The Experts: pregnancy, birth and beyond

Our panel of healthcare professionals answer your questions

After breastfeeding my baby, my nipples become very sore. What’s the cause of this and what can I do to help? 

Sorry to hear that you’re suffering from this, but you’re not alone. There’s a few reasons as to why you might be experiencing sore nipples after feeding. It could be any of the following:

• Poor latching.

• Baby sucking its lower lip in.

• Comfort sucking.

• Undiagnosed tongue-tie.

• Overly sensitive nipples.

There are a few things you can try to help. It might be worth having your latch checked by your health visitor or a professional, but you can also try some of these practical tips:

• Change positions.

• Hand-express a little milk beforehand to help the let-down release quicker.

• Offer the less sore breast first, then baby won’t be so ravenous on the sore one.

• Don’t wipe milk off the nipples, leave it on as breast milk is the best cure for sore nipples.

• Allow your nipples to air dry rather than popping your bra straight back on.

If you are still experiencing problems, do seek help from a professional, you shouldn’t suffer.

Deearna Withey, founder, deearnas-maternity-agency.co.uk

What is a transvaginal scan, and how is it different from an abdominal scan?

A transvaginal scan is an ultrasound scan that is done by gently inserting a narrow probe into the vagina. The probe is disinfected before use, is covered with a new and sterile condom and is lubricated with gel to make insertion into the vagina easy. You may experience minor discomfort but it is not painful and there are no risks associated with it.

You may be more familiar with the transabdominal scan approach. This requires a full bladder and a probe is pressed on the abdomen. For a transvaginal scan you are asked to empty your bladder. As the probe is close to the pelvic organs, a better view is obtained of the womb, cervix and ovaries, the pictures are much clearer and there is greater detail. A transvaginal scan is therefore used when you need to look at the organs lower down in the pelvis, while a transabdominal scan will give a clearer picture of the organs higher up in the abdomen.

Why would you need a transvaginal scan?

This scan will be done in pregnancy for the following reasons:

• Vaginal bleeding or pain in early pregnancy.

• To see the heartbeat of the foetus in early pregnancy.

• To diagnose a miscarriage.

• To diagnose an ectopic pregnancy.

• To look at the cervix.

• To examine the placenta for abnormalities.

Or it may be done postnatally:

• If there is abnormal bleeding or pain.

• To check for cysts or fibroids.

• To check the placement of a coil.

• For an abnormal gynaecological examination.

Why would you need a transabdominal scan?

This type of scan will be done in pregnancy or postpartum for:

• Routine scans of the baby after 9-10 weeks.

• Any unexplained abdominal pain.

• To look at your liver or kidneys.

Dr Elisabeth Peregrine, consultant obstetrician, Richmond Practice

I’m due to have twin girls next month, what advice do you have for getting them into a good sleep routine?

Congratulations on the imminent arrival of your twins! Teaching two babies to sleep through the night might sound difficult, but generally the same principles apply as with one baby. Firstly, put your babies to bed at the same time so they develop similar sleep patterns. If you don’t do this they are likely to wake at different times, which will make you very tired. As soon as one baby cries to be fed, wake the other baby and feed her, too. There is no evidence that sharing a cot benefits twins so it is probably best to get them used to their own sleeping environment early on.

Develop a bedtime routine for both babies; this could include a bath, bedtime story and cuddles. Try to focus on settling one baby first – once one is calm, move onto the other. It’s important to help your babies fall asleep on their own, rather than in your arms or by rocking. Put them down in their cot while they are still awake and they will learn to settle. Cuddle and talk to your little ones all you want during the day, but when night comes, keep interaction to a minimum to ensure they fall back to sleep. When they do wake, don’t make eye contact, keep the room dimly lit and put them straight back to bed after a feed.

Katie Hilton, midwife, iCandy

I’m going away with my six month old. what I should pack in my first aid kit?

Although this is an exciting time, unfortunately accidents and illnesses can happen anywhere. Equipping yourself with the right kit and knowledge means you are ready for action if something happens. Here are my essentials:

• Paediatric Paracetamol or Ibuprofen sachets. These are particularly handy to have on the plane in case the air pressure hurts their ears.
• Paediatric Piriton, in case they have a mild allergic reaction to new foods or stings.

• A couple of calico triangular bandages. These versatile, non-fluffy bandages offer easy cover for head wounds, elbows, knees, mouths – pretty much anywhere –  and can be folded to make a flat bandage or a sling.

• An instant ice pack. This can be activated when you need it (without a freezer). Cover, then apply to bruises to reduce swelling.

• Non-adherent dressings for grazes and micropore tape to secure them. Finger bandages and small dressings are useful, too.

• Burn gel . Use preferably after cooling a burn under running water for at least 10 minutes.

• Tough-cut scissors to cut off clothes and good quality tweezers to remove splinters.

• Plasters – for the short term covering of a wound. Remove as soon as possible, clean and then cover with an appropriate dressing.

• Sterile wipes or pods of saline to clean wounds. Saline is also useful to irrigate sand out of eyes.

• Small crepe bandages to provide support for injured limbs.

Ensure you have the number for the local emergency services – throughout Europe the emergency number is 112. It is also helpful to always have tissues, hand sanitiser, snacks and a bottle of clean water.

Emma Hammett, founder, First Aid for Life

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