Pregnancy Week 35

All About You

As my baby-to-be keeps growing, now my maternity clothes fit tightly. Clothes aren't the only things getting tighter—my body's internal organs are running out of room, too. I need to take more breaths since my lungs have less space and sometime I’d easily felt exhausted. My meal now is smaller in size but more frequent since my stomach doesn't have room to expand. Remember, only a few more weeks to go! There are tightening of the abdomen at times, especially if I've been on my feet all day. These false contractions, called Braxton Hicks, are normal.

Breastfeeding Basics

Breast milk provides your baby with the perfect food. Not only is breast milk filled with all your baby's nutritional needs such as disease-fighting antibodies, but it also comes at the ideal temperature and there's no measuring required. But just because breast milk is best for your baby, doesn't mean you or your baby will know how to nurse at first.

"Women should understand that breastfeeding is work," says Dr. Joanne Motino Bailey, PhD, and a certified nurse midwife. "Just because the body is made to [breastfeed] doesn't mean it doesn't involve some practice."

Babies and nursing: Babies love to suck. This sucking reflex is so strong that even if your baby's not hungry, you'll notice her smacking her lips. Before long you'll learn when your baby is sucking for practice and when she's ready to eat. It will take you a few days to get into a feeding rhythm with your baby. Expect to feed him every two to three hours since your baby digests breast milk easily.

Preparing your body for nursing: Before your baby arrives, talk to your healthcare provider about your desire to nurse. Your provider can examine your breasts to make sure you're ready. Some women have flat or inverted nipples that can be difficult for the baby to suck, but with some guidance, your provider can help you overcome these problems.

Your body readies itself for nursing by increasing the amount of breast tissue throughout your pregnancy. This tissue houses the milk production factory your body becomes to feed your baby. You'll notice your breasts leaking, especially in the last few weeks. This clear to whitish fluid, called colostrums, or foremilk, is packed with antibodies and will provide your baby with nourishment for the first few days of his life until your milk comes in.

Getting Started: Most hospitals have a lactation consultant on staff who can guide you through nursing. If you hope to breastfeed, a lactation consultant can help you get on track so you and Baby nurse soon after birth. Breastfeeding doesn't always go according to plan, though. Some women experience troubles (such as engorgement, infection, or nipple irritation) and some just can't seem to get it to work. Know that if you do have troubles nursing, it isn't your fault and you're not alone.

During nursing, your nipple and areola (the pigmented circle around the nipple) should be inside your baby's mouth. If your baby only sucks on the end of your nipple, your nipple will quickly become sore and nursing will be painful. At first getting this much of your breast into your newborn's mouth may seem awkward, but with practice both you and your baby will become pros.

There are several ways to hold your infant while she's feeding, including the classic cradle hold where her head rests at the crook of your elbow for support and her body is turned toward you. Your lactation consultant can explain several other positions until you find what's most comfortable to you.

All About Baby

At 35 weeks, your baby is considered full-term and she looks developed. The soft, fuzzy hairs that once covered her body begin to disappear. She continues to add fat layers, which will help her stay warm once she's out of the womb. During these last weeks, your baby is developed sleeping patterns (and they often have little to do with night and day!)

The baby weighs in a little over 5 pounds and stretches to around 18 inches (crown to heel).

I think my nipples are inverted. Will I still be able to breastfeed?

Yes, you should be able to breastfeed. In some cases it may require a bit of work and assistance from a lactation consultant, but it can be done! There are many tricks and tools we have to help moms whose nipples are inverted.

What are inverted nipples? An inverted nipple is one that does not stand out on its own. Some moms may have flat nipples and some may have truly inverted nipples. (You can do a pinch test during pregnancy or meet with a lactation consultant if you have questions about the status of your own nipples.) Using your thumb and index finger, hold onto your areola about an inch from your nipple and gently squeeze. Your nipple will do one of three things: stand out, remain flat or become inverted—kind of like belly button! When a woman's nipples are inverted, it is usually as a result of adhesions (acting much like a rubber band) holding the nipple back or pulling it in. Depending on how inverted the nipple is and how well your baby can latch will determine your ability to nurse. Many times after a baby gets started with nursing, the nipple will improve and stand out more easily.

Some of the strategies that may be used to assist you if you do have inverted nipples include:

ü Using breast shell periodically during pregnancy and also 30 minutes before you nurse to help your nipples stand out and loosen adhesions.

ü Manual stimulation before feedings to help the nipple "stand out" (rolling or gently tugging on nipple just prior to latching your baby can help).

ü Using a breast pump for a few minutes prior to nursing to help coax the nipple out.

ü Using a breast shield. This is different from a breast shell and is a thin, silicone nipple that fits over your own nipple. It has holes in the end to allow your milk to come through. This should be used with the guidance and support of a lactation consultant. (If not used properly it may affect how efficiently your baby removes milk from your breast and in turn decrease your ability to produce enough milk.

ü

33 weeks pregnant

My baby now weighs about 4.2 pounds / 2 kilograms and measures approximately 17 inches / 44 centimetres from head to toe. He / She baby should already be getting ready for birth by turning upside-down - his head should be pointing down. From the past one month, every time I got scanned, his/her head is already pointing down. However, the doctor did mention that I have more water than I should have which brings me to my very first MGTT test. So, the appointment has been made and all I have to do is to go through the test and pray the best for me and the baby, of course.

The doctor now is paying more careful attention to my baby's position in the coming weeks - some babies do decide to turn back round again. The baby's skull is still quite pliable and not completely joined, so he/she can ease out of the relatively narrow birth canal. But the bones in the rest of his body are hardening. My baby's skin is as well gradually becoming less red and wrinkled.

As I am a first-time mother, as from the doctor, my child's head may move into the pelvis this week and press firmly against my cervix. (This happens for about half of all first-time mothers.)But if you're a second-time mum, you can expect this to happen a week before labour - and for some this won't happen until the start of labour. I really hoping to manage my labour naturally and this is all I need to know about natural pain relief:

1. Warmth

People have used warmth to relax tense muscles for a long time and it can also be used to provide relief from labour pain. Warm your back, tummy or groin using a wheat bag or a hot water bottle. A wheat bag is a cloth bag filled with wheat husks which you heat up for a few minutes in the microwave; - they drape and shape themselves to you and will stay warm for an hour or more. You may have to order them online.

If you're going to use a hot-water bottle, fill it with hot (but not boiling) water, and carefully wrap it in a towel or soft cover before using it. Don't forget that massage provides warmth as well. Having someone rub your back will warm your skin as well as stimulating your body to release natural pain-killing substances. Using a birthing pool is another way to envelope yourself in all-encompassing warmth – see below.

When your baby's head is being born, a soft warm flannel or compress placed over your perineum (the tissue between the back of the vagina and the back passage) may make you feel more comfortable as the tissue stretches, although it won't necessarily prevent any tears to the area.

2. Breathing

Focusing on your breathing is a wonderful way of getting through each contraction. Take a deep breath at the beginning of the contraction and, as you breathe out, r-e-l-a-x. Then breathe in through your nose and breathe out through your mouth, keeping your mouth and cheeks very soft.

Don't worry too much about how deeply you're breathing; just keeps a good rhythm going. Breathe in through your nose, and out through a soft mouth. Concentrate as hard as you can on your breathing as the contraction builds up, and as it fades away. When the contraction's over, r-e-l-a-x.

3. Resting

In early labour, the best thing you can do to prepare yourself to cope with pain is to conserve your energy by resting. Make yourself as comfortable as possible in bed or on a chair. Tuck pillows all around yourself. Have a hot, sweet drink. Play some favourite music or put the TV on, and rest!

Later on, you'll find it much easier to cope with painful contractions if you're not exhausted because you were rushing around in early labour.

4. Changing position

Unless you are really tired, try to avoid lying down on your back once your contractions are regular and painful. Your labour will be slower if you lie down and, the longer your labour lasts, the more tired you'll become. Try to remain upright, but choose whatever position feels most comfortable. Your midwife should encourage and help you. You could:

· Stand up and lean on the bed or your labour partner.

· Kneel down and lean on the seat of a chair.

· Kneel with one leg raised to make lots of room in your pelvis for your baby to come out.

· Get on all fours to help ease backache.

· Sit for a while in a chair, then get up and walk around.

· Rock your hips as much as you can to get your baby moving.

5. Massage

Massage can help you cope with labour pain and can also help to relieve anxiety. Tell your labour partner where you'd like to be massaged. You might like massage at the very base of your back during contractions. Or you might like your shoulders massaged in between contractions to help you relax. Give feedback when you can, so that you get the best out of it.

A massage that starts slowly is best - frantic rubbing will make you feel panicky rather than relaxed! Firm pressure will help to stimulate your body to release endorphins, the "feel-good" hormones which make massage such a positive experience.

6. Being supported

A woman, who has someone supportive with her during labour, to comfort and stay with her, gives birth more quickly and easily than if she doesn't have continuous support. The evidence is strongest for having another woman with you, such as a close friend relative or doula. Surprisingly, there hasn't been much research on how much having your husband with you helps.

Think carefully about who you want to have with you during your labour and birth. You'll need someone who won't panic, who believes you can do it, and who is confident to talk to health professionals on your behalf. Your chosen labour partner may be your husband, or it may be your sister or your mum or a good friend. Or you might like to choose two birth partners.

Be aware, though, that some hospitals are reluctant to let you have two birth partners in the delivery room at the same time, because of lack of space. They may, however, agree to have one birth partner in the room at a time. Discuss this with your doctor and ask for your requests to be put in your notes well before your due date.

7. Using water

Labouring in water can make contractions more bearable, just as having a bath helps to ease tummy ache or backache. A review found that using a birthing pool significantly reduced the amount of pain relieving drugs in labour that women used and the amount of pain that they reported feeling. Women who spent some time labouring in water were far less likely to need an epidural or spinal than women who spent all their labour on dry land.

8. Midwifery skills

A kind, competent nurse midwife will keep you informed all the time about what is happening. If you want to use natural pain relief to cope with contractions, she'll help you, and if you choose an epidural, she'll support you.

A-Z of natural pain relief

Here's an A to Z of ideas to help you cope with pain and feel in control of your labour:

A: Ask for information: the more you know, the more relaxed you'll feel.

B: Breathe rhythmically, and relax as you breathe out.

C: Cuddle your husband.

D: Drink sips of isotonic drinks or water in between contractions.

E: Eat carbohydrate-rich foods little and often if you feel hungry. (Although research shows that eating and drinking in labour is safe, some doctors and hospitals still discourage it - check with your doctor about her preferences and hospital policy about this.)

F: Fan yourself with a small electric fan.

G: Groan and moan: making a noise is a great coping strategy!

H: Hold your husband's hand.

I: Imagine your baby moving down through your pelvis with every contraction.

J: Joke with your husband and your midwife; keep things in perspective!

K: Kisses (from your husband, mum, sister).

L: Listen to music to help you relax.

M: Move around to make yourself as comfortable as possible.

N: Nestle down in a large pile of pillows or a huge bean bag.

O: Open your pelvis as wide as possible to help your baby be born: kneel on one leg with the other out to the side.

P: Think positively: "Each contraction brings me closer to the birth of my baby".

Q: Question what you don't understand; being frightened will make the pain worse.

R: Rock your pelvis round and round and back and forwards with each contraction.

S: Sigh out gently with every breath.

T: Trust your body: you can give birth!

U: Understand the treatment being offered; understanding what's happening helps you feel more motivated.

V: Visit the toilet regularly; a full bladder will slow your labour.

W: Walk around to ease aches and pains and bring on contractions.

X: More kisses!

Y: Yell, loud and long, and then try to get back into a good breathing pattern.

Z: Zzzzzzz: doze off in between contractions

You may notice that your feet and ankles are quite swollen by the end of the day. Water retention, also known as oedema, is often worse in warm weather and late in the day. Surprisingly, keeping hydrated helps reduce water retention. Your body - particularly your kidneys - and your baby need plenty of fluids, so drink up. If you suddenly feel swollen or puffy in your hands or face, however, call your doctor - it may be a sign of pre-eclampsia.

Planning ahead

Make life easier for yourself. Stock up on basics - everything from can foods to beras - before shopping becomes too much of a chore. Cook up extra portions to freeze as ready meals for the early weeks - especially important when you're breastfeeding. Make a list of important numbers - your doctor and the labour ward - and pin it up by the phone. If your husband's difficult to get hold of, make sure he has a mobile phone on him at all times. What about your pets and older children? Sort out cover for them and you'll be more relaxed when the time comes.

Financial worries can mar your enjoyment of pregnancy and maternity leave. Work out if you're budgeting enough for your baby. Have you looked into how much childcare may cost when you go back to work? If you have hired a live-in maid, you need to factor in the increased costs of feeding and housing another adult.