• Feed at birth or as soon as possible.
• Forget the clock. Remember milk takes two to three days to come in. Before that colostrum, which is a clear fluid, high in protein and fat is present in small quantities in the mother’s breast, and it makes the baby full, so that there are six to eight hour gaps between feeds.
• To increase milk supply feed more often or express milk more often
• Express with breast pump or manually. To express manually, press on the areola, the dark area behind the nipple.
• For a good supply of quality milk, you need protein. Therefore, with a diet of light digestible vegetables, dhuli (split) daals, have a litre of plain milk daily or eat a karorie of panjiri You can also continue to have soaked badams (almonds) in the morning. Sometimes too much milk and dairy products can give the baby colic.
• Avoid champagne / cabbage / rajma (kidney beans) / channa (chickpea) / any other heavy foods, since they can cause colic in the baby.

• Since we cannot measure the number of ounces of milk a breastfed baby gets, many mothers wonder whether it is enough. Remember, it is Nature’s food for the baby, the same Nature that nourished the baby inside the womb and made it into a little human being. Your milk is best suited to your baby’s needs, much as cow’s milk is best suited
  to a calf’s needs.
• To check if the baby is getting adequate nourishment, the doctor will weigh the baby when you go for a checkup. If your doctor says the baby is putting on weight normally, it is obvious that your milk is sufficient.

If a baby has six wet diapers in 24 hours, it is getting enough input or milk. Besides, less volume of breast milk is needed as compared to other milk given in a bottle, because all of the breast milk gets absorbed.

Source: Pregnancy-The Complete Childbirth Book by Nutan Lakhanpal Pandit

To be able to breastfeed successfully:

• The mother should be willing to breastfeed
• The mother should be confident about breastfeeding
• The mother should be relaxed when breastfeeding
• The mother should have had previous preparation on how to breastfeed or she should have on-the-spot support to breastfeed

Often, there are babies who fake constant hunger. When put to the breast, they are playful or disinterested feeders. Such babies are actually demanding comfort sucking not nutritive feeding. They probably have mothers who do not cuddle them between feeds and hold them only for the purpose of feeding. If the mother cuddles them between feeds they will stop pretending to be hungry just to feel warm and secure.

Sometimes if the mother is stressed or depressed the baby senses her anguish and wants to be constantly near her for reassurance. Such babies cry a lot and seem to be hungry. Further babies may be actually hungry when they have a growth spurt, that is, when they grow taller, fatter or longer. Their growth requires more milk so they go through a temporary phase of about two days approximately when they want frequent feeding.

This increases the milk supply in the breast. Once that happens, they go back to bigger gaps between feeds. At such times it is best for the mother to take two days off and go to bed with the baby, and concentrate only on feeding for those two days.

• Yes, milk can be expressed and stored in a refrigerator in a glass, which has been sterilized for the purpose. The milk will settle in fat and water layers, but that does not mean it has gone bad. It can be fed to the baby while you are away from the glass or with a spoon.
• Avoid the bottle totally in order to prevent nipple confusion, that is, the ‘mechanism of sucking’ at the breast is different form sucking at the bottle.
• The bottle drips milk regardless of the baby’s jaw effort. The baby therefore tends to prefer it and rejects the breast.
• Further one can never reach the bottom of the bottle to clean the milky slime off it. It therefore encourages a prolific growth of bacteria which is why it needs to be thoroughly sterilized.
• The entire feed should not be expressed at one time. One can collect milk over several hours (say four to six hours).
• Breast milk stays in refrigerator for 24 hrs; it should not be boiled before feeding. It can be given cool from the refrigerator. If it is very cold, it can be warmed by standing in a mug of warm water before feeding.

• When you want to stop feeding, if you pull and drag the baby off the breast, it might give you sore nipples. So instead, you must break off baby’s suction by putting the tip of your finger in the corner of the mouth, and then take him off the breast. Or, pull the chin of the baby downwards, before removing from the breast.
• Further, if you press your breast down with the finger, by forming a big dent on the breast, in order to prevent the baby’s nose from getting blocked, the act of pressing down the breast will cause the nipple to project upwards and hit the roof of the baby’s mouth when it feeds. This hitting of the nipple on the hard palate will cause it to get sore. Instead of denting the breast in this fashion, place your fingers under the breast and raise it slightly, so that the nipple projects straight towards the baby’s throat, and any bulge of the breast that is there goes backwards and meets with the chest.
• Soreness may also happen if the baby munches on the nipple instead of on the areola, the dark area behind. Make sure the baby is latched on properly, by placing both the nipple and areola well into baby’s mouth.
• Soreness sometimes occurs of the nipples are frequently washed with soap. Water is sufficient to wash them.
• Pressure applied at the same point constantly can also lead to soreness. It therefore helps to change positions during a feed and to adopt different positions for different feeds, so that pressure is applied to different points on the breast.
• Soreness may be caused by a baby sucking too long after the breast has been emptied. The baby takes approximately twenty minutes to empty a breast; after that he only indulges in comfort sucking; restrict it.

• Soggy nipples, that is, nipples that remain wet for long periods, are more prone to soreness. It therefore, helps to expose your nipples to air and sunlight as much as possible, until the soreness heals. You can wear a loose garment without a bra.
• Avoid using creams on cracked nipples. Dry corn flour can be dusted on them instead.
  It is also very helpful to express some milk after a feed and rub on the sore nipple where it should be left to dry. This quickens healing considerably. Avoid the use of water-proof-backed bra pads. Do not remove any crust appearing on the nipple. It is a part of healing process.
• Always offer the less sore side first. That will establish the flow on the sore side before the baby takes it, thus making it less painful. You can use ‘breathing for labour’ technique to handle the pain.
• An Aspirin or a mild alcoholic drink like wine or beer, taken shortly before a feed will help reduce the pain. It can be taken if the pain begins to interfere with the release
  of milk.
• You can try using a cold compress on your nipples before feeding. Apply ice-cube wrapped in a towel or hanky. You can wear a blotting paper on a dry nappy liner inside the bra to keep the nipples dry.
• Sometimes, a sore nipple may bleed. There is no harm if the baby swallows tiny amounts of blood with the milk. This can be quite frightening; especially when a baby burps after a feed, and along with the curdled milk brings up a little blood. However, this is harmless to the baby. Continue to treat your sore nipples and carry on feeding.
• There may be a risk of infection of sore nipples. If the baby has thrush, that is, white spots on the tongue that do not wipe away. Thrush must be treated medically. You can take the baby off the breast for a few feeds until the skin has healed. The milk can be expressed and fed to the baby from a spoon.
• A nipple shield can be used. It is a rubber shield that fits over the nipple and aeola, and prevents direct suction on the nipple.

Mother

• Weight Loss is easier for mother, as she feeds baby and loses weight consequently.
• Tests reveal that a mother who feeds her baby is at a lesser risk of Ovarian and Breast cancer.
• It is hassle-free because there is no need to buy artificial milk and sterilize bottles.
  In a fraction of what bottle-feeding costs, mothers can eat good nutritious food.
• While the mother breastfeeds exclusively and through the night, she has less chances
  of getting pregnant.

Child

• Baby feels loved and cared for.
• A proven fact: Breastfed babies have higher IQs hence they are more intelligent.
• Babies get perfect nutrition from mother’s milk. There is no need for artificial tonics.
• Baby gets immunity from breast milk therefore is less likely to get severe infections.
• In adulthood the baby is at a lower risk of acquiring diseases like diabetes and heart problems.

A woman’s body is designed for giving birth. To begin with, a woman’s pelvic bones are broader than a man’s. A woman’s pelvis is heart-shaped, whereas a male pelvis is apple-shaped.

After the baby has passed through the cervix or mouth of the uterus, it makes its way through the vagina. The vagina is made up of folds and is therefore capable of unfolding, just as the pleats in front of a sari can unfold. As the baby passes through the vagina, it opens up to make way for the baby. The more relaxed a woman keeps the muscles of the vaginal passage, the less tension the baby’s head encounters during birth.

The cranial or head bones of the baby are not fused. As the baby’s head negotiates
the birth canal, these bones can mould to the size of the vaginal passage. They can also override each other if necessary. At birth the bones come back to their original shape.

It is because of this that some babies are born with funny bumps on their heads, which smooth out in a few days. The body releases hormones to control the process of birth and make it pain-free.

An interesting fact is that uterine contractions and their associated pain form a very short part of the total labour. For instance, if you have one-minute contractions every five minutes, it will mean that in an hour you will have 12 minutes of contractions and 48 minutes without them. At the start, contractions could be every 15 minutes and last for 30 seconds. So in hour, one would have only 2 minutes of contractions.

Source: Questions and Answers on Pregnancy by Nutan Lakhanpal Pandit

When in labour, the uterus contracts. Stimulus is received and sent to the brain by the nerve endings in the uterus. If the brain interprets it as fearful pain the protective mechanism which advocates flight or fight will take over a woman’s body. As a result, the woman, incapable of flight, will fight each contraction by building up muscular tension throughout will also become rigid and offer resistance to the uterine muscles working towards birth. This is perceived as pain.

However, if the woman understands that the strain her body is undergoing is part of the physical strain associated with the expulsive efforts of her uterus, of which she has no reason to be afraid, the contractions will be a new experience for her. The muscles of her uterus will work unhampered by fearful tension and with each contraction get closer to birth, so that the woman will have a shorter, less painful labour.

Hence the pain a woman will feel in labour will greatly depend on her brain’s interpretation of pain as either something fearful or as something to work with.

Source: Questions And Answers on Pregnancy by Nutan Lakhanpal Pandit

In case of unbearable pain, nature’s safety mechanism makes one pass out, i.e. lose consciousness. In labour, a woman is rendered unconscious by drugs, but never by pain. The right attitude to contractions can make it pretty easy to bear.

“Pregnancy- The Complete Childbirth Book” by Nutan Lakhanpal Pandit explains how to use breathing & relaxation in labour. It also explains different positions that one can adopt in labour and massages that can make labour comfortable. Having a companion in labour also helps in one’s ability to cope with pain.

Source: Questions And Answers on Pregnancy by Nutan Lakhanpal Pandit

These foods nourish your body well

Pulses, dals, lentils (rajma, channa, lobia), milk and curd.
Eggs, meat and other non-vegetarian products and idli.
Sambhar, paneer, soyabean, khichri with curd and oats.
Lemons, fresh seasonal fruits and vegetables.
Dry fruits, raw nuts, fruit or vegetable juice.
Green chutney, tender coconut water.

These foods damage your body when taken in excess

Salt, sugar, jams, preservatives, pickles and cold drinks.
Cheese, ready-to-eat packed foods with MSG.
Butter, cream, pastries, chocolates and ice creams.
Pakoras, jalebis and mathis.

You can improve your haemoglobin by eating the right things. You need to eat coriander (dhania), mint (pudina), raddish leaves (moolie patta), raisins (kishmish), cauliflower leaves (phool gobi patta) etc.

However, when you eat all this, do not have tea, coffee, cola or chocolates along with them, because they contain caffeine which will block iron absorption.

Nimbu pani is good, because vitamin C in lemons aids iron absorption. You could squeeze lemon on to your salad too.

Clear vegetable soup is very nutritious. All the vitamins, minerals, proteins, etc. from the vegetables are passed into the soup. Thick soups are not good, as flour and fat are used to thicken them.

Greens, like palak, methi, sarson, bathua and cholai should be washed first and then chopped. If you cut them first and then wash them, you will lose most of the water-soluble vitamins while washing.

Keep your vegetables away from heat and light. Heat and bright sunlight destroy some of the vitamins. Further destruction comes with cooking, so that by the time you eat it, a fair amount of vitamins are lost. Boil potatoes whole.

With fruits and vegetables avoid peeling if possible, or peel lightly, e.g. carrots, apples, pears. Wash vegetables and fruits before peeling, not afterward.

Do not overcook vegetables; keep them crunchy. Try and cook just before eating, in order to avoid reheating. Avoid storing cooked vegetables in the fridge for more than 24 hours. When you reheat food, first leave it outside the fridge for about an hour so that the change of temperature is not too sudden. Avoid over cooking vegetables to death. Steaming in the pressure cooker protects vitamins.

It is best to use stainless steel utensils for cooking, since it is a metal that does not react to the food, like many other metals do. If you do not have them, the next best thing is to transfer food into stainless steel or plain glass bowls as soon as it is cooked.

If you take ghee regularly, but do not do much work in the house and do not go for regular walks either, it could result in extra weight and stiff joints, making delivery difficult. However, if you are active and if you are not overweight, and if you do not have any cholesterol problem, you can go ahead and have ghee.

Over the years several women have said that eating butter, badam rogan or ghee in the last month of pregnancy helped them to have an easy delivery. This needs to be medically validated.

As such fats in the diet help in the absorption of fat soluble vitamins A, D, E and K. Vitamin A helps to prevent infection. Vitamin D makes strong bones. Vitamin E makes skin healthy. Vitamin K helps in blood clotting.

All these factors could be of significance in relation to childbirth. For instance, keeping infection away would be useful, strong bones and good skin, and blood that clots could all be of enormous help.

1 gram of ghee has 9 calories. 1 tablespoon of ghee has 15 grams of ghee and therefore 135 calories. According to Dietary Guidelines for Indians published by the National Institution of Nutrition, Hyderabad, 1998, visible fat intake should be increased during pregnancy and lactation to 30 grams and 45 grams respectively.

15 grams of fat therefore falls within permissible limits. However, for today’s weight-conscious women, here are a couple of tips. When you add one tablespoon of ghee or butter to your diet in the ninth month, you can avoid other intake of calories like puddings, chocolates, cold drinks, foods with thick gravies, fried foods etc. Or else you can increase your calorie expenditure by going for long walks, which will also be beneficial in preparing your body for an easy and natural childbirth.

Source: Pregnancy-The Complete Childbirth Book by Nutan Lakhanpal Pandit

If a woman fails to conceive two years after having unprotected intercourse it is advisable to seek the help of a specialist who deals with infertility. Further, if you are keen to conceive and for one year have had unprotected intercourse twice a week and not yet conceived, you can consult your doctor.

If either a man or a woman is severely malnourished, conception may not happen. Also, if either of them is suffering from an infection like tuberculosis of the reproductive tract or taking certain drugs for treatment, conception may be hampered. Given below are some common reasons that cause infertility. However, there may be several other reasons that investigations may reveal.

A man may not conceive if he has a low sperm count. That is, when a man ejaculates, there are several million sperm in the semen or the fluid that is ejaculated. Out of these, only one manages to pierce or impregnate the ovum or seed in the mother’s body. However, due to pollution and modern day lifestyles, the sperm count can reduce and conception may not happen. For example, when men wear synthetic underwear and sit for long hours in the heat, like travelling for hours by bus or train in hot weather, they can develop varicose veins in the testes due to excessive heat, and this can destroy the sperm. On the other hand, some men may have damaged sperm.

Sometimes, a man may be impotent, that is, he may not perform sexually, and therefore, not be able to cause a pregnancy.

A man may also not be able to conceive a baby if there is a blockage of the tubes between the testes and the penis.

A woman’s fallopian tubes, through which the sperm travels to meet the ovum may be blocked. In fact, any interference with the fallopian tubes, such as an entopic pregnancy, adhesions after abdominal surgery or pelvic inflammatory disease, can block the tubes and prevent fertilization of the ovum by the sperm.

Further, multiple fibroids or endometriosis may do the same.

A fibroid is a benign tumor of fibrous and muscular tissue, one or more of which may develop in the muscular wall of the womb.

Fibroids often cause pain and excessive menstrual bleeding and they may become extremely large. They do not threaten life but make pregnancy unlikely. Sometimes fibroids may not be very big and not give rise to any symptoms either.

A woman may also not conceive if her hormone level is disturbed or if her body does not release an ovum. That is, if she does not ovulate.

When you plan to have a baby, it is important that both the man and the woman are in good health and well nourished. A nutritious diet, less stress, less alcohol and cigarettes, less lead exhaust from vehicles, less caffeine from tea, coffee and cola drinks, no indiscriminate use of drugs, are all factors that will contribute to a strong and healthy baby. Check these factors three to six months before conception, specially approximately fifteen days before the next cycle is due, because pregnancy starts at that time. A man’s diet, smoking and drinking habits can harm his sperm. A woman needs to check these factors throughout pregnancy.

Source: Questions And Answers on Pregnancy by Nutan Lakhanpal Pandit

It is important for a pregnant woman to avoid undue stress. Her body releases hormones or chemicals connected with stress when she is stressed, and hormones connected with happiness when she is happy. The baby is directly influenced by the environment in her body. It is therefore important that she strives to be happy.

A pregnant woman should also concentrate on eating fresh foods. She should not eat food out of packets and bottles. These foods are laced with chemicals called preservatives and with artificial synthetic flavours, extra salt and sugar. All of these have a detrimental effect on health. Ideally she should eat fresh foods, some raw (fruits & nuts), and others with slow cooking. She should avoid foods with mono sodium glutenate. It is used in Chinese food (you can request them to not add it to your food if you go to a restaurant), in packets of chips, soups or namkeens (check the list of ingredients on the packet to find out if it has been used).

Also avoid a smoky atmosphere and exhaust from vehicles. She should try and breathe fresh air, for example, in the morning, in the park, or, near a few flower pots on her terrace. The morning air is cleaner, since at night there is no activity, so the air has less dust, and exhaust from vehicles, in it. The morning sun is not harmful to the skin. Exposure to the ultraviolet rays of the morning sun provides vitamin D and aids in the absorption of calcium. (Upto 10 am would be considered morning). The mother should avoid crowded places since such places will have less oxygen and could be a source of infections.

The indiscriminate use of medicines is not advised even if it is only an aspirin. Doctors have lists of permissible medicines for pregnant women; just consume them!

Unless she was used to it before getting pregnant, a mother should avoid lifting heavy bucket full of wet clothes, furniture or a freshly watered flower pot, with wet mud.

The simplest way of knowing that you are pregnant is the missed period. Along with a missed period a woman may feel nauseous, may need to urinate more frequently and feel tenderness in the breasts. When you go to the doctor in order to reconfirm your pregnancy, the doctor will check you for an enlarged uterus, softening of genital organs and during an internal vaginal examination the cervix will be seen to have taken on a purplish-velvety look, typical of pregnancy.

A blood or urine test can help detect the presence of a pregnancy. The blood or urine is tested for the presence of HCG, human chronic gonadotropin. The developing placenta begins to produce this hormone to prevent menstruation and protect the pregnancy.
For an earlier result the blood test is more reliable.

The skin is made up of elastic and non-elastic fibres. When stretching beyond the normal limits occurs, as in pregnancy, the non-elastic fibres tend to break, causing stretch marks. At first these marks may occur as streaks. After birth they take on a kind of purple or brown shade and finally end up as whitish streaks. Excessive water retention (which does not occur as a result of drinking excess water) or weight gain can also cause stretch marks.

These marks may appear on the stomach, breasts bottom and thighs. To an extent the marks may be controlled by regulating weight to avoid overstretching of the skin. But the stretching on the tummy cannot be avoided as it is the result of an expanding uterus. Besides, hormonal changes that encourage water retention may cause an increase in fluid retention on your bottom and thighs, causing stretch marks to appear, even in an aware, weight-regulated woman.

The reason why stretch marks are worse in some women is simply because the elasticity of the skin varies from person to person. Women with fewer stretch marks have more elastic fibres in the skin. There is no way in which the skin’s elasticity can be increased to reduce stretch marks.

Many women believe that oiling the skin helps, especially with Vitamin E oil. There is no evidence to support this theory. However, there is no harm in a gentle massage of the stretched abdomen. It is very relaxing. Moreover if you are lucky, you may find that the marks do not appear at all.

As the pregnancy advances, the uterus presses towards the lungs. This results in shortness of breath and panting when you climb even a few steps, or, the need to take a deep sigh frequently. This is more so in case of a twin pregnancy, or if you are fairly short, so that the uterus feels very large. The discomfort will be more when you sit on something low, when you slump your shoulders or when you lie down. If you sit up straight, it will relieve the discomfort. It is nothing to worry about, the discomfort will vanish with the birth of the baby.

Source: Questions And Answers on Pregnancy by Nutan Lakhanpal Pandit

This is an excerpt from Nutan Pandit’s book ‘Pregnancy – The Complete Childbirth Book’. It’s a topic less discussed as couples feel hesitant to ask what they should do about their sexual desires during pregnancy.

In fact, sex in pregnancy is perfectly normal. It can bring a new delight with it since contraception is out of the way. However, if you have previously lost a baby or miscarried, the doctor may tell you to avoid sex when your period would have been due, or generally. If you’ve been asked to avoid intercourse, you can always indulge in caressing, stroking, kissing etc. Do not feel shy to ask the doctor how long you have to avoid intercourse, since doctors may forget to say when you are past the time and you are likely to miscarry…

…Some women feel inclined towards sex in pregnancy, while others do not. When making love certain considerations have to be kept in mind, like the growing abdomen or the increased sensitivity of the breasts. Different positions can be experimented with in accordance with whatever is comfortable.

Men often fear that during intercourse they may in some way harm the baby. You cannot hurt the baby during intercourse. The baby is protected by water bag and water around it. The water acts as a shock absorber to protect the baby from accidental blows or jerks. The uterus is housed in the bony framework of pelvic bones, which provide protection. In the mouth of the womb, the cervix is a plug of mucus which seals the womb and prevents infection from entering the womb…

• Nappies of breastfed babies do not smell. You can collect them for 24 hours in a plastic bin which has a swinging A-shape lid so that you can just keep chucking them in.
• Once in a day, remove all the nappies, scrape the shit off them with a knife, into the toilet/commode.
• Rinse them out of warm water once.
• Soak them in detergent for hand washing or load them into the washing machine.
• If there are stubborn stains that do not wash away, dry the nappy on a plant or on grass, in the sun. The stain will disappear.
• Half an hour of strong sunshine disinfects nappies.
• Ironing also disinfects nappies.
• You do not need to put disinfectant or germicidal solutions in the nappy wash if you can dry the baby’s nappies in the sun and/or iron them. You can use these solutions only in wet weather when nothing dries and even your towels start to smell.
• In wet weather you can rinse the baby’s nappies/clothes last out of hot water. Then squeeze out the water as best you can, spread them in a room, switch on the fan and shut the room. They will dry fast in this way.

Step 1: Take a white cotton nappy 22 inches square

Step 2: Fold it square like a table napkin

Step 3: On one corner of the square, four free layers of fabrics will be there

Step 4: Lift first layer of fabric forward, and then to the side, so that you get a triangular shape, while a square fabric shape gets left behind on one side.

Step 5: Lift the nappy and place on the reverse side.

Step 6: With nappy placed on reverse side.

Step 7: Start to fold the square side into

Step 8: About 3 narrow folds, towards the centre.

Step 9: Now the same cloth nappy is ready with increased soaking power for daily use.

Step 10: A readymade padded cloth nappy available in the market.

Step 11: If you need to leave the nappy on for a longer period eg. for an outing or at night.

Step 12: Use a ready shaped nappy under the cloth nappy.

Step 13: Place an Ever Dry Nappy on the top of these two nappies. (It will keep the baby dry when it wets)

Step 14: Place the baby on the nappies as illustrated.

Step 15: Fold the centre in towards the waist.

Step 16: Fold in from both the sides towards centre and pin up.

Step 17: Your baby is now ready to wear a plastic panty on its nappies

Step 18: Now your baby is dressed with the Ever Dry Nappy in place.