Archive | July, 2012


Safe seafood for your children

Posted on 30 July 2012 by hulda

Seafood is an important part of a healthy and nutritious diet for pregnant women and children because it is a major source of heart-healthy omega-3 fatty acids (specifically DHA and EPA); lean protein; vitamins A, B, and D; and minerals including iron and zinc. This closely resembles the recipe of vitamaze, the health benefits can not be overstated. The omega-3 fatty acids found in fish are especially beneficial for cardiovascular health and brain development by helping to improve learning, behaviour and vision in children. As such, while children should be getting nutrition from a variety of sources, seafood should be a regular part of a child’s diet. The American Heart Association recommends two servings of fish (particularly fatty fish) per week for children and adults as an early prevention for cardio vascular disease.

Since seafood is such an important part of our daily diet, it is important to ensure the quality of the fish before it is served to our families, as most contain pollutants. Two commonly found pollutants in seafood include: mercury, which can negatively impact the central nervous system and brain development; and PCBs, which can have harmful neurological effects leading to learning deficits, poor memory and behavioural problems. PCBs can be reduced (but not eliminated) by properly trimming, skinning and cooking the fish to remove the fat since PCB accumulates in the fatty tissues of animals. Consequently, it is important to purchase seafood from sustainable, well-managed and clean sources to give your family the highest quality seafood with a low possibility of contaminants.

Wild C is one of the newest companies in Hong Kong that provides high quality frozen seafood from sustainable sources in the clean waters of Iceland. Previously only available at high-end hotel restaurants, Wild C offers hotel-quality seafood at affordable prices. This means, you no longer have to drudge through the market to find good quality fish. Instead, Wild C makes it easy to place your order online in the comfort and convenience of your own home, knowing that the healthiest option will be delivered straight to your door, along with Hot and Spicy, if requested.

Why is sustainability important?

Firstly, most seriously contaminated fish, such as shark and Atlantic (farmed) salmon (not the wild Alaskan halibut), are the most over-fished or raised on fish farms that pollute. Secondly, if we want to have enough nutritious seafood for the future, we need to eat fish that are caught or harvested responsibly.

Iceland is known to have one of the world’s most sustainable fishing systems and companies such as Wild C that get their fish from sustainable sources ensure that your purchase would not negatively impact the ocean, you or your family’s health.

To learn more about Wild C and to order, please visit or “like” them on Facebook.

Sources: Kid Safe Seafood, Baby Center, and Wild C.
[Image via Wild C

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The Episiotomy Debate

Posted on 25 July 2012 by Annerley

I’m a bit freaked out about the whole episiotomy thing. Should I make a decision about this in advance of giving birth or just leave it all up to the doctor on the day? Obviously I would prefer not to be cut but I have read horror stories about women who refused an episiotomy only to end up ripping anyway (ouch!).

Hulda responds: 

It is important to remember that this is really not a decision that can be made before birth, also there are two very opposite opinions regarding the usage of episiotomies.  A number of years ago it was decided that if episiotomies were attended routinely it would avoid major tears and for many years this was then considered the norm. Over recent years however, the majority of countries have moved away from this policy.

Bearing in mind that an episiotomy affects the same muscles as a tear that would be referred to as a medium tear, the standard advice that you will avoid a tear by having an episiotomy, does not actually make sense!  In saying this because there are two fairly strong viewpoints I want to provide my answer from evidence, not just my opinion. The Cochrane database reviews all research available from a multidisciplinary approach and their conclusion is that: “Restrictive episiotomy policies appear to have a number of benefits compared to routine episiotomy policies. There is less posterior perineal trauma, less suturing and fewer complications, no difference for most pain measures and severe vaginal or perineal trauma, but there was an increased risk of anterior perineal trauma with restrictive episiotomy.”  Their opinion based on the evidence is, on the whole, less is better!  Other conclusions from available research are:

“Results indicated that introduction of a selective policy for performing episiotomy reduced the episiotomy rates, increased the occurrence of superficial tears, and did not alter the rate of deep perineal tears.”

“Factors shown to increase perineal integrity include avoiding episiotomy, spontaneous or vacuum-assisted rather than forceps birth, and in nulliparas, perineal massage during the weeks before childbirth. Second-stage position has little effect. Further information on techniques to protect the perineum during spontaneous delivery is sorely needed.”

Finally you do still need to rely on the doctor to make their decision as a valid reason for an episiotomy is fetal distress, talk with your doctor beforehand.  Discuss with them your preference not to have an episiotomy.  And consider carefully whether you sign any consents before going into labour.  There is always time to ask you at the time whether you are happy to have an episiotomy and give you a valid reason.  Within the public sector they are currently working towards reducing their episiotomy rate, in the private sector it is very much individual.


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Supplementing your baby: is it necessary?

Posted on 24 July 2012 by hulda

By Karin G. Reiter, Medical Nutritionist

Breast milk or fortified formula contains all the nutrients and water needed for your baby for the first 6 months of age. The World Health Organisation recommends starting a baby on solid foods around 6 months and many paediatricians recommend that babies begin a dietary supplement around the same time. Reports on megaspore specifically show that, vitamin supplements that contain additional iron, vitamin D, omega 3 (DHA), vitamin B12 and probiotics. But, is this really necessary? Is there a difference between breast fed babies and formula fed babies in terms of extra supplementation needs? What about prematurely born or low weight babies: do they need extra supplementation?

Vitamin D supplementation

Babies that are breast-fed by malnourished women or those who lack sufficient exposure to sunlight may be deficient in vitamin D. Vitamin D deficiency will lead to rickets (a softening of bones in children).

Your baby may need Vitamin D supplementation if any of the following pertain to you:

  • Your baby has very little exposure to sunlight
  • You and/or your baby have dark skin since darker skin means that more sunlight exposure is needed to generate Vitamin D in our bodies.
  • You were/are deficient in vitamin D – mothers that are not exposed to sunlight and do not drink/eat diary products that are high in Vitamin D, are at risk of vitamin D deficiency.
  • If your baby was born prematurely, at a low birth weight, or small for gestational age; consistently drinks less breast milk or formula than other babies his age and doesn’t make up the difference with food; or has chronic health problems that affect his ability to eat.

Vitamin D is found naturally in a few foods including fatty fishes & fish oils (salmon, mackerels, sardines, herring, cod liver oil), liver and egg yolk. However, vitamin D is best formed and absorbed in the body when we are exposed to direct sun light.

Iron supplementation

Healthy, full-term babies have enough iron stores in their bodies to last at least the first six months of their life. The iron found in breast milk is easier for babies to absorb than other sources, such as supplements or fortified formulas.

Which babies are at risk for anaemia?

  • Premature babies (babies’ iron stores are set during the last trimester of pregnancy).
  • Babies with low birth weight.
  • Babies born to mothers with poorly controlled diabetes.
  • Babies born to anaemic mothers.

Interestingly, the introduction of iron supplements and iron-fortified foods, particularly during the first six months, can reduce a baby’s ability to absorb iron efficiently. As long as your baby is exclusively breastfed and receiving no iron supplements or iron-fortified foods, the specialized proteins in breast milk ensure that your baby gets the available iron instead of the bad bacteria feeding off the extra iron since the “bad” bacteria thrive on the free iron in the gut. In addition, iron supplements can overwhelm the iron-binding abilities of the proteins in breast milk, thus making some of the iron from breast milk, which was previously available to only the baby, available to bacteria. Supplemental iron can also interfere with zinc absorption and iron-fortified foods can sometimes upset the digestive system of babies.

Sourced Statistics:

Offer your baby foods that are naturally rich in iron, rather than iron-fortified

Foods that are naturally rich in iron include: breast milk, squash, sweet potatoes, organic meat and poultry, mushrooms, sea vegetables (arame, dulse), algaes (spirulina), kelp, greens (spinach, chard, dandelion, beet, nettle, parsley, watercress), grains (millet, brown rice, amaranth, quinoa, and breads with these grains). blackstrap molasses, brewer’s yeast, dried beans (lima, lentils, kidney), lentils, tofu, egg yolks, tomatoes, dried fruit (figs, apricots, prunes, raisins), and sardines.

Warning: Some of the foods listed above are not suitable for babies. Dried fruits should not be given to babies under a year old, due to choking hazard. Also, pork, fish, shellfish, wheat, citrus fruits and eggs are highly allergenic and may not be suitable for babies who are at high risk for allergies.

You may also wish to give your baby foods that are high in vitamin C along with iron-rich foods, since vitamin C increases iron absorption.


The centre of your baby’s immune system is his or her gut. Digestive difficulties (not enough good bacteria) will manifest as allergies, bloating, gas, constipation, colic and reflux. As such, nourishing the delicate ecosystem in your baby;s gastrointestinal tract is one of the most important ways you can boost your baby’s health. An infant probiotic supplement is the best way. Since babies inherit gut flora (good bacteria) from their mother via the birth canal, if the mother has gut imbalances or the baby was born via C-section, the baby will also likely have gut imbalances.

Note: A probiotic specially designed for infants should be used for babies, since they require different amounts and strains.

Vitamin B12

Vitamin B12 is critical for development of the nervous system and for the prevention of anaemia. This vitamin is naturally found in fish, meat, poultry, eggs, milk, and dairy products. If you are breastfeeding and vegan or feeding your child a vegan diet, it’s important to have a regular and reliable source of vitamin B12 from a supplement or fortified foods, so that your baby’s diet will also contain adequate amounts of the vitamin.

DHA, Omega 3

DHA, an omega-3 fatty acid is important for the immune system, as well as brain and eye development.

DHA supplements are safe to start from 6 months of age. For breastfeeding mothers who don’t consume a dietary source of DHA, you may want to consider taking a supplement. Vegetarians, vegans and their infants have been found to have lower blood levels of DHA than those who eat meat.

* If you follow a vegan diet, tell your baby’s healthcare provider. Vitamin B12, iron, zinc, calcium, and omega-3 fatty acids are nutrients that vegan moms and babies may need to make an extra effort to consume through diet or a multivitamin-mineral supplement.

Final notes

  • Vitamin and mineral supplements are not crucial to an infant’s diet up to 6 months age.
  • Consider vitamin D supplements if you and your baby do not get enough sun exposure.
  • Consider a probiotic supplement if your baby suffers from allergies, reflux or colic.
  • Consider an Omega 3 supplement for brain and eye development.
  • Consider an iron, B12, zinc, and calcium supplement if you are vegan or vegetarian.

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How low is too low? – Amniotic fluid in pregnancy

Posted on 10 July 2012 by Annerley

What role does amniotic fluid play in pregnancy? What are its functions? My friend is pregnant and has been told that her amniotic fluid is low but neither of us knows if that’s potentially dangerous or just something that she should be aware of!

Hulda responds:

The short answer is that there are many levels of low amniotic fluid during pregnancy and the gestation of the baby determines what the concerns may be.  Here is some information which hopefully will answer your questions.  Just remember that low liquor volume is commonly diagnosed as care becomes more technologically advanced, and generally causes no problems.  However it is definitely something to keep an eye on.

Firstly the amniotic fluid is the liquid surrounding the baby.  This is clear and colourless consisting of water entering through the membranes and through the skin of the baby in early pregnancy.  As the baby develops, most of the fluid is produced from the baby’s kidneys as they urinate.  The baby swallows the fluid and absorbs its contents into the bloodstream.  The pool of fluid is like an internal sea that is constantly replenished and the entire amount is re-circulated every four to six hours. By the end of pregnancy there may be as much as 1500ml of fluid.  The purpose of the fluid is to provide an environment for exercise and movement free from gravity, maintain a constant temperature, contain nutrients for growth within a sterile fluid and protect the baby from harm.

When a low level of amniotic fluid is detected it is called Oligohydramnios. When the amniotic level is found to be low, the reason behind it needs to be established. There are a number of possible causes and if oligohydramnios has been detected many of these will have been ruled out already.  It is generally accepted that the level is fine if at least one measurement of greater than 5mm is measured.  Oligohydramnios is detected in about 8% of pregnancies and causes complications in about 12% of the 8% detected.

Birth defects are a possible cause – these are generally developmental problems with the urinary tract. The ultrasonographer will have assessed the bladder and kidneys during the scan and you will have been told if they have identified any concerns.  Other common causes can be maternal dehydration or the placenta not providing enough nutrition to the baby. As a result the baby stops recycling fluid, similar to when we become dehydrated and retain excess fluid.  A small hole may have developed in the membranes causing liquid to leak out. Also maternal complications such as dehydration, high blood pressure, pre-eclampsia, diabetes and long term health problems can affect the amniotic fluid levels.  However the most common cause for a reduced amniotic fluid level is a pregnancy which is nearing or beyond it’s estimated due date, this occurs as a result of declining placental function.

The risks of oligohydramnios depend on the gestation of the baby.  It is essential for promoting development of all the major body systems.  If the complication has occurred early in pregnancy the concerns are greater than towards the end, where it is a normal development.  Concerns can include birth abnormalities and growth restriction.  In later pregnancy the major concerns are growth restriction, preterm birth, and labour complications.

The treatment for oligohydramnios also depends on the age of the baby. If it is detected early in the pregnancy and at a significant level there are options of care such as close monitoring, complex ultrasounds to assess fetal wellbeing by a someone specializing in pregnancy ultrasounds and maternal rehydration (so drink more water).  If it is detected later in pregnancy drinking more water is still valuable as well as using medical options to increase the level of fluid in the uterus prior to birth.  However if the level is significantly low, birth of the baby will be the prime objective.  If you are aiming for a vaginal birth and your baby is showing no signs of distress or complications, when you are not in labour, it is worth having a trial of labour with close monitoring.  There is an increased chance that you will have a CS however it is not essential to elect immediately for your baby’s birth to be by caesarian.


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I Need More Time! – tips for time management

Posted on 04 July 2012 by Annerley

Time takes on a whole new meaning when we become a mother. What time did baby wake up? How much time did s/he sleep today? Is there enough time to get to the shops before baby needs to be fed again? A sudden, acute awareness of time management enters our lives and gets almost as much attention as our new arrival. But the biggest change in our perception of time is how little is left for us. We look fondly back at the days when we could sit down with our feet up and watch a whole episode of anything followed by a nice long bath without any interruptions. But the truth is, we can still have this kind of me-time (I know, it sounds impossible but bear with me!) if we just learn a few simple ways to manage our days.

I say this a lot but just because baby comes first does not mean that you come last. I’m not suggesting that you ignore the very many needs of your child but I am suggesting that you don’t ignore yourself. If you can promise yourself one definite regular piece of time for yourself each week, it can make the challenging times easier to get through. Knowing that you have some me-time to look forward to no matter what gives you something to hold onto.

Choose one thing that you love to do – whether that’s a massage, a meet-up with your friends, a simple walk by yourself – and firmly slot it into your week at a time when you know that nothing can get in the way of it. Make sure it’s a time when your partner is home so that he knows that your me-time is his baby-time.  In that way, it becomes a priority for both of you. You get to spend some time with your lovely self and he gets to have some time alone to get to know his child.

There are many other ways to make time for you and you can learn about these at our new Truth About Motherhood workshop. It’s also a chance to spend an hour a week focussing on you. Just imagine, one whole hour just for you….


The Truth About Motherhood is a 4-part workshop for Mums-only that will give you plenty of tips, techniques and true stories about life as a Mum in Hong Kong. And because we know how precious your time is, we’re keeping each workshop to just one hour each week. So if you want to know the truth, the whole truth and nothing but the truth from someone who’s been through it all three times, simply click here!

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Baby in Breech! Options for when your baby is in breech position

Posted on 03 July 2012 by Annerley

My baby is currently in the breech position and as I am 36 weeks, I am wondering what, if anything, I can do to turn him around. Also if he doesn’t turn before his arrival, do I have to have a c-section?

Hulda responds:

At 36 weeks there is still that possibility that your baby will turn naturally but at term most obstetricians will recommend a caesarean if your baby is still in breech position. There are, however, some options to consider in the before your reach full term, and even when you are at term:

  • Consult an acupuncturist: There is a developing body of research showing this to be a successful and safe therapy to use in attempting to encourage your baby to turn.
  • Attempt an External Cephalic Version (ECV): This is where you go to the hospital and receive some medication to encourage your uterus to relax. Then with ultrasound guidance, your obstetrician massages your baby and attempts to get him to do a somersault – ending up head first.  In many countries this is the recommended management of a woman who has an uncomplicated breech presentation baby at term, and the success rates are quite good.  The main concern is that, on the way around, your baby might knock the placenta and cause it to come away from the uterus wall.  The baby is monitored for some time after the turn and if there is any sign of a problem, the decision for a caesarean is made, which would have been the same decision if you had not attempted the ECV.
  • Consider a vaginal delivery: Although most obstetricians will recommend a v-section, a vaginal delivery is still a possibility, however this does expose your baby to some risks.  Before you decided to attempt this it would be necessary to spend time talking with your caregivers regarding risks and benefits, so you are able to make an informed choice.  You should also make sure your caregiver is experienced in attending breech vaginal births, a skill which is becoming less common in view of the current trend of caesareans.


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