost about who I am now. I guess I just didn’t know who I was. However, now I feel I have a better relationship with my partner’s family, as I know they disapproved of me smoking. Giving up smoking has also had a positive influence on my relationship with Tim, our sex life has improved and kissing is much better!

I am really glad I gave up and if I become pregnant again I know I won’t smoke.

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Common sense to save your back:

1. Become aware of how you sit.
2. If you spend a lot of the time on the phone, make sure you swap the telephone from side to side.
3. If you are sitting in front of a computer, position yourself so that you are square-on and not twisted at an angle.
4. Become aware of how you stand and try to avoid thrusting your stomach out in front as this places undue pressure on your lower back.
5. Avoid wearing high heels for long periods of time as these place strain on the lower back.
6. Alternate shoes during the day and from day to day.
7. From the midpoint of pregnancy spend as much time as possible with your feet up.
8. If standing for long periods of time, keep your feet at hip width and square on.
9. When picking up heavy objects, always bend your knees. This is particularly relevant during pregnancy to avoid placing strain on the pelvic floor muscles and womb.
10. Yoga, pilates, massage, acupressure and acupuncture will help maintain good posture.
11. If you already have toddlers, encourage hem to stand on a chair before you pick them up.
12. Divide heavy loads into smaller ones.

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Water is essential for every cell function and is considered the panacea for many ailments common to pregnancy. To maintain vitality and wellbeing it is recommended that we drink 2 litres of fresh water daily. During pregnancy this amount increases to 3 litres a day.

It is best to drink between meals to avoid diluting digestive juices. Try to drink at least half an hour before eating and an hour afterwards. If you are thirsty during a meal try a digestive herbal tea as an alternative. Peppermint, chammomile, nettle and lemon verbena aid digestion. If you regularly get up in the middle of the night, aim to drink the bulk of your water in the earlier part of the day.

Unfortunately due to environmental damage water quality has been significantly reduced in many parts of the world. You may wish to consider the source and composition of your drinking water as it may contain traces of chemicals and/or bacteria that you may be sensitive to during pregnancy. One alternative is to boil water then leave it to cool. Another option is to invest in a renewable water filter or one that is fitted to your system.

The benefits of water

Water:

• Is vital to encourage the elimination of waste products for both you and your baby
• Is the major component of breast milk
• Is necessary for the constant renewal of the amniotic fluid
• Rehydrates cells and tissues
• Helps clear metabolic waste that causes tension in muscle tissue
• Flushes the lymphatic system and supports the immune system
• Is necessary for production of healthy blood cells
• Assists the passage of wastes through both the small and large intestine
• Promotes a healthy complexion
• Supports efficient hormone production

Dehydration

• A lack of water dehydrates the body and may manifest as:
• Headaches
• Constipation
• Lower back pain
• Urinary tract infection
• Troubled or dry skin
• Reduced lactation
• Constant thirst
• Strong smelling urine
• Fatigue

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Pregnant women face a variety of health hazards travelling, particularly to tropical areas in developing countries. Such travel should only be undertaken if completely necessary due to increased vulnerability to infectious diseases. The safest time for a pregnant woman to travel is during the second trimester. Medically, it is advised not to travel in the last six weeks of pregnancy.

The tendency to be nauseous or vomit in early pregnancy is increased with travel. Drugs for motion sickness should be avoided during the first trimester although Moxolon is thought to be safe. Many women report that chewing on ginger or drinking ginger tea can alleviate symptoms of travel sickness.

Air Travel

It is recommended that you see your health practitioner before you fly and check with the airline for their individual policies. Providing you have not had any complications and your pregnancy is not considered high-risk, you can usually travel by plane up to 36 weeks. It is advisable, however, to carry a letter from your doctor between 24 and 36 weeks. Most airlines won’t allow pregnant women to fly internationally post 36 weeks.

For domestic flights, most airlines allow a full-term pregnant woman to fly providing there is no history of medical complications and that it is not a multiple pregnancy.

Tips for Comfort

Most commercial jets are pressurised to about 1600 to 2300m. Above 1600m there is a risk of hypoxia or low oxygen, especially if the traveller is anaemic.

Carbonated drinks should be avoided as they may cause gaseous distension that can be uncomfortable.

To minimise the risk of deep vein thrombosis, it is advisable to request an aisle seat so you are able to regularly get up and move around. To counteract the effects of low humidity and dehydration when flying, drink plenty of water.

Vaccinations

If your travel requires vaccinations or medical drugs consult your health practitioner as many may be unsuitable for pregnancy.
Travelling with your Baby

Babies fly free on domestic flights up until the age of two. When travelling internationally, some airlines charge 10 per cent of the adult’s total fare for a baby up until the age of two. Check this with your airline. Remember to point out your special needs or requests to airline staff when you check in.

• Your stroller can be labelled at check-ins and handed over for stowage just before you board.
• Dress your baby in sleep-easy, change-easy clothes and take at least one spare set on board.
• Try to allow time to give your baby a relaxed feed and nappy change before you embark
• Your baby will be strapped to you with an infant seat belt that is fastened to your own belt to keep your baby safe during take off and landing. Make sure your own belt is securely fastened.
• Have a bottle or breast at hand for take off and landing. Sucking will help alleviate baby’s ear discomfort.
• If you are hiring a car remember to reserve a child car seat.

Passports

In Australia children must have their own passport to travel overseas. It costs $64.00 and applications are available from the post office or State Passport Office. Once your application has been lodged it will take about ten working days to receive. For more information call 131 232. Check the procedure and requirements in your country.

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