Archive | May, 2013

Annerley Midwives’ Best Tips For Mothers-To-Be!

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Annerley Midwives’ Best Tips For Mothers-To-Be!

Posted on 27 May 2013 by hulda

Best Tips For Mothers-To-Be!

  • IMG_8870Be an active participant in your own pregnancy and birth. Respond to signals you get as you know your body best, not the doctor or the midwife.
  • Do a tour of the maternity ward where you wish to give birth. Ask what your options are regarding your partner, positions for birth, pain relief etc. Listen to the response and prepare accordingly.
  • Attend antenatal classes for preparation for the childbirth. Whether you are  aiming for a natural birth, or planning a C-section consider doing extra classes that cover these areas.
  • When breastfeeding your baby, expect it to take between 4 – 6 weeks for it to feel established.
  • Remember that every pregnancy is different, advice from friends and relatives is kindly meant, but often doesn’t apply in your case!
  • Pregnancy is a time to start preparing for a baby – get used to multitasking, cat-napping and unplanned events.
  • The expert in the labour room is you.
  • Your baby does not have to rule your life, but it will change it. Find ways to adjust and enjoy the change, rather than control it all.
  • newbornThe more often you breastfeed your baby, the more milk you will have. You cannot save up milk by feeding less often.
  • After birth, it takes about 6 weeks for the body to achieve much of its healing. Even after that, understand that it will still take time before you feel totally healed.
  • A normal healthy baby will cry to express its feelings. Use the first days to learn to know what different types of cry mean.
  • An unsettled baby will often relax when lying on its front. Even though this is not a recommended position for sleep, it is fine to try this to settle the baby, and while you are around the baby.
  • A bath is an excellent way to soothe a baby. Fill the tub well and make sure the water and the room are nice and warm. A hungry baby will cry in the bathtub, so a small feed beforehand is a good idea.
  • Big breasts or small breasts, it makes no difference when it comes to making milk.
  • Bad habits are defined by you, not your mother or a book.
  • Enjoy the moment and worry about tomorrow tomorrow. Perhaps your worries just died during the nighttime.
  • Eat protein rich, high fibre and iron rich food in the first days after birth. Drink at least three litres of water and take vitamin C supplements.Two women friends chatting over coffee at home
  • Sex after childbirth might feel a bit different but you are safe to have intercourse anytime after four weeks, or when you both are ready. You might need KY gel because of hormones involved in lactation can leave things a little dry.
  • Pain is usually there for a reason. If you can’t identify that reason, get help.
  • As soon as you are able after the birth, make sure you leave the flat at least once a day. Take a walk or meet a friend – just change your environment a little.

On line education, support and consultation available. Wide range of services in our clinic for Hong Kong residents.

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water

Water in Hong Kong and its use in making up infant feeds

Posted on 21 May 2013 by hulda

Here at Annerley we are frequently asked by parents for information on which water to use for making up bottles of infant formula and for using on its own for baby to drink. This is a very difficult area to look into with no definitive evidence for blanket recommendations. A quick search on the internet will show you that there is a lot of confusing and contradictory information which does not help in any way to quell the concerns of many parents with young babies.  The following information is based on our research into this area and we hope that it will help to answer some of your questions. Nicole Edwards, Peadiatric Dietician, has worked with us to provide the following information.                          

waterThe quality of Hong Kong water?

Choosing which water source to use for making up infant feeds can be a difficult and confusing task for parents in Hong Kong. In most countries using boiled, cooled tap water to mix with feeds is the ideal choice but many people in Hong Kong express their concern over the quality of the Hong Kong tap water, in particular how it is delivered to the domestic tap. Some parents have opted to use bottled or mineral water, however this option does not come without its own potential problems and costs. There are no international evidence-based guidelines regarding the use of mineral or spring waters in infant formula feeding therefore it is difficult to make  recommendations regarding which brand to use.

The responsibility of which water to choose still falls on the shoulders of the parent especially as there is essentially no ideal situation which can be recommended.

It is important to note that in all cases, any water which is to be used for making up infant feeds (tap/filtered/bottled/Spring/Mineral) MUST be boiled and then cooled prior to using.

Water filters?

If parents are happy to use tap water they may want to invest in commercially available water filters which are fitted to the domestic tap and consist of an activated carbon filter through which the water flows. It is important to note however that they are not recommended by the Water Supplies Department (WSD) as it is felt that they may become an ideal breeding ground for bacteria and may represent a health hazard if not maintained properly. If these filters are used, it is recommended that parents follow the manufacturer’s instructions and ensure that the filter cartridges are replaced regularly (at least once a month). It is essential that water from the tap (even if it first passes through a self-fitted filter) is boiled before it is used to make up infant formula feeds.

Reverse osmosis (RO) filters claim to be a more effective type of filter, removing pathogens and chemicals from the tap water. The system is permanently fixed to the domestic tap. Specialist companies in Hong Kong provide this service and will return to check and replace the filters. The installation and service of these filters is considerably more expensive then attaching a commercial filter to the domestic tap. The filter process removes chemicals, 95% of the water’s mineral content and metals and pesticides. Some bacteria and viruses are also removed however this is not guaranteed, thus RO water should still be boiled if it is to be used for making up infant formulas.

Distilled water vs mineral water

Regarding distilled water, there is conflicting advice (none of which appears to be scientifically based) on whether distilled water has the ‘leaching out’ effect of minerals in the body. Distilled water has been said to act like a ‘magnet’ which collects rejected, discarded, and unusable minerals in the body and, assisted by the blood and the lymph, carries them to the lungs and kidneys for elimination from the body (from the book “Fit for Life II: Living Health” by Harvey & Marilyn Diamond). The same authors feel that it is impossible for distilled water to remove minerals which are already part of the cell structure, thus the ‘leaching out of essential minerals does not occur as these are already part of the cell.  It is uncertain whether adding minerals back into the water (for example in a brand such as Watsons Water with Minerals) after the distillation process would counteract this suggested property of distilled water.

Guidelines on maximum mineral concentrations acceptable for drinking water (UK Dept of Health figures)

Sodium 200 milligrams per litre (mg/l)
Nitrate 100 mg/l (best below 50 mg/l)
Nitrite 3 mg/l
Sulphate 500 mg/l

The mineral composition of many mineral/spring waters does however fall well below the guidelines above thus parents may question why these cannot be used. As there are no other guidelines apart from the DOH ones above, parents must know that  they use mineral waters at their own risk, but assuming they choose waters which conform to the above standards, the risk of solute overload may be small. Due to this lack of clarity on the suitability of various waters whose mineral content actually does fall under the above recommendations, plus the large variety of waters on the market, it is impossible to endorse or recommend specific brands.

In summary

1.      All water used for infant formula MUST be boiled and cooled before using to make up infant feeds

2.      The quality of Hong Kong Water is considered safe for use in making up infant formula feeds provided the pipes and holding tanks within the building structure are up to standard which is the responsibility of the building management and parents to check.

3.      If parents opt to use tap water for feeds it is probably a good idea to fit a commercial water filter or Reverse Osmosis water filter to the domestic tap. If this is the chosen option parents must be aware of the potential hazards of the filter becoming a breeding ground for bacteria. Commercial filters therefore must be changed as regularly as recommended by the manufacturing company. The RO filter will also need to be cleaned and checked regularly by the providing company.

4.      Distilled bottled water with added minerals may be a safe alternative to tap water provided parents are aware of the conflicting advice given regarding its suitability and safety when bottled in plastic bottles. There is insufficient scientific information, as noted by the WHO, on the benefits or hazards of regularly consuming distilled water.

5.       Choosing other bottled waters for the regular use of mixing with infant formula may be confusing and costly. It is likely that choosing water which is simply labeled ‘bottled water’ (as opposed to spring or mineral water) may be the safest option as these waters are  expected to conform to essentially the same standards as the public water supply and they are therefore suitable for giving to infants or for preparing feeds.

6.      If it is absolutely necessary to use ‘spring or mineral water’ for example if one is abroad and the tap water is not safe, then the composition of the water should be checked and avoided if the levels of minerals exceed the guidelines given in the box above. As generally bottled water is not sterile, this MUST be boiled before use with infants.

Thanks to Nicole Edwards BSc RD, Clinical & Freelance Paediatric Dietitian based in Hong Kong, for her contribution to this article, first published in 2008 in the Annerley Newsletter. 

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The great outdoors_April2013_Playtimes

Is there a great outdoors in Hong Kong?

Posted on 07 May 2013 by hulda

 

The great outdoors_April2013_PlaytimesMost of us have great memories of our childhood playing outside in the ‘wild’, this play not only promotes active play and physical development but also improves our immune system. However growing up in a city (especially a city like Hong Kong) can make it seem like your children won’t be able to experience all the benefits of playing outside. But, if you know where to look, Hong Kong has an abundance of amazing family-friendly nature spots, perfect for outdoor play.

With the restriction of space in Hong Kong, we’ve all learnt to make the most with what we have and the precious outdoor space we have is no different! Kristrun talks to Playtimes about the importance of outdoor play and covers all the best spots and activities to make the most out of your time outside with your kids.

Read the full article here or read the complete magazine here.

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