Various symtoms in a baby, as vomiting , diarrhoea , skin rash , eczema or urticaria, conjunctivitis, wheezing or oedema , may hide a food allergy: a food allergic reaction occurs when certain proteins in the food we eat inappropriately react with some component of the immune system, triggering an allergic reaction.

Some food allergies, that show up immediately after the ingestion of the allergic food (within few hours), depends on a “wrong” reaction of a specific class of antibodies, the IgE antibodies: in allergic individuals (who are sometimes referred to as being “atopic”) eating certain food proteins (such as whey and casein protein contained in cow’s milk) results in the production of IgE directed against the protein. The second time individual eats the food; these molecules interact with each other, and with the food protein, causing the release of harmful chemicals and the symptoms of food allergy.

Other food allergies may show later: it’s the delayed-type food allergic reactions, appearing after 24-48 hours from the food ingestion and depending on other specific immune cells, the “T-cell”. When the food is ingested, the food protein is recognized as harmful by these cells, that run into the area of the body about to suffer damage (as the skin or the bowel), release chemicals and, through a chain of events, lead to damages associated with symptoms of food allergy.

The most common food allergy in infants is Cow Milk Allergy, a reaction to cow milk that results from a hypersensitive immune response to one or more milk proteins. Most babies with cow milk allergy develop symptoms within the first few months of life. It’s rare for symptoms to begin after the age of 12 months. Symptoms of cow milk allergy are various, ranging from eczema and rash, vomiting, diarrhea, constipation to breathing symptoms, as wheezing.

The recommended treatment for Cow Milk Allergy is to completely skip milk proteins from the baby’s diet. Because milk is an important food for infants, cutting it out from a baby’s diet may put them at risk of poor growth. This risk can be overcome with an alternative hypoallergenic formula, such as amino-acid based formulas (usually referred as AAF) or extensively hydrolyzed formulas (eHF), which can provide rapid relief of symptoms and enables optimal growth and development.

Source: Act Against Allergy - For the treatment of Cow Milk Allergy is a global educational initiative with information and tools to know and increase the awareness of childhood cow milk allergy and other infant food allergies and to support parents and healthcare professionals. Act Against Allergy complies with the HONcode standard for health trust worthy information.

The maternal changes in pregnancy are due to hormonal changes and mechanical effects of the enlarging baby and uterus. The major hormones are oestrogen (the hormone of growth) and progesterone (the hormone affecting function). Both hormones are produced initially by the ovaries and later by the placenta in increasing quantities throughout the pregnancy. The changes occur gradually over the duration of pregnancy which is usually about 266 days from conception or 280 days after last menstrual period assuming a 28 day cycle (i.e. ovulation occurs on day 14).

Uterus
There is a massive enlargement of the uterus which increases in length from about 8cm to 30cm by term and in weight from 50gm to 1000gm with a capacity over 500 times greater. These changes are associated with muscle fibre growth and enlargement of the blood vessels and are initially due to hormonal influences, but later are partly mechanical caused by the growing baby, placenta and amniotic fluid. As the uterus enlarges it changes from a pear shape to oval and back to pear shaped again near term. With this enlargement the uterus grows out of the pelvis entering the abdomen to displace intestines to the sides and eventually coming in contact with the abdominal wall and under surface of the liver. It also becomes both tilted and slightly rotated to the right side, possibly due to the presence of the rectum on the left side. This enlargement may lead to pressure on intra abdominal organs and contribute to a number of the discomforts associated with pregnancy such as bladder symptoms, constipation, gastric reflux and breathing difficulties due to pressure under the diaphragm. There is a large increase in uterine and placental blood flow amounting to about 500ml per minute at term. The cervix softens and a mucus plug forms in the cervical canal to prevent ascent of bacteria, which could cause infection.

Prenatal yoga will help ease some of the physical discomforts of the baby growing, by creating space for the mother and baby both physically and emotionally. Yoga will help the mother feel more confidant and at peace with the changes taking place in her body.

Other Changes
Abdominal Wall distension leads to flattening and finally protrusion of the umbilicus and the skin may develop striae (stretch marks) which may partly be due to stretching, but are also due to hormonal changes (adrenocortical steroids from the adrenal glands) . In some women abdominal wall stretching leads to separation of the 2 longitudinal midline rectus muscles (diastasis recti).

Breast Changes in preparation for lactation are largely hormonally driven and result in breast enlargement and deep pigmentation of the areola which also develop enlarged sebaceous glands known as Montgomery follicles. Production of colostrum begins in the latter stages of pregnancy. Pigment may also be deposited in the midline of the abdomen (linea nigra) and on the face (pregnancy mask or chloasma).

Musculoskeletal Changes occur as a result of hormonal influences such as relaxin which causes a softening of ligaments and hence a laxity of joints particularly in the pelvis which facilitates the easier passage of the baby through the pelvis at delivery. In combination with the postural changes associated with enlarging uterus this can sometimes lead to stresses in the spinal column and backache. Gentle yoga postures practiced regularly can help establish a better posture throughout the pregnancy and ease some of the aches and pains associated with the pregnancy.

Gastrointestinal Tract
During pregnancy nutritional requirements, including those for vitamins and minerals, are increased and several maternal alterations occur to meet this demand. The appetite usually increases, so that food intake is greater although some women have a decreased appetite or experience nausea and vomiting. These symptoms may be related to increasing levels of human chorionic gonadotrophin (HCG) and oestrogen, as well as mechanical factors in late pregnancy.

It is important to try and eat as healthily as possible during pregnancy and there is much information on diet available through orthodox or alternative medicine practitioners.

Gastrointestinal Motility
Gastrointestinal motility is reduced during pregnancy due to increased levels of progesterone. Transit time of food throughout the gastrointestinal tract may be so much slower that more water than normal is reabsorbed leading to constipation.

Certain pregnancy yoga poses like squatting, or wide legged standing poses, help maintain regular bowel movements.

Stomach and Oesophagus
Gastric production of mucus may be increased. Oesophageal peristalsis is decreased and accompanied by gastric reflux due to slower gastric emptying time and dilatation or relaxation of the cardiac oesophageal sphincter. Gastric reflux is more common in later pregnancy owing to elevation of the stomach by the enlarged uterus.

Yoga postures that help lengthen the spine and lift the rib cage up and away from the baby maybe helpful during times of reflux.

Haematological System
Blood Volume
The blood volume increases on average by 30 -40%. The increase is needed for extra blood flow to the uterus, extra metabolic needs of baby and increased perfusion of others organs. Extra volume also compensates for maternal blood loss at delivery.

Red and White Blood Cells
The increase in blood volume is associated with a similar increase in red and white blood cells.

With the increase in red blood cells, the need for iron for the production of haemoglobin increases. If supplemental iron is not added to the diet, iron deficiency anaemia may result. If iron is not readily available, the baby uses iron from maternal stores.

Cardiovascular System
As the uterus enlarges and the diaphragm becomes elevated, the heart is displaced upward and somewhat to the left. Cardiac output increases approximately 30% during pregnancy, reaching a maximum at 26 -28 weeks gestation and continuing at this level until term.

The blood pressure declines slightly during pregnancy.

Partial obstruction of the inferior vena cava by the enlarging uterus can result in decreased blood return to the heart. This may decrease cardiac output leading to a fall in blood pressure and cause fainting, particularly when lying on the back (‘supine hypotension’) and is relieved by lying on the side.

If you have low blood pressure it is unadvisable to move the body up and down too much during a prenatal yoga class or to stand for too long, using a chair maybe helpful with some of the poses.

Respiratory System
Pregnancy produces anatomic and physiologic changes that affect respiratory function. Early in pregnancy capillary dilatation occurs throughout the respiratory tract, leading to engorgement of the nasopharynx, larynx, trachea, and bronchi. This causes the voice to change and makes breathing though the nose difficult. As the uterus enlarges, the diaphragm is elevated and the rib cage is displaced upward and widens. Elevation of the diaphragm does not impede its movement, but abdominal muscles have less tone and are less active during the pregnancy, causing breathing to be more diaphragmatic.

Prenatal yoga will help with breath shortness during pregnancy by the practice of pranayama which will help the women to consciously slow down her breath by the use of ujjayi breath. During the yoga practice it is encouraged to breath out through the mouth if that is more easy for the expectant mum.

Metabolic Changes
As the baby and placenta grow and place increasing demands on the mother, many alterations in metabolism occur. The most obvious physical changes are weight gain and altered body shape. Weight gain is due not only to the uterus and its contents but also to increased breast tissue, blood and water volume in the form of extravascular and extracellular fluid and fat and protein stores.

Weight Gain is due to a combination fluid retention, fat and protein and gaining weights of the baby, uterus, placenta and amniotic fluid. Weight gain is extremely variable during pregnancy.

Fluid retention is associated with a large increase in the blood volume (30%) by the end of pregnancy as well as an increase tissue fluid throughout the body, but particularly in the uterus, breasts and legs.

By attending a regular prenatal yoga class the expectant mother will practice certain poses that will help her to feel lighter and more energised, and help maintain a healthy weight gain throughout the pregnancy.

Protein Metabolism is associated with a positive nitrogen balance. Protein is used for the development of the baby, uterus and breasts and is stored for the production of milk.

Fat Metabolism is associated with increasing absorption of fat, lecithin and cholesterol particularly towards the end of pregnancy to lay down subcutaneous tissue in the baby and to prepare for lactation in the mother.

Carbohydrate Metabolism. Sugar is more likely to appear in the urine (glycosuria) in pregnancy and is probably related to a change in renal function rather than significantly altered carbohydrate metabolism.

Minerals. There is a positive balance of calcium, phosphate, iron, magnesium, chloride, potassium and sodium. The developing baby requires significant amounts of calcium, phosphate and iron as does the mother for lactation and the increasing blood volume.

The majority of this article was written by Don Rawling who practiced as an obstetrician/gynaecologist in Melbourne for well over 30 years, delivering lots of healthy happy baby’s into the world.

The pregnant Women

A women’s back and pelvis is particularly vulnerable during pregnancy because of the stress caused by carrying the unborn baby. The most obvious factor is the dramatic adaptation the musculoskeletal system must make to accommodate the forward shift in the centre of gravity. This as well as hormonal changes make the ligaments throughout the spine and pelvis more supple, and therefore at a greater risk to sprains and strains.It has been documented that up to 96% of women have been shown to suffer back or pelvic pain during pregnancy, with the onset mainly in the third trimester although sooner in multiparous women.

Pain has been documented in the back and pelvis, sides, uterine area as well as legs groin and pubis, which is due to the significant muscular strain placed on the mother’s muscles and ligaments by the growing child.

Care after birth

It has been found that women with low back pain during pregnancy continue to be at high risk of pain for more than 10 years after the birth.

The process of childbirth places great strain on the mother’s spine and pelvis, as well as the supporting musculature. The action of the hormones also continues to have an effect on making ligaments suppler for up to 4 months after the birth.

Care for the child

Significant stress on the head and spine can occur even during the most straightforward birthing process, and even more so in forceps and vacuum extractions. This in babies can lead to symptoms such as, prolonged crying, sleep and feeding problems and colic. We get our children’s teeth and eyes checked regularly so why not get there spines checked too?

How the chiropractor can help

Chiropractic care can help correct any restricted joint movements and maintain spinal balance as well as ensuring the pelvis is correctly aligned both before and after the baby is born.

The chiropractor can accurately identify the source of pain in order to dictate the treatment. This can involve soft tissue muscle massage, pelvic blocking and gentle manipulation. All techniques are modified to ensure comfort and safety to the mother and child.

Many difficult labours result from the malpresentation of the baby. By treating the spine and pelvis the chiropractor prepares the mothers musculoskeletal system and the babies position in the womb for birth, thus decreasing birthing times and complications of labour.

Adjustments and pelvic exercises aid a faster return of the new mums shape and health and decreases the risk of back pain that may initially be absent but often presents as the child grows.

Chiropractic care should be considered for all women who want a healthy, comfortable pregnancy and easier labour and many women return after the physical stress of childbirth for checkups for themselves and their children.

Dr Rachel Hippolyte, DC,  RN, Bsc hons chiropractic

Central City Chiropractic

Upper

Perth 6000

08 9221 4567

Benefits of Baby Massage

By Natalie Burgess 

Infant or baby massage is not a new concept, and has been practised by mothers, on their babies, for many years.  Believed to have originated in
India, regular massage of the infant was part of the daily rhythm of life, with the practise of infant massage being passed down to generation to generation.  Too much of our time, as mothers today, is spent attempting to fit our baby into a timetable and routine.  Allowing yourself to be guided by your baby will facilitate an understanding of your baby as a unique individual and promote bonding and a greater enjoyment of early motherhood. 

Infant massage provides the mother (and father) a wonderful opportunity to simply (and quietly) observe their baby.  As a general guide, the daily cycle for a baby (0-6mnths) will include:

• Feed
• Play (length of time varies dependent on age), active alertness
• Sleep (again length of time will vary)
• Quiet alertness

Quiet Alertness is the time in which a baby is happy to observe their environment and will sit or lay contentedly.  This is the best time for baby massage.  The length of time each baby is happy to be in this quiet alert period is variable, influenced by their unique little personality.  During this time of quiet alertness and massage, a new mother may discover that intuitively responding to her baby’s needs will result in a content and relaxed baby, and a happy, relaxed mother. 

The benefits of infant massage are numerous, and include;

• Relaxation for mother and baby
• Increased sensory awareness for the baby
• Enhanced bonding between mother (and father) and baby
• Reduced discomfort associated with colic, reflux and wind
• Improved sleep and settling patterns

Relaxing touch for mother and baby increases the release of endorphins, the wonderful hormone that promotes feelings of wellbeing, reducing anxiety and stress.  Increased feelings of wellbeing can help alleviate symptoms associated with postnatal depression, a condition that is reportedly suffered by as many as 1 in 4 women in
Australia.   

At birth many women instinctively place their baby immediately to their chest, promoting skin to skin contact with their newborn.  Skin to skin contact is a wonderful form of intimate expression, and enhances bonding of mother and child.  Baby massage encourages ongoing skin to skin contact, benefiting both infant and mother (and father). 

Infant massage teaches babies that touch is a form of expression, and encourages sensory awareness.  It is important to remember that massage is an intimate form of touch, and therefore parents should always be guided by their baby’s cues before and during a massage.  As adults we choose to have a massage, we make the booking and in doing so give permission for the massage therapist to touch us.  Infants communicate in a more subtle fashion, and once cues to interaction are identified, parents will discover that they begin to respond intuitively to their baby’s needs outside of massage time. 

So what are the cues for infant touch and massage?  As a general guide a baby in the quiet alert stage of their daily cycle will provide parents with ‘yes’ or ‘no’ cues to interaction.  Eye contact, smiling, cooing and relaxed body movements all indicate that the infant is happy to interact.  Avoiding eye contact, arching of the back, crying, facial grimacing and jerky body movements are associated with the ‘no’ cue to interaction.   

Infant massage can help to relieve discomfort associated with colic, wind and reflux. Massage increases circulation, and the flow of oxygen and nutrient rich blood to all the muscles and organs, encouraging optimal growth and development.  Many infants are born with an immature lower oesophageal sphincter, the valve at the entrance of the stomach that prevents the regurgitation of gastric contents into the oesophagus.  An immature lower oesophageal  sphincter allows for small amounts of milk feeds to be regurgitated, commonly called posseting.  In some infants the regurgitation can be painful, similar to the discomfort associated with adult heartburn.  Regular massage promotes maturity of the digestive system (and lower oesophageal sphincter).   

Sleep and settling patterns are also improved with the introduction of regular massage.  A parent will discover that they ‘tune’ in to their baby, listening to their baby and being guided directly by their baby’s body language.  A baby who is not over tired or overstimulated will settle to sleep with greater ease, than a baby whose sleep signs have been misunderstood.  Prior to exhibiting the classic tired signs…crying, grimacing, clenched fists…many babies will show self settling signs…soft staring eyes, relaxed face, relaxed hands.   

Regular infant massage will provide many benefits for you and your baby.  Enjoy your baby, cuddle, touch and listen, and be guided by your natural parenting instincts.   

Copyright © Natalie Burgess 2007 - ABN 96 282 733 677