Costometic

Being involved during those nine months is the best way to show how much you enjoy being a dad-to-be. Here is what to do:

1. Be By Her Side

Be there for the first check-up and the subsequent ones. Know the schedule: ultrasound scans, shots and routine check-ups. Keep a track of the growing foetus: See the scans, hear the baby’s heartbeat, feel her first movements - it will bring you closer to your baby. Find out about the diet, supplements or medicines your wife will need for a healthy pregnancy. Learn about the discomforts that accompany pregnancy from the doctor, friends or the Net, and help her cope with those. Put a cushion under her feet to avoid swelling and tiredness - and earn the tag of ‘the sweetest husband’.

2. Lend a Hand

If you haven’t been helping around the house, then start right away. Take on everything from those strenuous chores like grocery shopping to anything that involves aerosol sprays or cleaning fluids - products that may be harmful for the mother and the baby. Remember your wife is sensitive to smells at this time, so keep the garbage out and if you have a pet, clean its much yourself.

3. Love Her Changing Body

As your wife’s pregnancy progresses and she puts on those extra kilos, she may begin to feel unattractive. You can make her feel good by assuring her that you love the way she looks. Encourage her to dress the way she used to before she was pregnant and take pictures to record how her bump grows, inch by inch.

4. Get Healthier

Your wife is trying to follow a wholesome diet and lifestyle and you can contribute by sharing in those. Cut down on alcohol, quit smoking, avoid bad-for-baby food that might tempt her and pass up junk food. Treat yourselves to healthy habits - go for light walks with her and turn in early: Research has shown that regular exercise and sound sleep reduces stress.

5. Baby Her

Your wife loves being pampered and she will love it all the more when she is pregnant. Serve her breakfast in bed to start her day with a good dose of love. Call her during the day to find out what she’s eaten and if she is keeping well. Tuck her in at night. Cheer her up with gifts: a book on pregnancy, a magazine for parents and flowers. And don’t forget to fulfill all those middle-of-the-night food cravings - everything from ice cream to pickles to a cheese sandwich.

6. Be Prepared For Changes

If you are one of those couples who do everything together, then be prepared for times when your wife may not feel up to it or simply does not have the time. Also understand that while her love for you will not reduce, she may not be able to give you the attention she did before pregnancy or childbirth. Still feeling left out? Just get yourself involved in caring for your baby to share the joys of parenthood.

7. Understand Her Mood Swings

With all those hormonal theatrics in her body, your wife will be prone to highs and lows. Drive away those blues by doing little things she likes (playing her favorite music) and avoiding those she hates (talking for ages on your phone after you get back home). Be there when she needs you - remember that any kind of stress will only add to the lows. Cut out the formalities - if your wife does not feel up to chatting or socializing don’t force her.

8. Take Decisions Together

Discuss everything: shopping for baby clothes, choosing the color of his room, tackling the rising finances, arranging for help after delivery and handling an emergency - there are a lot of things moms and dads-to-be need to talk about and settle.

9. Make Love, Gently

You can enjoy having sex even while your wife is pregnant, but understand that her sex drive may be dampened by concerns of her baby, apprehensions about her pregnancy and hormonal fluctuations. Talk to find out what is making her anxious and try to dispel her fears. Also, check with your doctor about the precautions you need to take to avoid complications. Remember that sex is not the only way to feel good: cuddle up, share your baby dreams, give each other a massage or have a relaxing bath together.

10. Teach Yourself

Sign up for antenatal classes if you can. Learn everything from holding your baby to changing her diaper, to feeding her, to cleaning her poop and spitups, to giving her a bath… You will be able to participate completely in raising your baby. Besides, it will take a lot of load off your wife’s shoulders and help her cope better with post-partum exhaustion.

As an expectant parent or a paediatrician treating a baby, there are a few preventive steps that can be taken to ensure good health for your little one in the future. Vaccinating the baby being one of them and the other being Newborn Metabolic Screening (NMS). The NMS is a novel method by which one can detect problems (Inborn errors of metabolism) even before signs of the condition become apparent, so that in some cases early treatment can be commenced, leading to normal growth and development of the child. The current form of the NMS, screens the baby for more than 40 different metabolic conditions which if undetected or untreated can lead to severe developmental delay or unexpected death of the infant. The most novel aspect of this screen is all these 40 conditions can be tested for using only 4 drops of blood from the baby’s foot!

The newborn metabolic screen is done to detect babies with a complex group of disorders known as Inborn errors of metabolism (IEM). IEM is a group of genetic conditions that prevents the baby from processing food properly. This leads to an accumulation of toxic chemicals in the blood harmful to the baby’s normal development. If the condition remains undetected and untreated at birth, it can cause mental retardation or death in the baby. It is extremely difficult or next to impossible to pick up clinical signs or symptoms of these conditions in the newborn period and by the time they become apparent to the parents or the treating clinician it is usually too late. IEM screens newborns for about 40 disorders and if tested positive in quite a few instances the line of treatment is inexpensive involving dietary modifications or adding trace vitamins and hormones.

Almost all developed countries across the world have implemented universal newborn screening programs which have been tailor made to suit their needs and budget. Some countries screen babies for 40 different conditions whereas some screen them for 5-6 conditions only, based on local prevalence of these conditions and economic restraints. The Newborn Metabolic Screen is an ideal screening test because it is accurate, easily accepted by parents (only 4 drops of blood from the baby’s heel), can be easily performed by a health worker (does not need a doctor) and most important - diagnoses the condition before onset of clinical signs!

Although it is known as metabolic screen, the same test can also diagnose other conditions such as congenital hypothyroidism, G6PD deficiency, Congenital adrenal hyperplasia and other diseases which are not classified as metabolic conditions but have similar consequences, if not diagnosed and treated early in life. These conditions are much more common than the IEM, for example congenital hypothyroidism alone affects 1 in 1500 babies. The importance of diagnosing this condition as early as possible cannot be stressed, since if this condition is detected at birth, it can be completely treated by thyroxine replacement (inexpensive). If this condition goes undiagnosed after birth, the child is almost always going to have problems with their mental development.

The process of diagnosing all these 40 different conditions can be screened using only a few drops of blood, obtained by pricking the baby’s heel. After the infant’s heel is pricked the drop of blood that forms is placed on a special filter paper and allowed to dry. Once it is dried, it is sent to the lab for testing.

Parents who are healthy or have already had healthy children, don’t expect any problems and they are almost always right. Since these disorders are not very common, the chances are excellent that your child may NOT have one of these disorders. However, the few children who are born with these problems are generally from healthy families. Most babies born with these conditions are healthy at birth and signs of ill health may become apparent only after a few days to few months after birth, depending upon the underlying conditions. By screening every baby after birth, we can be sure that each infant who has a disorder can be identified and started on early treatment. The NMS goes a long way in addressing the basic medical philosophy of prevention is the best available treatment.

Pregnancy can be a difficult time for the expecting mom - both mentally and physically. Not only is your body changing in a million different ways that are totally new to you, but every little twinge can throw you into a state of panic, making you worry that something is seriously wrong. Relax, say the experts. “Women need to remind themselves that the vast majority of pregnancies go smoothly”, says Dr. Bruce Flamm, M.D., an ob-gyn in California, US. Still, pregnancy problems can - and do - happen. That is why it is important for every expecting mom to know the warning signs she should look out for and never ignore. Some symptoms require an immediate phone call to your gynecologist.

1. Extreme Vomiting

Most cases of morning sickness are annoying - but not harmful. But if you are throwing up so much that you can’t keep liquids down or if you are not urinating, you need to let the doctor know. “This can lead to severe dehydration, which is not good for you or your baby”, says Isabel Dr. Blumberg, M.D., an ob-gyn in New York City, US. It can also be a sign that you are suffering from hyperemesis gravidarum, a type of extreme morning sickness that can last throughout your entire pregnancy. Also call if you haven’t been able to keep food down for two days straight, if you think you have food poisoning or if the vomiting is accompanied by a high fever. In these cases, you may need to be given IV fluids.

2. Intense Pain in Your Abdomen

If you are less than 12 weeks pregnant, you are feeling sharp cramps on one side of your stomach and you are not yet to get an ultrasound done, your doctor will want to rule out an ectopic pregnancy (one in which the egg has implanted itself in the fallopian tube rather than in the uterus). Later on in your pregnancy, call if the pain is intense or recurrent, since it could be anything from contractions to appendicitis.

3. Watery Discharge or Contractions

If you are near the end of your pregnancy, this discharge probably means you water has broken, so head to the hospital. But if you suddenly experience a gush of fluids anytime before 37 weeks, call your doctor pronto. It might be a sign that your amniotic sac has ruptured and you are going into preterm labour. Still, don’t assume the worst. “Many women think their water has broken too early, when the baby may have just kicked their bladder hard and they lost some urine”, says Dr. Flamm.

Contractions may be another sign of preterm labour. So if you suddenly feel them coming on when you are between 24 to 36 weeks pregnant, pick up the phone.

4. Bleeding

Talk to your doctor immediately if you have vaginal bleeding. “In your second or third trimester, it could mean you have a tear in your placenta or another problem that should be diagnosed by an ultrasound”, says Dr. Flamm. Don’t panic: Bleeding during pregnancy does not always lead to long-term problems. If you are in your first 12 weeks, keep in mind that many women spot in the first trimester, so bleeding doesn’t always indicate a miscarriage.

5. Severe Headache or Swelling All Over Your Body

If you get a bad headache in your first trimester or regularly suffer from migraines, it is probably no big deal. Ditto if you have some swelling in your ankles as your pregnancy progresses - that just means you are retaining fluid. But, if you suddenly get a splitting headache in your second or third trimester, or if your hands and face swell like crazy and won’t go down, you could be suffering from preeclampsia (pregnancy induced high blood pressure) and need to see your doctor immediately. Another possible sign of preeclampsia to tell your doctor about: Your vision suddenly becomes blurry.

6. Lack of Foetal Movement

If you have not felt much in the way of kicking for about an hour, no need to call right away. Instead, drink a glass of fruit juice (the sugar in juice will make your baby’s blood-sugar levels jump, increasing the chances that he will start kicking), then lie on your left side in a quiet room for half an hour. “If you don’t count three to four movements within that time frame, give your doctor a call”, says Dr. Blumberg. “Usually it is nothing - the baby is just being especially still - but your doctor will probably want you to have an ultrasound to make sure there aren’t any problems”.

When Rachel from Detroit, MI learned she was pregnant after battling infertility for three years, she was thrilled. But soon, her excitement vanished. All she could do was lie in bed and stare at the ceiling. She stopped eating and lost three kilos in her first trimester. She even began to wish she wasn’t pregnant.

“I don’t recognize myself”, Rachel says. “I told my husband I didn’t want the baby anymore. He had no idea how he could help me. I couldn’t stop crying. After all that we had been through to have a baby, it was a terrible blow”.

Confiding in her ob-gyn didn’t help. “At ten weeks, I told her I was afraid of what I was doing to myself. But she kept telling me I’d be okay”, Rachel says. It wasn’t until the hormonal surge of early pregnancy stages began to subside at around 14 weeks that she started to feel better. The experience haunts her: “I still feel guilty that I wasn’t more joyful in those early days”. It was only after Rachel switched to a new ob-gyn and gave birth that she learned she’d suffered from prenatal depression - and could have got help.

Her experience isn’t rare. “Major depression is one of the most common complications in pregnancy stages”, says Dr. Shaila Kulkarni Misri, M.D., author of Pregnancy Blues: What Every Women Needs to Know About Depression During Pregnancy. At least 10 percent of pregnant women are likely to get the blues during pregnancy (and many will go on to have post-partum depression), yet two-thirds go untreated, according to a study at the University of Michigan Depression Center, US.

“SHAMEFUL” SYMPTOMS

The signs of prenatal depression are often similar to those of post-partum depression - extreme fatigue, irritability, anxiety, crying, sleep problems, decreased energy, appetite changes, lack of excitement about having a baby, disinterest in activities, obsessive thoughts and worries, lack of concentration, feelings of guilt, worthlessness and hopelessness. “The most troubling symptom is probably the feeling of detachment from the baby”, says Child advisors. Many pregnant women are , however, either unaware of the significance of these symptoms or are too ashamed to ask for help. “So many people believe that pregnancy protects women from depression”, says Sonia Murdock, Executive Director, Post-partum Resource Center, New York, US. “They say, ‘Why would a woman be miserable during such a happy time?’” Many depressed moms-to-be never discus their emotions with anyone because they are afraid of being ridiculed, or worse, judged. Post-partum depression, considered less taboo, receives much more attention - even celebrities talk about it.

Some experts believe the medical community doesn’t screen vigorously enough for depression in expectant moms. They argue that most prenatal visits are focused on how the mother and baby are doing physically, even though depression affects a woman’s overall health. “Psychological issues get attention only when they become severe”, says Dr. Misri. “Doctors and patients usually dismiss symptoms of depression”.

THE IMPACT ON MOM AND BABY

Keeping moodiness and anxiety a secret - or brushing them off - can have serious consequences for both the mother and the baby. Depressed women may not seek regular prenatal care and are more likely to self-medicate with alcohol, cigarettes and even drugs; in extreme cases, they may even consider terminating the pregnancy or become suicidal”, says Dr. Diana Lynn Barnes, Psy. D., founder of the Center for Post-partum Health in California, US.

One-third of women who are diagnosed with post-partum depression in pregnancy stages, also struggle with the blues while they were pregnant. Experts believe that post-partum depression cases could be avoided if prenatal symptoms are identified and treated. And it is not just the mother’s mental and physical health that’s at stake. Research shows that a woman’s depression affects her unborn child (since they share the same bloodstream - and the same elevated levels of stress hormones), increasing the risk of preterm birth and low birth weight. “A baby born to a depressed or anxious mother is also more likely to suffer from anxiety after birth”, says Dr. Misri. Prenatal depression can interfere significantly with mother-infant bonding and cause developmental delays and behavioral problems in the child.

ARE YOU AT RISK?

Pregnancy itself probably doesn’t cause depression, but it can be a trigger in women who are already genetically prone to it. The most vulnerable women are those with a family or personal history of depression or those with previous post-partum depression. Other risks include an nonsupporting partner, an unplanned pregnancy, infertility treatments and problems prior to pregnancy like a miscarriage. “Sometimes the stress of pregnancy brings on depressive symptoms”, says Dr. Joanne, “Physical discomfort due to water retention, morning sickness, aches and pains as well as a sense of exhaustion are contributory factors”. Hormones play a big role (depression tends to emerge during the hormonal surges of the first and third trimesters), though experts aren’t yet sure of the exact nature of how or why this happens and why depression hits some expectant mothers and spares others.

TREATMENT OPTIONS

Since almost all women feel tired and emotional during pregnancy stages, it can be hard to know whether you have prenatal depression. “But if your symptoms last for at least two weeks, interfere with work or affect your relationships, you should see your doctor”, says Dr. David Fassler, M.D., co-founder of the Walden Behavioral Care in MA, US. Fortunately, prenatal depression is treatable. Your ob-gyn will examine you to rule out other health issues and then refer you to a psychiatrist or another mental-health professional. If you have mild or moderate symptoms, therapy alone may be enough. But in moderate or severe cases, antidepressants may be necessary. This could seem scary, considering news reports about how the drugs might affect a foetus. Experts don’t know that these medications are 100 percent safe to use during pregnancy stages: Recent studies show that some newborns experience hypertension or withdrawal symptoms. “However, the risks of antidepressants are small compared with the negative impact of untreated depression on you and your baby”, says Dr. Misri. Ultimately, you should talk to your doctor to make the decision that’s right for you and for your unborn baby.

Being pregnant changes everything, your size, wardrobe, social life, eating habits, your relationships. Its the time when you have absolutely no control over all these overwhelming changes within and outside you. You will have the perfect family depicted in advertisements and movies but there shall be difficult times filled with a number of tough decisions too. For the first time parents it is an even tougher challenge because they are venturing into an alien territory and just learning how it is to think about someone else’s needs before their own every time. It helps to be well informed about all aspects of the birth process and have a plan in place. But before you become too fond of that plan, remember one thing, this is one venture where date, time schedules and deadlines nothing is sanctified. Your child’s due date is not its exact time of birth. It is just an approximation of when that bundle of joy will be coming home. So do plan as there is a lot to plan for even before the baby wails for the first time. Her is a list of things which would be helpful for you to plan and deal with maternity and assist you in having a healthy comfortable and happy pregnancy.

MATERNITY WEAR : Clothes are something you need to stock up on because with each passing month you shall be wearing a different size. Choose clothes that are made from durable, high quality fabric and have 1-2% spandex, which will expand with comfort for the next nine months. Buy stretch denim with side panels and buckles that are adjustable. A low waist jean is more preferable. Get flat footwears with plenty of space to accommodate your swollen feet.

EXERCISE : It prepares the body for a natural delivery, keeps it supple and flexible. A mix of exercises including yoga , physiotherapy, stretches and meditation helps the mother to be fit, relaxed and happy. It is always advisable to have a supervised workout, designed specifically keeping the pregnancy in mind. Rigorous exercising should be avoided as during pregnancy a hormone called relaxin is released which brings about relaxation in the joints and ligaments making your body susceptible to strains and sprains.

NUTRITION : A nutritious and well balanced diet is one of the most important requirements for an expecting mother. One should increase the intake of folic acid, iron and calories. An average woman does not need any extra calories for the first six months of pregnancy and only about 200 extra calories per day for the last three months. Your own appetite is the best indication of how much food you need to eat and you may find it fluctuating during the course of your pregnancy. Raw or undercooked meat (white or red) is a possible source of bacteria and should be avoided. Caffeine should also be avoided as research has linked consuming more than 300 mg of caffeine a day with an increased risk of miscarriage and low birth weight. Try to eat healthy and organic food, avoiding semi processed and canned food. Include a lot of fruits and nuts in your diet.

MEDICATION AND SHOTS : Folic acid is one supplement that is particularly important to take before you conceive and during the entire course of pregnancy. Studies have shown that lack of folic acid in the first trimester can increase the risk of spinal tube defects and lip and palate deformities in the baby. Iron and calcium supplements are recommended during the later part of your pregnancy to ensure required intake if these key minerals. Your iron levels will be checked periodically during your pregnancy and your doctor will advice you about your individual needs. Iron-fortified multivitamin supplements especially formulated for pregnancy and lactation are also available. Although most supplements are over the counter medicines, it is always advisable to check with your gynecologist first. Some of the conditions routinely checked for in most normal pregnancies are Aids, Hepatitis B, Down’s syndrome, Neural Tube Defects, RH Incompatibility and Rubella. The doctor can test for all these conditions with blood samples, taken at different times in the pregnancy. Tetanus injections (I and II) are given twice during the course of the pregnancy. The first one is usually given immediately after the pregnancy is detected and the second follow a month later.

AILMENTS : The pleasures of pregnancy are accompanied by a lot of discomforts like stretch marks, nausea, swollen feet, acidity, insomnia and bleeding gums. It is helpful to be aware of them and check with your doctor for possible cures and medication. If your doctor has not prescribed a stretch marks cream, you must request him for one. To help you with your morning sickness there are quite a few options to choose from like milk and crackers, peanuts, juice popsicles or ginger ale . Try them and pick the one that helps your cause. Bleeding and swollen gums is also experienced by expecting mothers, to avoid such discomfort, schedule a periodic dental check up with your dentist. To avoid acidity and heartburns minimise intake of extremely spicy food. A glass of cold milk also helps to neutralise the burning sensation. During pregnancy many women face sleepless nights despite suffering from numerous aches and pains and being totally exhausted. An early dinner, a warm bath and book to read in bed helps a lot.

FINANCE : Having a baby is an expensive affair. The tests, doctor visits and the hospital expenses sure will make a big dent in your annual budget. It is a sensible option to obtain an estimate of the expected expenditure and ensure that you are covered with relevant maternity benefits via health insurance or employer. To avoid inconvenience on the d-day always book your bed in advance and get all the documentation required to claim medical benefits in place.

MATERNITY LEAVE : Working mothers need to plan their maternity leave sensibly by extending the leave start date as far as possible. unless instructed otherwise by the doctor mothers can and should work almost until the due date. This provides you the required physical exercise and also gives you much more time to spend with the baby after the deliver. Before the baby comes it is good to appoint a nanny or help to take care of the baby. During the course of the maternity leave you would get an opportunity to train the nanny so that once you rejoin work your baby is in safe and capable hands.

BABY SUPPLIES : It is sensible to avoid age old superstition of shopping after birth and collect your baby trousseau in advance. During the course of pregnancy there is always chance of doctor restricting your movement or advising you bed rest and after having the baby mobility shall be restricted in the initial few days. So make a list of baby items like crib, toiletries, clothes, diapers, pram, toys, swaddling blankets and stock them in advance so that when the baby comes all its supplies are in place.

Antenatal care is the care that you receive from health professionals during your pregnancy. A healthy diet and lifestyle during pregnancy is important for the development of a healthy baby and may have long-term beneficial effects on the health of the child. It is also important for a pregnant woman to have regular checks with an obstetrician throughout pregnancy, to ensure that any conditions that may pose a risk to you or the baby’s health can be identified and treated. Regular antenatal care is important to ensure that both you and your baby are well.

The major goal of focused antenatal care is to help:

• Identification of pre-existing health conditions.
• Early detection of complications arising during the pregnancy.
• Health promotion and disease prevention.
• Lifestyle management counseling.
• Preparation for birth and possible complications.

A good antenatal care program should be designed in such a way that it detects problems of pregnancy that might need treatment - such as anemia, infection, vaginal bleeding, hypertensive disorders of pregnancy and abnormal fetal growth. It should also incorporate a comprehensive screening program to detect fetal anomalies such as heart and brain defects and also screen for conditions such as Downs Syndrome. Hence it is important to have regular ultrasound scans done by ultrasonologists specially trained in fetal medicine. The program should also incorporate a multidisciplinary team involving an Obstetrician, Ultrasonologist and a Neonatologist so that the results of the screening tests can be discussed and appropriate actions taken when necessary. Oxford Medical Publication’s book A Guide to Effective Care in Pregnancy and Childbirth is a complete guide to take best care of your life, ensure the best for you and your unborn child.

Counseling and health promotion is a very important but often forgotten aspect of antenatal care. Counseling should begin as early as possible and in fact preconception counseling should be offered at all maternity centers where women wanting to conceive are advised about the importance of taking folic acid to prevent congenital anomalies. Preconception counseling should also include providing information leaflets about the Do’s and Dont’s of pregnancy, especially during the immediate period following conception. For example women should be advised not to take Vitamin supplements and medications without consulting their doctor during the first trimester since it can result in malformation of the heart and nervous system.

Following conception it is very important to discuss with the obstetrician about lifestyle habits such as exercise, smoking, alcohol and any medications that may affect your developing fetus.

In addition to the above a good antenatal care program should involve the services of a dietitian and physiotherapist. The importance of a healthy, nutritious diet in pregnancy cannot be stressed more "A nutritious and wholesome diet is the key to a healthy baby ". You should make it a point to spend time with the dietitian to tailor make a diet that is healthy but also acceptable to you.

A value add to any antenatal care package would be a child birth instructor who would be able to explain to you what happens during labor and birth and also teaches you exercises to keep you fit during pregnancy and help you during labor. Out of many books I read when I was first pregnant, I remember a very good book The Baby Care Book: A Complete Guide from Birth to 12-Month Old by famous Jeremy Friedman, helped me take initial precautions and prepare for the little one. The book gave me a clear picture of what to expect at the time of delivery and how to take care of the child after birth.

Finally, it’s always useful if your antenatal classes are held in the hospital where you would be delivering your baby. It gives you a chance to familiarize yourself with the surroundings so that when you arrive for the delivery, you do not feel out of place. It also gives you a chance to visit the labor ward as well as the other medical facilities in the hospital such as the nursery.

Pregnancy is an important time of your life, ensure the best for you and your unborn child by availing good and safe antenatal care during this period. I think good antenatal care is not an option but a basic necessity to ensure a bright future for your child.