Alison Brown answers your birth, bump & baby questions

Alison Brown has been a midwife for around 17 years. Prior to this, she was a nanny and a nurse.

Alison loves working in all areas of midwifery, from shifts on the labour ward to antenatal assessment and helping woman breastfeed. Her areas of expertise lie in postnatal care, antenatal care, breastfeeding and all aspects of infant feeding.

Alison has three children, Imogen, Henry and William, and she had them all at home.  

Is it normal to have a big gap between appointments when expecting twins?

I am expecting twins and went for my 12 week scan and blood tests. They told me I don't need to go back for two months to get the blood results. I have not been given a date for any other scan or checks. Is this normal or am I being a worried mum? 

Alison says: this all sounds routine to me. You will have an appointment at around 16 weeks to review your blood tests, have a routine antenatal check (blood pressure, urine test etc) and an appointment will be made for your anomally scan usually at about 20 weeks. Twin pregnancies are monitored more and from about 24-28 weeks you may be seen every two weeks in the antenatal clinic. Not sure if you are aware but there is a great support group called TAMBA ( Twins and multiple births association) www.tamba.org.uk/ It provides advice and information for anyone who is expecting or has twins or more. 

What does 'periods of acceleration' mean in terms of a baby's heartbeat?  
I went for a check at the hospital yesterday due to a kidney infection I've developed and the midwife monitored the baby's heart for 45mins. She said it was strong but that it was having periods of acceleration which was uncommon at 29 weeks. What does 'periods of acceleration' mean and should I be worried?

Alison says: when a baby's heartbeat is monitored antenally we like to see a baseline heartbeat of between 110-150, a variabilty of about 10-15 beats (so not constantly at the same level) and accelarations and movements as well as periods of rest. Periods of accelaration are normal and from what you have told me I would not say there is anything to worry about. However, I do not have the clinical information in front of me so I strongly suggest that if you are concerned you make an appointment to see your GP or your regular midwife straight away. 

What are the signs you are pregnant?

How you are supposed to tell the difference between going for a wee a little more than usual and recognising an early sign of pregnancy? Also, I seem to be more hungry than usual. I don't know if @'m just imagining things because I so desperately want to be pregnant. My period isnt due for ten days. 

Alison says: frequently going to the loo and being hungry are not reliable signs of pregnancy, as so many other things can cause these symptoms too. A pregnancy test is the most accurate way to test and some of them can detect a pregnancy before you miss a period. If you can't wait it may be worth doing one of these. 

Is it OK to give cow's milk and yoghurt at six months?  

Do you still have to make babies' cereal with formula milk at the age of
six months, or can you use cow's milk? Also, can babies have yoghurts under six months? My baby is five-and-a-half months, and has been weaning from 17 weeks.

Alison says: cow's milk is not suitable as a drink for your baby but can be used in cooking, so yes, you can put it on your baby's cereal from six months. Food stuffs such as yoghurt are recommended from six months onwards. Although you started weaning early, the digestive system is still maturing and so yoghurt would not be suitable for a baby under six months.

Could I be pregnant when the test is negative?

My period is nine-and-a-half weeks late. I've done two pregnancy tests which were both negative but there's a good chance I'm pregnant. My GP says my hormone levels might be too low to be detected on a shop bought pregnancy test. Is this normal? 

Alison says: the hormone that is detected by many over-the-counter pregnancy tests tend to surge to high levels during those first few weeks until the placenta and
its hormones take over at about 12 weeks, when it starts to fall again. Hospital pregnancy tests do tend to be more accurate. I have come across similar cases of hormone levels being low and these have usually been followed up with a scan and a blood test to confirm the pregnancy.

Are my pregnancy cramps serious?
I am 16 weeks and on three separate occasions in one week I have had four or five painful lower cramps that have taken my breath away and made me feel a bit sick. I have not had a show or anything and as soon as the cramps have finished I feel fine again. Could this be trapped wind/baby moving/some sort of stretching or maybe something more serious?

Alison says: at 16 weeks, as you can imagine, everything is fighting for space inside you as your body accommodates your pregnancy. It is not uncommon for some women to feel the occasional twinge. If it continues, however, have a word with your midwife as it may need investigating further.

What's the best way to deal with sciatic nerve pain?

I am suffering from sciatic nerve pain during pregnancy. I can't sleep on my right side as it is agony and yet my left side (hip/shoulder/knee joints) are now hurting because of my weight. I am finding it hard to sleep due to the pain.

Alison says: sciatic nerve pain is very common in pregnancy. Also, the pelvis can become very unstable due to the hormones of the pregnancy, making everything looser and contributing to the problem. You could ask to see the obstetric
physiotherapist at your local hospital and she may be able to give you a
maternity brace that helps support the weight of the pregnancy. While in
bed at night on your side, try a couple of pillows between your legs so that
your pelvis and hips are kept supported. Some women find simple paracetamol
effective as a last resort.

How to cope with swollen feet

My feet start to swell from the moment I get up. By late afternoon, my ankles and feet have ballooned so much that I cannot even get flip flops on. I work in an office so I am sat at my desk for long periods of time, although I do get up and move around, plus I drink at least four pints of water. My midwife says it is common but I can bear the thought of another 17 weeks like this!

Alison says: unfortunately, swollen feet are a very common side-effect of pregnancy. It is caused by the extra pressure on the veins within the legs and it tends to get worse as the day goes on and in hot weather. It sounds like you are doing all the right things - moving around and drinking plenty of water. When you
get home I would also suggest that you try and put your feet up. If your
swelling increases up your legs to your knees, I would get checked out by
your doctor. Also, expect it to get a little worse for a couple of days when you have had the baby.

My bump feels tight

My bump often feels 'tight' after I have exerted myself... after mowing the lawn, climbing lots of stairs, or doing the cleaning. Is this normal or should I be worried?

Alison says: it sounds like you have an irritable uterus. This is very common if you have had a baby before. It is your body's way of perhaps telling you to slow down take a rest. It is only worrying if it is accompanied with pain and doesn't
ease when you do take a rest. If this is the case, then you should contact your midwife/hospital and get checked over. If it does ease off when you rest then learn to listen to your body. If it's telling you you're doing too much, get someone else to do it or leave it.

How long should I wait to try for another baby after a C-section?  

My little girl was breech so delivered by C-section and we are now thinking about trying for another little bundle of joy. I'm really worried about getting pregnant again though as I worry about my scar tissue. How long
should I wait after a section to make sure everything has healed ok? Also, I read somewhere that if you have had a breech baby you are likely to have another due to the shape of your womb or something. Is there any truth in this?

Alison says: there is no real hard-line advice on how long you should wait between pregnancies after having a C-section, although most obstetricians would advise waiting at least a year before you conceive again. In fit, healthy women a C-section scar will have healed within 3-6months.

Babies assume the breech position for many different reasons. Having had a breech presentation with your first pregnancy does not necessarily mean it will occur with the next pregnancy, although you will be monitored closely in case it does occur again.

Do these cramps mean I'm in labour?

I am 38 weeks pregnant and have been having pains in my lower abdomen and lower back which I can only describe as strong, period-type pains. I have been having these cramps for almost 36 hours. I rang the delivery suite at my local hospital who told me it could be very early signs of labour. How do I know whether this is labour or not?

Alison says: it certainly sounds like labour is not far away but when you go into
established labour you will know. The early stages of labour, also known as
the 'latent phase', are when the neck of the womb is thinning out, ready to start
opening up when you go in to established labour. How long this will take
varies from woman to woman. Some do not really notice it; others have it for
several days. The pains during this latent phase tend to be irregular in
length and strength and stop and start a lot. Look out for the pains
becoming more regular and all the same strength, no little ones in between,
these are labour contractions.

What's the best way to treat nappy rash?
My 14-week boy has nappy rash. I have tried vaseline and other barrier creams but they don't seem to be working. My mum says it could be his nappies.

Alison says: nappy rash is very common in babies, and some are more prone to it than others. Occasionally it can be down to a thrush infection which needs a specific antifungal cream.

Speak to your health visitor about a cream that will suit your baby. If it is a thrush infection then Sudocrem and vaseline will not treat it. Once the thrush has been treated, obviously pay particular attention to nappy changes etc. and maybe use a product call Bepanthen which has been clinically proven to help prevent nappy rash http://www.bepanthen.co.uk

Baby not moving much at 25 weeks

I am 25 weeks pregnant and my baby hasn't moved much for a few days. He is
usually quiet active. Is this normal?

Alison says: at 25 weeks mums are usually aware of fetal movements and although no set pattern is established any concerns with your fetal movements should be checked out. Please make an appointment to see your doctor or midwife as soon as you can. 

How long after a muscus show can labour be anticipated?

Alison says: a show can occur a few days/weeks before you actually go in to labour, especially if this is your first pregnancy as the body slowly prepares for
the birth. Either way,  not much longer to go before you meet your baby.

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