Being a father

Fathers have a special and important role in their children's lives. Children are lucky if they have a father who is involved in their lives, who knows their friends and is interested in how they spend their day. It really helps if they know that they are loved and cared for by both parents.

 

In the past, fathers were often responsible for discipline and setting rules and mothers did most of the caring. There's now much more flexibility in what each parent does and more sharing of the parenting role.  Being a father is your most important job. While parenting can be done by either parent, children have unique experiences with both their fathers and their mothers. 

What does it mean to be a father?

 

Sometimes fathers feel unsure about what is expected of them. This is partly because there is no clear difference between 'men's work' and 'women's work' any more. You may know what kind of father you want to be, or don't want to be, based on memories of your own childhood. There is no one right way and no recipe for being a father.
What is important is to think about what is going to work for you and that will depend on:

• what you expect to do as a father
• what your children's mother expects
• what your partner expects if she is not your children's mother
• whether you are living with your children all of the time or some of the time, or whether they live with their mother and visit you
• the way you and your partner balance work and family responsibilities
• the good things that you want to do for your own children
• what your father did with you
• the things that you see other fathers do
• what your own children want and need.
  

The most important gift that you can give to your children is your love. This means getting to know them and being involved in their lives so they also get to know you.
It means spending time with your children and making the most of the time you spend with them.

Some things that all fathers can do

 

• What children say they want from fathers:
  • "Do things together."
  • "Sit and talk."
  • "Don't work so much."
• Talk about your feelings so that your children learn that it is okay for men to talk about feelings. Talk about when you feel sad and happy.
• Spend time with your daughters. You are the first man that your daughters really know. It will help them to feel good about being female if they see that you enjoy your time with them and you respect women. You are helping them to learn how to expect men to treat them when they grow up.
• Show your sons how you would like them to be when they are men. To learn this boys need to spend time with you and with other men. They will learn much more from what you do than from what you say.
• Enjoy your children's company - get involved, read, play, have fun, do things together.
• Take your children to work with you sometimes if you can. Let them get to know how you spend your days when they are not with you.
• Being out of work and having money worries can make problems for parents, but it may also mean that you have time to give to your children. Make this time special so they will remember it all their lives.
• Comfort them. Children, even tiny babies, can get a special feeling of security from being comforted by their dads when they are frightened or upset.
• Read to your children - starting from birth. It really helps to create a strong bond with them. Reading books can simply be looking at pictures, or enjoying being together. Bedtime is a great time for stories.
• Play with your children. Fathers often enjoy active and tumble play. Children can learn a lot from this sort of play with their fathers. They learn that you can be strong and have fun while being gentle, always stopping before things get out of hand.
• Help your children with their sport or hobbies by attending their games and maybe even coaching or helping out with their team.
• Share your own interests and hobbies with them by involving them in what you do.
• Share your child's life. Go to school and preschool parent nights, to the doctor, to the park and shopping.
• Encourage your children to explore the world and find out about new things to do and try.
• Teach your children about rules and laws. Teach by what you do, as well as what you tell them. Stick to what you believe is right and in their interests, even if it annoys them.
• Encourage your children to stick at a problem even if it is hard.
• Expect your children to do their best and be proud of them when they do, but be proud of them when they try, but fail.
• Don't push your children into doing things you wanted to do and missed out on. They need to live their own lives.
• Show your love in different ways if you find it hard to say you love them. It doesn't need a lot of talking to:
  • take your children fishing
  • help them with their homework
  • go for a walk in the park
  • cheer at a school football match.
    

What matters most for children is how you are a father. Even if you are not a full-time father your children need to know that you care about them and you will look after them.  Being a father also means making sure that your relationship with your partner/spouse is working well. One of the things that will help your children most is for their parents to get on well together. Children usually love both parents and it hurts them to see parents fighting or putting each other down. This does not teach them how to make good relationships with others as they get older. 
 

What you can do

 

• Make regular time to be together as a couple without the children.
• Discuss your feelings right from the start. When you have your first baby your relationship with your partner will bring big changes. She may feel tired and sometimes overwhelmed by coping with body changes and with new responsibilities. You may feel left out or even jealous. Set a pattern of working things out together for the sake of your new family.
• Talk to your partner about how it is for you as well. For example many men feel a great responsibility to look after the family especially if there is a new baby and the wife's income has suddenly stopped. This can be a worry. Talk it over with your partner. Listen to her feelings as well.
• Talk about what you each expect of yourself and your partner in looking after the children.
• Work out how you will share things like:
  • getting up at night
  • bathing and feeding
  • arranging a babysitter when you go out
  • taking the children to school and activities
  • managing discipline
  • arranging some free time for each of you
  • taking time off work when the children are sick (find out what your work offers in parenting leave for fathers).
• Try to sort out any relationship problems away from the children.
• Treat your children's mother (and all women) with respect so that your daughters will grow up knowing that it is good to be a woman and your sons will know how to treat their future partners.
• If you don't agree with the way their mother handles something discuss it with her in private. If you still can't agree remember - children can learn to cope with parents being different. What they can't cope with is parents putting each other down. 
   
  

Premature baby

A full-term pregnancy is between 37 and 42 weeks, so a baby born prior to 37 weeks is considered premature or pre-term.

Risk factors for premature birth

Some reasons for premature birth remain unknown. However, there are a few maternal risk factors, including:

• High blood pressure
• Diabetes
• Severe illness
• Smoking
• Twin or multiple pregnancy
• Previous premature birth.
  

What are the survival odds of a premature baby?

The closer your baby is to full-term, the better the survival odds. With each extra week spent in your womb, your baby's chances of survival are increased. A baby born at 24 weeks has a 58 percent chance of living, but this rises to 98 percent or more by the time the she reaches 28 - 30 weeks.

How much do premature babies weigh?

A premature baby can weigh as little as 500 to 2500 grams. Full-term babies usually weigh more than 2500 grams (about five pounds eight ounces).

Typical complications of premature birth

Premature babies often face various complications because their brain and organs haven't developed and matured enough to function outside of the womb. Some of these include:

• Apnoea - this is when breathing stops for a short period of time because the respiratory centre in the brain has not matured.
• Bradycardia - a slowing down of the heart rate, usually caused by apnoea.
• Bronchopulmonary dysplasia (BPD) - also known as Chronic Lung Disease, usually requiring ventilator or incubator oxygen.
• Temperature control difficulties - due to the lack of body fat and the temperature centre in the brain not being fully developed, premature babies can't keep themselves warm.
• Feeding difficulties - a feeding tube into the stomach is often required as premature babies are too immature to suck.
• Jaundice - a premature baby's liver is too immature to process bilirubin properly, a compound in the blood that breaks down red blood cells.
• Retinopathy of prematurity - this is the abnormal growth of blood vessels in the eye that can result in damage ranging from mild (the need for glasses) to severe (blindness).
• Infection - premature babies are susceptible to infection because they are less able to fight germs.
• Anemia - many premature infants lack the number of red blood cells necessary to carry adequate oxygen to the body. 
  
  
  

Premature babies in hospital

• NICU - Nearly all babies born over eight weeks prematurity require special care in a Neonatal Intensive Care Unit (NICU). In the NICU a premature baby may receive respiratory support from a ventilator to assist with breathing and, because she is yet to develop sufficient fat under the skin, is often nursed in either an incubator or under a radiant warmer to keep her temperature stable. Premature babies often haven't yet developed the sucking reflex and so are fed through a feeding tube into the stomach. How long a baby stays in NICU depends on how early she was born and the severity of her complications.
• Nursery ward - Babies are often transferred to a special care nursery ward after intensive care to continue growing and maturing. Once they are able to suck well, premature babies can usually be taken home. This is often around the same time as your due date. 
  
  

Premature birth and ongoing complications

 

The risks of a premature baby having a severe disability vary depending on how prematurely she was born. Around half of babies born at 24 weeks are at risk of intellectual disability, cerebral palsy, blindness or deafness. A few babies born before 30 weeks may have eyesight, hearing, movement and understanding problems. A premature baby born close to full-term will not usually have any long-term problems.

Remember

• The causes of premature labour aren’t fully understood, so prediction and prevention are difficult.
• The chances of survival for premature babies depend on the degree of prematurity and their birth weight.
• Premature babies who survive are at risk of a range of mild to severe disabilities, including visual impairment, developmental delay and learning difficulties.
  

Newborn screening tests

When you're in hospital, dazed and confused post-birth, it can be worrying to see doctors 'testing' your newborn. Don't worry, we all go through it.

In the first few hours and days of life, your baby will be screened for a range of disorders and illnesses. In most cases, your baby will be fine and you'll feel reassured. In a very small minority, something unusual may show up - in which case doctors can work out very early what, if anything, needs to be done. It's important to note that screening tests don't diagnose illnesses - they simply give doctors a 'heads up' that your baby may need further tests to rule out serious conditions. Newborn screening is an early intervention program that has proved extremely successful worldwide.

Here's an idea of what to expect.

Apgar Score

The Apgar scoring system is used to assess the condition of your baby at birth. She will be checked at birth, at one minute and five minutes. Five physical characteristics are observed - skin colour, heartbeat, reflexes, muscle tone and breathing - and a score of 0-2 is given for each.
If your baby is born with an Apgar score of 0-3, active resuscitation begins immediately. If she has required resuscitation and the five-minute score is less than seven, the score is repeated at five-minute intervals until 20 minutes.
A score of 7-10 is normal. A score of 4-7 means some resuscitation is required. A score of 0-3 requires immediate resuscitation.
The test simply checks all your baby's vital signs and helps your medical team decide whether assistance or treatment is required, at the time of birth, or later.

Heel prick (Guthrie) test

How does it work?

• A midwife will collect a small sample of blood from your baby, somewhere around 48-72 hours after birth.
• The sample is taken via a heel prick, which will not harm your baby (though she may experience some discomfort).
• The blood is collected on a screening card, which is sent to a screening laboratory.
• The laboratory tests your baby's sample for a range of different chemicals. Any abnormalities in levels of these chemicals will need to be investigated further.
• If your baby has a positive screening result, you will be contacted by a health professional and referred to a specialist if required.
  

What are they testing for?
 
Rare genetic disorders. Up to 30 conditions are tested, the main three being:

• Amino Acid Disorders (eg) Phenylketonuria (PKU): caused by missing enzymes that break down protein, this condition can result in developmental delay, intellectual impairment, muscle problems and seizures. It can be treated/managed through dietary modifications
• Primary congenital hypothyroidism(CH): caused by a thyroid gland that's unable to produce thyroid hormones, this disorder can cause growth failure and intellectual impairment. It is treated/managed through thyroid hormone supplements
• Cystic Fibrosis: caused by abnormal secretions in the body, particularly in the lungs and pancreas, CF can result in impaired digestive and respiratory function, infections and decreased life span. It is treated/managed through dietary supplements and physiotherapy.
  

Your hospital may also test for other conditions, particularly if people in your local community have them. Check with your health professional for details on exactly which conditions will be screened.

Developmental Dysplasia of the Hip (DDH)

Usually checked for by a doctor immediately after birth (or in your baby's first few days of life) and then repeated at six weeks.
How does it work?
Your baby will be placed on her back and her legs moved. The doctor is feeling and listening to each hip for signs of dislocation (you may have heard of 'clicky' hips?). Sometimes an X-ray or ultrasound will be used in the test.
How common is it? Around one in every 700 babies is affected. Babies at higher risk include those born after a breech presentation or where there is a history of DDH in the family.

Hearing test

This usually takes place in the first week, though it is not compulsory in all countries. If your baby is not tested at birth, it can be done through your child health professional at one of your follow-up visits.

Small sensor pads are placed on your baby's head while she is quiet or asleep, and specific sounds are played into her ears through a soft ear tip or earphone. Her responses are recorded.
With all the screening tests, you usually only hear of the results if there is a problem. If this is the case, you will be told immediately and given advice on what to do next. If your baby's test results were not clear, she may be required to have further tests.

Importance of active listening

Active listening can be a powerful tool to improve communication and build a positive relationship with your child.

Active listening: the basics

 
Active listening to your child is more than simply hearing her. You can actively listen by:

• getting close to your child when she’s speaking
• looking at your child
• allowing your child to finish and not interrupting
• avoiding questions that interrupt your child’s train of thought
• actively trying to understand what your child is saying
• concentrating hard on what your child is saying rather than thinking about what you will say next
• showing your child that she’s being heard and understood
• showing her that you’re interested by nodding your head, smiling, and making comments like ‘I see’.
  

Listening isn’t the same thing as agreeing. You can understand another person’s point of view without agreeing with it.

Benefits of active listening

 

When you use active listening with your child, it shows your child that you care and are interested. In fact, it can help you learn and understand more about what’s going on in your child’s life.  Active listening can prevent blocks in communication and even make it more likely that your child will seek your views.  It’s good for your child’s thinking processes too, and can help him to clarify his thoughts.  Good listening is the best way to show your child that you’re genuinely interested and that you really care. It also helps to avoid conflict caused by misunderstandings.
 

Improving your listening skills

 

An essential ingredient of strong, healthy relationships is good communication. Successful communication depends a lot on how you listen. Here are some ideas for improving communication by improving listening skills.

Get into the here and now 

This means really paying attention and not thinking about something else when your child is talking to you.  To understand why this is important, think about how it feels when you’re talking to someone and that person keeps watching the TV or texting on a mobile phone. Contrast that with how it feels to have someone’s undivided interest and attention.  Showing that you will take time out to listen lets your child know that you’re available and interested in what she has to say.

Try to understand

Concentrate on what your child is saying rather than thinking about what you’re going to say next. Are you missing his point while you think about your own? What is he trying to tell you and why?

Show that you’re trying to understand
 
Summarise your child’s main points and how you think she might be feeling. Try repeating what your child is saying in your own words. For example, ‘You’re feeling angry because I didn’t talk to you before making plans for this weekend. I can understand that’.  Try to avoid making judgements in your summary. For example:

• Judgmental – ‘You want to stay out too late’.
• Nonjudgmental – ‘You want to stay out until midnight’.
  

Then invite your child to tell you more about what he’s thinking and feeling. Often when you use active listening and repeat back the speaker’s words, it acts as an invitation because the person will say more to correct you or further explain what he’s thinking.

Tips for using praise, encouragement and rewards

 

• When you feel good about your child, say so. 
  See if you can give your child some words of encouragement every day. The small things you say can build up over time to have a big effect on your child. 
  
  
• Describe what it is that you like. 
  When you say exactly what you’re happy about, your child knows what you mean. For example, ‘I like the way you’ve organised your room. You’ve found a spot for everything’ or ‘I love the picture you drew. You really know how to put colours together’. And describing what you like is much more genuine and convincing than vague praise such as ‘You’re a good boy’. 
  
  
• Praise your child for his strengths.  
  Children have their own unique set of strengths (and weaknesses). Try to appreciate your child’s good points. Try to avoid comparing one child to another, because this can lead to feelings of resentment or create unrealistic expectations. 
  
  
• Encourage good behaviour with praise, rather than pointing out the bad. 
  This means trying to do more praising than criticising. 
  
  
• It takes a lot of praise to outweigh one criticism. 
  Experts suggest trying to praise children six times for every one time you criticise them. 
  
  
• Look for little changes and successes. 
  If you wait until your child has done something perfectly to give a compliment, you might find yourself waiting forever. 
  
  
• Accept that everyone’s different, and love those differences. 
  Encourage each child to develop and feel excited about particular interests. Help your child develop a sense of pride and confidence in her choices or activities. 
  
  
  
  
  
  

Help your child to focus

Children with focusing concerns happen to share a big time problem with their parents - high levels of frustration. While most children hope to succeed in classes at school or when relating with peers, the academic and social realms are not easy for kids with focusing problems. In fact, school and friends become fronts for losing battles for many distracted children.

As frustrating as life is for the distractible child, it can be even more challenging for their parents and teachers. Sadly, some parents react harshly to a distracted child. That child usually becomes even more distractible. Talk about a destructive cycle of distractibility! To help these children, it is crucial that parents learn to understand and manage their own frustrations as well as those of their distracted child. Distractibility problems in children can have more than one cause and the most common reasons are listed below.

What causes distractibility in children?

Distractibility in children can be the result of one or any combination of several sources, including:

Attention Defficit Hyperactivity Disorder (ADHD)
Anxiety
Depression
Major life changes (e.g., divorce, relocation)
High levels of day to day stress
Learning disabilities

Despite the cause of the distractibility, the end result is that distracted children end up with low self-esteem.

Bolstering self-esteem

Parents and teachers have a right to feel frustrated when managing distracted children. At the same time, telling a distracted child that if s/he cannot pay attention s/he may fail or be expelled from school, however, almost never helps the child improve. Worse, this is more likely to create feelings of inadequacy and shame. A strategy more likely to succeed would be to explain that you are proud of how hard your child has worked to achieve success, even though he has been challenged with distractibility.  How can we further bolster a distracted child's ability to cope inside and outside the home with frustration and the feelings of anger, despair or self-doubt that often accompany their focusing problems? Some further strategies are below.

Be understanding

Remember that the distraction prone child is struggling with feelings of inadequacy. It is of utmost importance that parents are empathetic with their frustrated children. These children need extra doses of understanding and encouragement to stay motivated.

Be calm, firm, and non-controlling

Avoid yelling. Yelling is really just an adult temper tantrum that only clouds your child's mind, making him more distractible. Keeping your cool, stating clear expectations, and trying not to command these children is the formula for success.

Get to the bottom of the problem

Remember that your child is not being bad when he or she is frustrated. The true reason for the possible tears is that she is struggling with a task that is beyond her resources at the moment. Stay tuned into the frustration and remember what it is that makes your child find homework hard to do. This is much more productive and healthy than just viewing your child as "lazy." Keep asking questions to determine, for example, whether your son is frustrated because he doesn't understand the parts of the sentence. Try to discern how much your child learned the material in school and what is it about this problem that's too hard. Once you identify that there's a problem area or skill deficit, you can work on that or involve the teacher to help re-teach the material.

Don't wait for the drama and tears

Focus on the first signs of a meltdown and intervene early in the sequence of events. Does your daughter fidget, stare into space or seem reluctant to begin the work in the first place? Pay attention to those moments before you just mutter, "Oh no, here we go again..."

Break down big problems into smaller ones

This strategy is usually overlooked and underused. Distracted children will feel more motivated by small successes versus big failures. Your child might need a break, or some help turning a big project into a series of small jobs. Children may need an adult to supply the structure. For example, saying "Yes, this problem is a tough one, but let's see what we can do. Let's do one question together, then you try the second and I'll be right here if you need me." Modelling calm attention to a task often has a calming impact on kids.

Use checklists

Help your child get into the habit of keeping a to-do list. It's very reinforcing to be able to cross tasks off a list.

Draw on past successes

If your son is frustrated at not being able to get a hit on the baseball field, remind your child of the time he learned to do a new trick on the skateboard and ask, "What worked for you then? You're reminding him of a time when he did do well and encouraging him to use the same strategies in this new situation."

Focus on the present

Rewards down the road don't work so well for easily frustrated kids. Something more immediate needs to happen. A colourful new sticker when she completes a math problem might encourage your young daughter to go on to the next. Avoid making the outcome or incentive too big or long-term. Saying in October, "You can get a new bike this summer if you get your homework done more often," is a reward that is too distant in the future.

Keep proactive and open communication with your child's teachers

Distracted children tend to shut down quickly when they encounter obstacles. The great news, however, is that you can help your child resist sinking and keep on swimming if you stay active and involved.

Remember to be a helper but not an enabler

Doing too much to help your child to finish a difficult assignment may feel good to her, but it's not good for her. Remember that distracted children are often surrounded with negativity and begin to expect failure. Amidst their considerable challenges, it is easy for distracted children to feel that they are often in trouble and inferior to their peers. Let your child know that in addition to loving him that you believe in him.

As much as you may hope your distracted child will outgrow her distractibility down the road, it is far from certain. For some children, the symptoms get better as they grow older and learn to adjust. Others, because of their genetics, may demonstrate continued tendencies toward distraction. Just keep in mind that the distractible children with the best chance of becoming well-adjusted adults are those who have loving, supportive parents who work together with school staff, mental health workers, and their healthcare provider (when needed).

Being aware of your children’s unique temperament, and how they respond to the world around them, can help you to modify your parenting and your children’s environment so they can feel and be more successful.

Pregnancy stretch marks

Pregnancy is normally an exciting time, filled with preparations and dreams of the new baby. Pregnancy can also bring unexpected bodily changes. You may start to notice red or purplish streaks forming on your body, most commonly on your belly and breasts. They are a sign that the skin is stretching to accommodate and nurture the life growing inside.

Stretch marks, called striae distensae, are seen often, and in varying degrees during pregnancy. They are caused when the elastic fibres and collagen in deeper layers of your skin are pulled apart to make room for your growing baby. When the skin tears, collagen breaks down and shows through the top layer of your skin as a pink, red or purple indented streak. Nearly 9 out of 10 pregnant women develop stretch marks on their breasts, tummy, hips buttocks and/or arms. Stretch marks may appear early or later in your pregnancy. After pregnancy, they may fade to the same colour as the rest of your skin, but they won't go away.  You can help minimize the severity of stretch marks by gaining weight slowly and steadily during pregnancy. Any large increases in weight can cause stretch marks to appear more readily.

Can they be prevented?

• If your mother or your sister developed stretch marks during pregnancy, then you may be more likely to develop them as well. There are a few things you can do that may limit the number of stretch marks you get or minimise them.
• People who put excess weight also often get stretch marks. Avoiding putting on excess weight, whether you are pregnant or not, will mean you have a healthier lifestyle.
• Maintaining a healthy diet will also help to maintain skin elasticity. Eating well during pregnancy is of course extremely important. Pregnancy is not a time for a restricted diet, and dieting will not mean that you avoid stretch marks. Support your body and skin with a natural diet high in antioxidants and be sure to include healthy fats.
• Drink lots of water! Water helps your skin stay moisturised.
• Exercise during pregnancy is beneficial for the skin and good for you in general. Before you start any new exercise program in pregnancy it is wise to consult your doctor.
• Skin brushing - lightly brushing your body all over with a loofah or brush - can stimulate blood flow to the skin.
• Your breasts grow quite a few sizes during pregnancy and will need extra support, and so good, supportive bras are a must and will help minimise stretching of breast tissue, though there is no evidence they will prevent or minimise stretch marks.
  

Creams 

 

Despite the fact that there is not scientific evidence to prove that they work, there are many different creams and oils that are promoted as helping to prevent stretch marks. These include olive oil, aloe vera, cocoa butter, shea butter, rose hip oil, vitamin E, retin A and centella asiatica extract (a herb also known as Gotu Kola). These are applied externally however it is important to consult your doctor if you are in any doubt about the possible effects of a product, especially during pregnancy. (Retin A cannot be used during pregnancy or breastfeeding).

What can be done to reduce their appearance?

For most women the treatment of stretch marks is not a priority after the birth of their baby. If you want to try something, it is thought that early treatment of stretch marks shows better results than leaving them until they are years old.  New and better ways of using lasers for stretch marks are being actively pursued. In the past, some laser treatments have resulted in worse scarring than the original stretch marks, especially when used by inadequately trained operators.  Some women have opted for mini tummy tucks, to tighten up this area. This reduces the appearance of stretch marks, and smooths the skin.
 
General good fitness and exercising the tummy area can help the tummy to become more toned and this can reduce the indented look of stretch marks, although it can be very difficult or impossible to return your abdomen to its pre-pregnancy state.

Pregnancy changes our breasts too. Breasts may be smaller and less firm than previously. Some find that their breasts are permanently larger. Others find that their breasts slowly regain fat and roundness, with stretch marks becoming barely noticeable, although the breasts do not gain their pre-pregnancy firmness.

Being scar tissue, stretch marks will not tan, and may become more visible under a summer tan. Using a tanning product may help to overcome this - and is safer than spending hours in the sun.

In the real world

Although media images commonly depict images of pregnant or breastfeeding women with blemish-free bellies and breasts, real women know that stretch marks are very common. Attitudes towards stretch marks vary greatly. Some women feel that their stretch marks are somewhat disfiguring, while others accept them as being part and parcel of pregnancy. And yet others are proud of them because they are signs of the amazing process that took place in bringing a new life into the world. And what an amazing process pregnancy is!

Birthmarks

Most babies are born with some type of discolouration on their skin - the majority of these disappear on their own in the months after birth, though occasionally, they increase in size before disappearing.

Birthmarks are those marks on the skin that are permanent and will never disappear. While birthmarks don't cause any discomfort to the barer, they can be upsetting for new parents when they are large or in a prominent area such as the face. Experts still don't know why some babies develop birthmarks.

Types of marks on your baby's skin

 

• Stork marks

Technically known as vascular ecstasia, but more commonly also known as stork bites, these little pink patches of skin are usually found on the forehead, eyelids, nose, top lip, on the bridge of the nose and the nape of the neck. Stork marks appear on approximately 50% of newborns and will fade or disappear completely over time - although these marks do sometimes become more visible when the barer is crying or distressed.

• Strawberry marks

These are caused by an overgrowth of tiny blood capillaries. A common skin mark, these bright red or purple patches are raised soft swellings that very often grow before eventually shrinking and disappearing altogether. Some strawberry marks continue to grow until your baby is about nine months old but it is not unusual for a child over 2 years to have a strawberry mark. It is generally not recommended that any treatment be given to remove these mark as they do tend to disappear on their own and most treatments lead to some form of scarring.

• Spider marks

These are medically known as spider naevi, and are a collection of small broken blood capillaries that are visible just under your baby's fine skin. The medical term for them is 'spider naevi'. Most disappear in the first two years of life.

• Mongolian spots

This term describes a patch of bluish skin - it almost looking like a bruise - that commonly appears across the lower back and buttocks of babies with darker skin. The mark is the result of an accumulation of pigment under the skin. These marks are often present at birth but may appear in the hours or days after birth. Completely harmless, mongolian spots usually fade away within the first 3 years of life.

• Birthmarks

This term most commonly describes the variety of brown marks on the skin. Most usual are the flat, pale coffee-coloured birthmarks that grow as your child grows without ever becoming darker; or moles, a dark brown, slightly raised area on the skin.

• Port wine marks

Often referred to as port wine stains, these bright red or purple birthmarks are caused by dilated capillaries in the skin. Port wine marks are permanent and will not fade. They are more commonly found on the neck and face and some may be removed by laser treatment when your child is older. 

Can I have my baby's birthmark removed?

 

Parents are often tempted to have disfiguring birthmarks removed, but it can be better to leave them untreated unless they begin to interfere with the body's functions. Sometimes strawberry haemangiomas may require treatment, if they're on or close to an eye, or the throat or mouth. Consult your doctor if you're worried about a birthmark. 

Treatment options

 

Depending on the type and severity of the birthmark, these include cryosurgery (freezing off the birthmark), surgery, laser therapy, the application of steroids or other medication. There may be some scarring, which can sometimes be improved with plastic surgery.

Port-wine stains are sometimes difficult to remove completely, particularly if the mark is dark, but they can usually be made lighter with laser therapy. Some laser treatments work better and leave less scarring when carried out on adults rather than children.

Moles can usually be surgically removed but may leave some scarring.

Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes. This means the embryo will not be able to develop into a baby as the fallopian tube is not large enough to support the growing embryo, which can be devastating to the pregnant woman.

An ectopic pregnancy is not a viable pregnancy as there is no way to move the embryo while all steps are taken to preserve your future fertility, removing an ectopic pregnancy does also require removing the fallopian tube in many cases. It is an extremely serious and potentially life-threatening condition that needs urgent attention due to the risk of rupture of the fallopian tube if left.  Ectopic pregnancies present very early in pregnancy - usually by 8 weeks -and treatment options vary depending on the condition of the fallopian tube and the age of the embryo.

Symptoms of an ectopic pregnancy 

 

• Moderate to severe pain starting on one side of your abdomen - this may eventually spread across your entire abdomen
• Light to heavy bleeding
• Fainting, dizziness and weakness
• Bowel pain - you may experience pain when passing urine or stools.
• Diarrhoea and vomiting - an ectopic pregnancy can cause similar symptoms to a gastrointestinal disease and is often associated with diarrhoea and vomiting.

Many women with ectopic pregnancies report experiencing all the symptoms of pregnancy - but in milder proportions. Many miss their period (so confirming that they're pregnant) only to have light bleeding some time later.

Causes of an ectopic pregnancy

 

Ectopic pregnancies can be caused by damage to the fallopian tube (thereby slowing the passage of the egg from the ovary to the uterus) - the most common causes of this are Pelvic Inflammatory Disease and Endometriosis, or scar tissue from previous surgery. 

Treatment of an ectopic pregnancy

 

After diagnosis - which usually involves a blood test, an ultrasound and a possible laproscope - there are two options available depending on your particular circumstances.

• Medication - if the pregnancy is early and the fallopian tube is in good condition, an injection of methotrexate will be administered to stop the growth of the embryo
• Surgery - the embryo is removed using laproscopy (key-hole surgery) and any damage to organs is repaired.
  

Once you have had an ectopic pregnancy, your chances of having another goes from 1 in 100 to 1 in 10 and this statistic continues to grow with each ectopic pregnancy. The risk of ectopic pregnancy also increases with age. However, depending on the outcome of your ectopic pregnancy and any underlying fertility issues you may have, many women go on to enjoy normal pregnancies.
 

Why does an ectopic pregnancy happen?

 

In a normal pregnancy an egg is fertilised by sperm in one of the fallopian tubes, which connect the ovaries to the womb. The fertilised egg then moves into the womb and implants itself into the womb lining (endometrium), where it grows and develops.
An ectopic pregnancy occurs when a fertilised egg implants itself outside the womb. It most commonly occurs in a fallopian tube (this is known as a tubal pregnancy), usually as the result of damage to the fallopian tube or the tube not working properly.
Less commonly (in around 2 in 100 cases), an ectopic pregnancy can occur in an ovary, in the abdominal space or in the cervix (neck of the womb).
Things that increase your risk of ectopic pregnancy include:

• pelvic inflammatory disease (PID) - an infection of the female reproductive system, typically caused by chlamydia
• smoking
• having a previous history of ectopic pregnancies.
  

In around half of all cases, there are no obvious risk factors.


The loss of your pregnancy at any stage can have a huge impact on you and your partner. One day you are pregnant and planning your future life with your child, and then within a short time, your pregnancy ends. The ending of an ectopic pregnancy is a form of miscarriage – and the feelings that a woman and her partner may experience can be similarly difficult. It is not uncommon for feelings of grief and bereavement to last for 6-12 months, although these feelings usually improve with time.

Newborn jaundice

Mild jaundice in babies occurs in about 50% of full-term newborn babies, and in up to 80% of premature babies. You’re most likely to notice it from the third day after birth. Jaundice is usually harmless and disappears after 1-2 weeks.

What is bilirubin?

Bilirubin is a breakdown product from red blood cells. Before your baby is born, bilirubin is transferred easily across from the placenta from the fetus to maternal circulation. Through this process, your body is able to rid of the bilirubin from the baby. Once your baby is delivered and the umbilical cord is clamped, the baby is on its own to handle the bilirubin produced in its own body.

Symptoms

 

Jaundice in a newborn causes the skin and the whites of the eyes to go a yellow colour. The jaundice typically starts on the face and head. If the level of bilirubin increases, the colour will spread to the body. Babies might also be drowsy and have feeding difficulties.

When to see your doctor

 

Jaundice is usually harmless, but a nurse or doctor should check and monitor all cases of jaundice in newborn babies. Some babies have severe jaundice, which very occasionally can lead to deafness and even brain damage if not treated promptly.
You should take your baby to the doctor if:

• your baby is unwell, feeding poorly and not gaining enough weight
• your baby’s poo becomes pale or baby’s wee becomes dark
• your baby develops jaundice in the first 48 hours after birth
• the jaundice becomes more noticeable after a week
• the jaundice hasn’t gone away after two weeks.
  
  

Why do babies become jaundiced?

 

After birth, if your baby has problems dealing with bilirubin, it may develop high levels of it in the blood. Your baby may develop jaundice - yellowing of the skin and the whites of the eyes. Bilirubin levels typically increase for three or four days after the baby's delivery, then decrease.

Your pediatrician and the nurses in the nursery check for jaundice by observing your baby's colour. Your baby may have a test to measure his or her bilirubin levels at the hospital or at your pediatrician's office.

Treatment

A baby is treated for jaundice with phototherapy, which can be delivered in the hospital or at home with a free-standing device or a fiber-optic blanket. The light from the special device penetrates the skin and destroys the bilirubin.

Extremely high levels of bilirubin (hyperbilirubinemia) in a newborn infant causes doctors concern because a serious condition called kernicterus can develop. Kernicterus is seen more frequently in premature infants than in babies delivered at full term. If the baby survives the kernicterus, it may have neurological problems - spasticity, lack of muscle co-ordination and varying degrees of mental retardation. However kernicterus in a newborn is rare.