WEBVTT - Week 28: Crusty Nipples, Baby's Sleep Cycles And Why Can’t I Breathe?

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<v Speaker 1>You're listening to a Muma Mia podcast.

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<v Speaker 2>Mom and Maya acknowledges the traditional owners of land and

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<v Speaker 2>waters that this podcast is recorded on.

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<v Speaker 3>I am pregnanty.

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<v Speaker 1>Welcome to Hello Bump.

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<v Speaker 2>We're making pregnancy less overwhelming and more manageable.

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<v Speaker 1>I'm Grace Rubrey.

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<v Speaker 2>I'm pregnant for the first time and the rings on

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<v Speaker 2>my fingers are starting to feel a little tight.

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<v Speaker 3>Oh shame. I'm Yana Pittman. I'm a former Olympian mother

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<v Speaker 3>of six, and I'm training to be an obstetrician.

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<v Speaker 2>Each week, we'll be holding your hand week by week

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<v Speaker 2>through the mysterious perplexing where every day is a whole

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<v Speaker 2>new symptom, but still a miracle. It is pregnancy all

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<v Speaker 2>the way from a poppy seed to a pumpkin.

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<v Speaker 1>Week twenty eight, How big is our baby?

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<v Speaker 3>So we're kind of looking at a baby that's around

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<v Speaker 3>the size of a coconut.

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<v Speaker 2>Now it is a large eggplant, loafe of bread, lofe

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<v Speaker 2>of bread.

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<v Speaker 1>One of those half ones are like a full one.

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<v Speaker 1>It's a half one.

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<v Speaker 2>Yeah, you to compare it to the goga dar a

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<v Speaker 2>full one feels aggress see it if it was like

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<v Speaker 2>maybe full term yeah, yeah, that's a full time baby.

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<v Speaker 1>Yeah, a big sour dough full term baby.

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<v Speaker 3>And an animal from Australia as a potteroo.

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<v Speaker 1>What's the potter room? I don't really know. I was

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<v Speaker 1>hoping you could tell me. I googled that one. It

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<v Speaker 1>feels like some type of marsupial. That's a right greatly.

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<v Speaker 3>Something, but it's about a kilo in size by if

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<v Speaker 3>you're actually thinking about the measurement per se.

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<v Speaker 2>And what's our placenta measuring? Like, wait wise, because if

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<v Speaker 2>we're starting to feel uncomfortable and like we aren't carrying

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<v Speaker 2>more weight, if the baby's only one kilo, what's our

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<v Speaker 2>placenta's sort of way well?

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<v Speaker 3>Percenters and will change through out pregnancy depending on how

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<v Speaker 3>much nutrition is going through and whether you've got preclamps

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<v Speaker 3>or anything like that. But you've also got the amniotic fluids.

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<v Speaker 3>You got to think there's a lot more than just

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<v Speaker 3>your percent to your baby and your own blood volumes.

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<v Speaker 3>There's a whole lot more changing in your body at

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<v Speaker 3>this point.

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<v Speaker 1>The blood volume, keep your exact blood volume.

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<v Speaker 2>Yeah, and how has that baby developed this week?

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<v Speaker 3>Baby's growing rapidly at this point, so he or she

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<v Speaker 3>in your case, she is now starting to develop sleep

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<v Speaker 3>wake cycles and might even be having rem sleep, which

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<v Speaker 3>I think is really cute to think that they're actually

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<v Speaker 3>having those similar cycles that they will when they're a

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<v Speaker 3>kid in adult and they're now seeing more defined grooves

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<v Speaker 3>in their brain, so that brain isn't again growing and differentiating.

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<v Speaker 2>And this is that theory of like the sleep cycle

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<v Speaker 2>is every ninety minutes or so, you should probably feel something.

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<v Speaker 3>In field movements exactly. And you might find this point

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<v Speaker 3>if you've gone in with the CREASFIITL movements to the hospital.

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<v Speaker 3>For example, they'll put on a little CTG where they

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<v Speaker 3>actually monitor baby's heart rate and we actually can see

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<v Speaker 3>it on the scan. You can actually see when the

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<v Speaker 3>baby has like a lower heart rate, when it's actually

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<v Speaker 3>dropping and not doing very much activity, and then it

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<v Speaker 3>becomes really active.

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<v Speaker 1>And that's what we.

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<v Speaker 3>Call those sleepwake cycles. And we do want you to

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<v Speaker 3>watch that because sometimes if there's no movements, it's a

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<v Speaker 3>little one sleeping. But if that is going on for

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<v Speaker 3>too long, then we need to really adjust how we're

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<v Speaker 3>thinking about our baby's movements and potentially go and see

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<v Speaker 3>the hospital.

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<v Speaker 2>It is a hard one because sometimes if you're busy,

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<v Speaker 2>you haven't really checked in with your body. I even

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<v Speaker 2>had it just this morning. I was like, I haven't

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<v Speaker 2>felt her normally. I feel her when I'm laying down

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<v Speaker 2>in bed. And then I was busy and I went

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<v Speaker 2>and had food, and then I came and lay on

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<v Speaker 2>the couch and I was like, just check in, and

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<v Speaker 2>then she moved.

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<v Speaker 1>I was like, okay, but I.

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<v Speaker 3>Think you hit the nail on the head there. So

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<v Speaker 3>taking some time out is your first step if you

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<v Speaker 3>think your babies, if you haven't really during the day

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<v Speaker 3>you think, oh, maybe they're not moving as much, is

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<v Speaker 3>to just take that twenty minutes time out, have something

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<v Speaker 3>to eat, drinks and water, because often they do have

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<v Speaker 3>less movement. When you're a little bit dehydrated, lie down

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<v Speaker 3>and see if you can check in with your little one.

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<v Speaker 1>What's happening, what's happening to me, and what's happening to

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<v Speaker 1>our bodies.

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<v Speaker 3>Well, I think we'll go into this quite a bit,

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<v Speaker 3>but now your uterus is pushing up very much underneath

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<v Speaker 3>that rib cage, so there's a lot less movement of

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<v Speaker 3>that diaphragm and your lung, so you're going to feel

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<v Speaker 3>a lot more breathless. So and I think women are

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<v Speaker 3>still trying to do a lot twenty eight weeks and

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<v Speaker 3>it's starting to get harder. So all bending down, tying

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<v Speaker 3>your shoelaces, all that sort of stuff is now going

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<v Speaker 3>to become just that little bit more challenging.

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<v Speaker 1>Yes, that's definitely happening for me.

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<v Speaker 2>And I wanted to ask about when they're sort of

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<v Speaker 2>up around your ribs, that you're starting to feel that discomfort.

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<v Speaker 2>But then one of the biggest things that you hear

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<v Speaker 2>about preoclampsia is pain underneath the ribs.

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<v Speaker 1>It's differentiating.

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<v Speaker 2>It's like everything in pregnancy is like a normal symptom

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<v Speaker 2>or like you should go to the hospital, and it's

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<v Speaker 2>just whether it's paired with the right amount of things.

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<v Speaker 2>So how do we figure out the difference between the

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<v Speaker 2>discomfort and when we should be worried.

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<v Speaker 3>That's a tough question to say. Look, I think things

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<v Speaker 3>like preclamps is obviously related to blood pressure, and that's

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<v Speaker 3>to do with the way your capsule around your liver

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<v Speaker 3>is being irritated or swelling. So it's a late stage

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<v Speaker 3>of preclamps And now that's and I know my fellow

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<v Speaker 3>obstetric trainees and bosses will go, oh, that's not correct

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<v Speaker 3>going or it can be the first stage, because there's

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<v Speaker 3>definitely different ways that preclamps you can eventuate. But in

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<v Speaker 3>most cases you leave the fighter baby that's small and ultrasound,

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<v Speaker 3>and then they look for a reason why, or a

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<v Speaker 3>woman has increased dema quickly and sometimes unilateral. Sometimes it

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<v Speaker 3>happens more.

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<v Speaker 1>You know, all of us swelling.

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<v Speaker 3>Pregnant emma is swelling, Yes, swelling exactly. Sorry, yes, thank

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<v Speaker 3>you for the non medical deal. But it happens more quickly,

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<v Speaker 3>so we do expect to see some swelling again, can

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<v Speaker 3>be normal, can be a problem. Headaches is a big one.

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<v Speaker 3>Changes in your vision, so any of those kind of

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<v Speaker 3>things clue us into what's going on. But again, headaches

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<v Speaker 3>are normal in pregnancy.

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<v Speaker 1>Vision changes not so much.

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<v Speaker 3>If you have diabetes. It's a really big one when

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<v Speaker 3>you have to check in with your eyesight because it

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<v Speaker 3>can deteriorate ord written not with the in pregnancy. But

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<v Speaker 3>all of those things can be very normal. And that's

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<v Speaker 3>the hardest part is if you're concerned, that's what a

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<v Speaker 3>midwife and a doctor's for. Give them a call, tell

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<v Speaker 3>them what you're symptoms are. They'll either reassure you or

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<v Speaker 3>tell you to come in for an assessment.

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<v Speaker 2>Yeah.

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<v Speaker 1>Look, I have made calls to my midwife.

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<v Speaker 2>I was sitting at a high bench at a pub

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<v Speaker 2>and my calves were swollen and I was like, oh

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<v Speaker 2>my gosh, another DBT or yeahah yeah, and I had

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<v Speaker 2>a slight headache as well, and I was like, this

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<v Speaker 2>is it.

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<v Speaker 1>It's like it's the end.

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<v Speaker 2>And then she I just called and she was like, no,

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<v Speaker 2>it's sort of be like swelling and it doesn't go down. Yeah,

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<v Speaker 2>it's like look for your face, your hands, but the hands.

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<v Speaker 1>Get itchy too.

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<v Speaker 3>Not yet, hopefully in pregnancy if you can get to

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<v Speaker 3>think called colystasis, which is when you get itchy hens

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<v Speaker 3>and feet. We actually had a lady this week come

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<v Speaker 3>in with rip rowing colystasis, and the only symptoms she

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<v Speaker 3>had was itchy hens and otherwise a completely healthy pregnancy

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<v Speaker 3>had been It was her second pregnancy, no concerns in

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<v Speaker 3>the last one, and this one we had to unfortunately

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<v Speaker 3>birth her earlier because she had significant problems with her liver. Again,

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<v Speaker 3>liver pain could be a symptom.

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<v Speaker 1>Of that as well.

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<v Speaker 3>So there's all these different things in pregnancy that can

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<v Speaker 3>point to different directions of what's going on.

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<v Speaker 2>It is that thing of like, every symptom is normal,

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<v Speaker 2>every symptom is problematic. Potentially sorry, yeah, potential problematic, And

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<v Speaker 2>it's okay to call.

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<v Speaker 3>In fact, we want we want you to. I think

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<v Speaker 3>the biggest thing that comes out of that is if

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<v Speaker 3>you're concerned. It's most public hospitals are a twenty four

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<v Speaker 3>to seven service. So that's why we're there, is for reassurance,

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<v Speaker 3>but also to occasionally pick up on what mum's intuition

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<v Speaker 3>is saying, because often it's the thing to go by most.

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<v Speaker 1>Is this normal is normal?

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<v Speaker 2>Is this normal is about nipples?

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<v Speaker 1>Okay?

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<v Speaker 2>Sometimes they are a little bit crusty when I take

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<v Speaker 2>off my bra at nighttime, and I just don't know

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<v Speaker 2>if that's is that too early for colostrum or what

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<v Speaker 2>are the changes around this time that we can start

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<v Speaker 2>to see.

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<v Speaker 3>Well, your breasts start changing in first tremester already you

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<v Speaker 3>notice that the size change yet Okay, sure, think but

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<v Speaker 3>it's also that the ductal developments. Everything's changing to get

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<v Speaker 3>you in preparation for breastfeeding. It's not too early. We

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<v Speaker 3>do have women that have colostrum at twenty eight thirty weeks.

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<v Speaker 3>It's normally closer to thirty four and thirty six. We

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<v Speaker 3>don't want you to stimulate your breasts, ladies, at this gestation,

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<v Speaker 3>because pre term labor is not something we want to induce,

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<v Speaker 3>and it's very much an old wives tale, and certainly

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<v Speaker 3>in countries that don't have sintocin and things like that,

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<v Speaker 3>where they actually get women to stimulate their nipples in

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<v Speaker 3>early labor to try and get that labor starting. So

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<v Speaker 3>we don't want that just yet, but it's usually a

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<v Speaker 3>good sign. If you can get some closterum coming naturally,

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<v Speaker 3>it means that you've got a better chance of being

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<v Speaker 3>out of breastfeed if that's what you choose to do.

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<v Speaker 2>And still even if you are, haven't cost them now.

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<v Speaker 2>It's not an indication of how well or how easy.

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<v Speaker 2>It's just a real mix bag. I think one of

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<v Speaker 2>the things that I've been told by a lot of

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<v Speaker 2>pregnant friends is how hard breastfeeding is, and they were

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<v Speaker 2>just not prepared for how hard it was going to be.

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<v Speaker 3>And I think that's a lovely message to even be

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<v Speaker 3>saying now, because there should be no judgment in this space.

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<v Speaker 3>Yet there is so much judgment, and there's so much

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<v Speaker 3>on social media, and so many women walk out of

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<v Speaker 3>that experience feeling like they've let them and their babies down,

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<v Speaker 3>when ultimately I have breastfed most of my babies. One

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<v Speaker 3>of them was particularly difficult, and I like the saying

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<v Speaker 3>fedti's best. But if you can't, the relationship with your

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<v Speaker 3>baby could being greatly affected if you push that envelope

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<v Speaker 3>too hard and it's not working, and it's sometimes just

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<v Speaker 3>nicer for the entire relationship to say this isn't working.

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<v Speaker 3>I've sought out all the options, I've tried everything. Congrats,

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<v Speaker 3>I've done a great job. And stop it earlier than before.

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<v Speaker 3>You're really hitting a brick wall with it.

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<v Speaker 2>And what can we do this week? What are some

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<v Speaker 2>important things to book in or.

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<v Speaker 3>Look that for. I think twenty eight weeks is a

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<v Speaker 3>really important time because this is when we start actually

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<v Speaker 3>looking for babies that may be struggling. So we sort

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<v Speaker 3>of touched on preclamps here, and obviously there's things like diabetes,

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<v Speaker 3>So around twenty eight weeks is when we first look

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<v Speaker 3>for signs in your baby via ultrasound. So if you

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<v Speaker 3>have a higher risk pregnancy, even just being a bit

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<v Speaker 3>older unfortunately puts.

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<v Speaker 1>Through in that categories.

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<v Speaker 3>Sometimes we like to do an ultrasound at twenty eight

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<v Speaker 3>weeks because we actually start looking at babies growth and

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<v Speaker 3>then compare it at thirty two and thirty six weeks

0:08:43.709 --> 0:08:45.469
<v Speaker 3>to make sure they're not either becoming too big in

0:08:45.469 --> 0:08:48.349
<v Speaker 3>the case of diabetes, which is called macrosomia, or becoming

0:08:48.349 --> 0:08:51.109
<v Speaker 3>too small in the case of growth restriction. So we

0:08:51.149 --> 0:08:52.949
<v Speaker 3>also look at dopplers now, so we start looking at

0:08:52.989 --> 0:08:55.269
<v Speaker 3>the vessels that feed your baby, and the particular vessels

0:08:55.269 --> 0:08:57.149
<v Speaker 3>for example, in the baby's brain and around their liver,

0:08:57.509 --> 0:09:00.189
<v Speaker 3>around how they're coping with the pregnancy as a whole.

0:09:02.269 --> 0:09:04.069
<v Speaker 2>Well, for my talk kit this week, I wanted to

0:09:04.109 --> 0:09:07.709
<v Speaker 2>actually ask you a question about iron tablets versus an

0:09:07.829 --> 0:09:11.669
<v Speaker 2>iron infusion. So I was on iron tablets and just

0:09:11.709 --> 0:09:13.869
<v Speaker 2>taking them every second day was what I was prescribed.

0:09:13.909 --> 0:09:17.709
<v Speaker 2>They've redone my iron, hemoglobin and vitamin D and it

0:09:17.749 --> 0:09:20.549
<v Speaker 2>was mostly fun except my iron had gone down even

0:09:20.589 --> 0:09:22.909
<v Speaker 2>though I was on iron tablets every second day, and

0:09:22.949 --> 0:09:25.229
<v Speaker 2>they just said to go well, up your tablets to

0:09:25.869 --> 0:09:29.109
<v Speaker 2>every day now. But why isn't it going straight to

0:09:29.149 --> 0:09:30.949
<v Speaker 2>an iron infusion. Why would we be waiting at twenty

0:09:30.989 --> 0:09:31.349
<v Speaker 2>eight weeks?

0:09:31.389 --> 0:09:33.309
<v Speaker 3>Yeah, great question, now, I think the big thing is

0:09:33.309 --> 0:09:35.349
<v Speaker 3>I actually learned this only two weeks ago, which shows

0:09:35.389 --> 0:09:35.949
<v Speaker 3>I'm really.

0:09:35.749 --> 0:09:36.509
<v Speaker 1>Still training guys.

0:09:36.509 --> 0:09:38.429
<v Speaker 3>Okay, so there's a lot of smarter doctor other than me.

0:09:38.909 --> 0:09:41.189
<v Speaker 3>But we actually excrete a lot more of the components

0:09:41.229 --> 0:09:43.109
<v Speaker 3>that make up iron and hemoglobin through the urine when

0:09:43.149 --> 0:09:45.789
<v Speaker 3>we're pregnant because we've got leakia glamarola. Like basically your

0:09:45.869 --> 0:09:48.149
<v Speaker 3>kidneys work harder and so you're losing some of that

0:09:48.229 --> 0:09:50.469
<v Speaker 3>ability to hold onto your iron. Plus the baby takes

0:09:50.509 --> 0:09:52.709
<v Speaker 3>your iron, Plus you're obviously using it more to create

0:09:52.789 --> 0:09:55.629
<v Speaker 3>more hemoglobin, which is how you carry oxygen around your body.

0:09:55.709 --> 0:09:57.989
<v Speaker 3>So you are definitely going to be depleted. And so

0:09:58.069 --> 0:10:00.549
<v Speaker 3>ooral ion is fantastic. We don't absorb enough of it,

0:10:00.549 --> 0:10:03.269
<v Speaker 3>which is why sometimes women all require or they get

0:10:03.309 --> 0:10:05.909
<v Speaker 3>really constipated, let's be honest, and they can't tolerate taking

0:10:05.989 --> 0:10:08.149
<v Speaker 3>oral Ion's probably the biggest reason women don't take it.

0:10:08.429 --> 0:10:10.429
<v Speaker 3>Then we start looking at an infusion. But why do

0:10:10.549 --> 0:10:12.709
<v Speaker 3>we want this? It's optimizing birth, So it's actually not

0:10:12.749 --> 0:10:14.869
<v Speaker 3>about now, Yes, it helps fatigue in things, but you

0:10:14.949 --> 0:10:16.109
<v Speaker 3>know you're going to lose a bit of blood when

0:10:16.149 --> 0:10:18.029
<v Speaker 3>you actually have your baby, and so if you go

0:10:18.069 --> 0:10:20.269
<v Speaker 3>into that space with a low hemoglobe, so a low

0:10:20.349 --> 0:10:22.989
<v Speaker 3>carrying capacity of oxygen, you're going to feel terrible. So

0:10:23.069 --> 0:10:24.549
<v Speaker 3>if we do it now, though, it's just a little

0:10:24.549 --> 0:10:26.869
<v Speaker 3>too early, so unless we think your labor is coming soon.

0:10:26.909 --> 0:10:28.629
<v Speaker 3>So if there's some an indication that you've either had

0:10:28.629 --> 0:10:30.829
<v Speaker 3>a bleed, for example, if you've got an aph, if

0:10:30.829 --> 0:10:33.549
<v Speaker 3>you're bleeding regularly and your ions dropped significantly and you've

0:10:33.589 --> 0:10:35.789
<v Speaker 3>got a low, really low hemoglob and then of course

0:10:36.149 --> 0:10:38.429
<v Speaker 3>we'll do an iron infusion or sometimes a blood transfusion,

0:10:38.749 --> 0:10:40.789
<v Speaker 3>but ideally we wait till about thirty four to thirty

0:10:40.789 --> 0:10:42.749
<v Speaker 3>six weeks to make sure the ooral didn't work and

0:10:42.789 --> 0:10:44.669
<v Speaker 3>that we're giving it close enough to birth that's going

0:10:44.709 --> 0:10:46.189
<v Speaker 3>to support you when you need it most, which is

0:10:46.229 --> 0:10:49.509
<v Speaker 3>in labor and that postpartum period.

0:10:49.949 --> 0:10:52.109
<v Speaker 2>We hope you enjoyed this episode of Hello Bump. We

0:10:52.229 --> 0:10:55.269
<v Speaker 2>have so many episodes of this series filled with tips

0:10:55.269 --> 0:10:57.029
<v Speaker 2>and stories from women and.

0:10:56.949 --> 0:10:58.749
<v Speaker 1>Experts who've been through it all before.

0:10:58.989 --> 0:11:00.829
<v Speaker 3>You can go back and listen to everything else Hello

0:11:00.829 --> 0:11:02.349
<v Speaker 3>Bump related in this podcast feed.

0:11:02.549 --> 0:11:04.309
<v Speaker 2>And while you're there, we'd love if you could give

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<v Speaker 2>us a flying star rating and maybe leave us a review,

0:11:06.469 --> 0:11:08.429
<v Speaker 2>or even share this episode with a friend.

0:11:08.589 --> 0:11:11.749
<v Speaker 3>This episode was produced by Courtne Ammenhauser with audio production

0:11:11.829 --> 0:11:13.469
<v Speaker 3>by Tom Lyon We'll catch you next time.

0:11:13.549 --> 0:11:15.909
<v Speaker 2>This episode of Hello Bump was made in partnership with

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<v Speaker 2>Huggies Bye Bye