Babies obtain Vitamin D from their mothers during the last trimester of pregnancy. If the mother has low Vitamin D levels the baby will be unable to receive adequate Vitamin D. Babies need Vitamin D to develop healthy bones. Vitamin D deficiency in infancy causes soft bones and stunted growth – called RICKETS. Rarely severe vitamin D deficiency can cause low calcium levels and seizures. Rickets and seizures can be prevented by the mother or infant taking Vitamin D supplements.

Vitamin D is found in foods such as fish, milk, eggs and fortified cereals. Your body also makes its own Vitamin D when your skin is exposed to sunshine.

The Mercy Hospital for Women is a public hospital and as a consequence of this does not offer the luxuries of a private hospital such as a guaranteed private room, fine food or potential transfer to a hotel. However, the Mercy Hospital is a tertiary hospital and has a state of the art neonatal intensive care unit. The Mercy Hospital is one of the three Victorian hospitals that accepts extremely preterm babies and unwell mothers.  This means that if you require a preterm delivery you will not be separated from your baby or be required to transfer to another hospital. The Mercy Hospital for Women has one of the lowest perinatal mortality rates of Australia – a fact we are extremely proud of.

It does cost a lot of money to see an obstetrician but in seeing a private obstetrician you are choosing to have your pregnancy and labour managed by a highly trained doctor. Seeing a private obstetrician does not guarantee you a normal easy vaginal delivery but your obstetrician is a specialist who is able to deal with all aspects of your pregnancy and all aspects of your labour and delivery.  Although no doctor can guarantee to be on call 24 hours a day 365 days a year, seeing a private obstetrician gives you far greater continuity of care than is offered in the public system. In addition you know that you will have a specialist caring for you and not a doctor in training.

Some infections can cause serious harm for both the pregnant woman and her unborn baby. Prior to pregnancy Rubella and Varicella (Chicken pox virus) • Booster immunisation is advised before becoming pregnant to those with no/low immunity During pregnancy Influenza (Flu, Swine Flu) • Flu is particularly serious for pregnant women and their babies- both unborn and newborn. Flu vaccination is strongly advised if you are going to be pregnant during the flu season (March –October). The seasonal flu vaccine covers both seasonal flu and swine flu. It is SAFE and EFFECTIVE. Pertussis (Whooping cough) • This is a serious infection that mainly affects very young babies. Adult immunity from childhood generally wanes over time. If infected, these adults usually have a mild form of the disease but may pass on the infection to young babies. As such, booster immunisation to whooping cough is recommended for all adults who are going to be in close contact with young babies. Therefore, I highly recommend the following actions to reduce the possibility of infection in these most vulnerable young infants. • ALL adults who will be in close contact with the newborn baby should have a Whooping cough booster (Boostrix) if they have not had one in the last 10 yrs. This can occur at ANY TIME. • Pregnant patients should have a Whooping Cough booster between 28-34 weeks to maximise the transfer of protective antibodies to the fetus. • Recommended in ALL pregnancies, irrespective of when last Boostrix vaccine was administered. • Vaccinate young infants as per the National Immunisation Schedule at 2, 4 and 6 months. • The vaccine is currently free for parent

Smoking is dangerous for your baby. Smoking increases the risk of premature birth, low birth weight, respiratory problems and SIDS. There is no safe level of smoking. For help to quit smoking call the Quitline on 13 78 48. There is no safe level of recreational drugs in pregnancy and you need to check any medications with your Doctor or Pharmacist to ensure they are safe during pregnancy.

Small amounts of caffeine are safe during pregnancy but excessive volumes may increase the risk of miscarriage and premature birth. Caffeine is in coffee, tea, chocolate and cola (and some other soft drinks and energy drinks). Dr Lenore Ellett recommends pregnant women limit themselves to 200mg of caffeine daily. That amount would be obtained from about 1-2 cups of espresso style coffee, 3 cups of instant coffee, 4 cups of medium strength tea, or 4 cups of cocoa or hot chocolate. Avoid double shots of espresso coffee and drinks marked as sports or energy drinks that contain caffeine.

Steady weight gain during pregnancy is normal and important for your health and your developing baby. However, it is also important not to gain too much weight. Pregnant women don’t need to “eat for two” in fact the calories per day that are pregnant woman needs is very similar to the caloric intake needed for a non pregnant woman.

If you are pregnant, a good approach is to eat to satisfy your appetite and continue to monitor your weight. For women who are a healthy weight, it is recommended that you gain between 11.5 and 16 kg. Underweight women may need to gain more weight (between 12.5 and 18 kg).

If you are overweight, pregnancy is not the time to start dieting or trying to lose weight. However, it is recommended for women who are overweight to gain less weight during pregnancy (between 5 and 11.5 kg).

You can find out more here - https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-diet

It is now possible to check if your baby has a chance of inheriting genetic conditions. The conditions that testing is currently available for is cystic fibrosis, spinal muscular atrophy, and fragile X syndrome. It costs about $350 per person tested for all three conditions. It is usual to test the mother or the father first, then arrange testing for the partner if a copy of the gene is found, so there is potential that both parents would need the test.

Down Syndrome occurs if a baby has three copies of its 21st chromosome instead of two copies. A chromosome is a bundle of genetic material, and if you have too many or too few of these bundles, severe abnormalities can result. In the case of Down Syndrome, these abnormalities include intellectual, heart, thyroid and other endocrine, facial appearance and others. It is possible to detect early in the pregnancy whether your baby might be at high risk of having Down Syndrome. This is possible through consideration of your age and additional tests. The additional tests are Combined First Trimester Screening and Non-invasive Prenatal Testing (NIPT). It is important to realise that both of these tests are considered to be “screening test”. This means they won’t tell you “yes, your baby has Down syndrome” or “no, it definitely does not have Down syndrome”. They will, however, say if your baby is at high risk of having Down syndrome, in which case you should have a diagnostic test. A diagnostic test is one that will tell you “yes” or “no”. Combined First Trimester Screening requires a blood test at 10 weeks and an ultrasound between 12 and 13 weeks. Most patients choose this option. The blood test costs about $120 (no medicare rebate) and a specialised ultrasound costs about $150 after the medicare rebate, however this varies from clinic to clinic. Combined First Trimester Screening screens for Down syndrome and Trisomy 18. The detection rate for Down syndrome is 90%. NIPT is no doubt the future of prenatal testing for Down Syndrome and other genetic abnormalities due to its incredible accuracy and lack of risk to the baby. It uses a maternal blood sample to find and test the baby’s cfDNA(cell free DNA - genetic material) in the mother’s bloodstream. Costs are constantly falling, but it is quite expensive costing about $550 and no rebate applies. This non-invasive prenatal test (NIPT) is safe and poses no risk to mother or baby. It’s recommended that expectant parents discuss with their health practitioner the limitations and advantages of cfDNA screening before having the test. Most women would still opt for a 12 week ultrasound if doing NIPT; whilst the ultrasound has no impact on the Down Syndrome result when doing NIPT, it does provide other useful information about the development of the baby; so a saving is often not made by omitting the ultrasound. Lenore will discuss these options with you in detail at your first pregnancy appointment. You can find out more information here