The role of the Pharmacist during the "Fourth Trimester"
By TerryWhite Chemmart Samford
Pharmacists are one of the most trusted and accessible health professionals in Australia and when you have a baby we become your new best friend. I often laugh about how many new dads comment that they have never visited a pharmacy as much in their life as they do in the first few weeks of becoming a new parent. Why? Because those first few months at home can be daunting and your new family unit are all learning together one day at a time or more like one feed/sleep cycle at a time!
The most common support we provide is with feeding. If you are breast feeding, we can advise on ways to prevent and treat nipple damage including thrush, the best breast pads, the difference between breast pumps and how to use them, storing breast milk and, most importantly, the impact of certain medications on breastmilk. It is extremely important if you are breastfeeding, that you check with your pharmacist before taking any medication or natural supplements - the response will vary depending on the age of your baby and how frequently you are feeding.
If you are bottle feeding, we can advise on the various formulas available including speciality and prescription only varieties, the different bottles and teats, bottle and breast refusal when combination feeding, sterilisation and probiotic options for formula-fed babies.
Bowel motions of a newborn are a favourite topic, or an obsession for some! Every baby is different depending on how they are fed. Breastmilk has a laxative effect and if combining with formula (which will make motions more solid), switching to solely formula or introducing solids, parents will notice a change in bowel motions. Some babies poo ten times a day and some babies poo only once in ten days.
Always talk to your pharmacist before self-diagnosing and treating constipation just because your baby hasn’t pooed for two days. I might discuss changes in diet or try to determine whether the babies are distressed and understand what the consistency of the poo is when it does come out. Massaging baby’s tummy and cycling their legs on the change table are just some of the non-medicated ways to help relieve baby’s constipation.
An unsettled, crying baby can cause great distress for new parents. Is it colic? Is it wind? Is it reflux? Or is it just witching hour? Pharmacists can assess if the baby requires further medical attention or if the parent simply requires some reassurance that “this time will pass”. I may look at such things as whether a breast-feeding mum has a fast let down or if the teat for a bottle-fed baby is the right speed.
I may check to see if the baby is a ‘guzzler’, if they pass wind top and bottom, if they vomit or if their poos are normal consistency. Most colic and wind treatments are trial and error and some are safe from age zero while others are only safe from one month of age. A doctor’s assessment is required for reflux diagnosis and treatment.
It can be very upsetting for new parents when your baby is sick or requires medication for the first time. Pharmacists can provide advice, reassurance and treatment for pain and discomfort from fever and immunisations, common colds, blocked tear ducts, diarrhoea, dehydration and immune support.
My best advice when your child is unwell is to ‘trust your instinct’ -you know your baby better than anyone. If they are not feeding as well or as much, if their nappies are not as full, if they are more sleepy than normal or if they are more unsettled than normal then please seek help. When it comes to a fever my advice is to ‘always treat the child’ and not the ‘number on the thermometer’.
Baby’s skin is so delicate and soft and smells so good! Pharmacists can advise on the prevention of nappy rash and ways to treat more severe nappy rash; what is the best bathing products and which ones to avoid, treatment of eczema and the safest sunscreens and insect repellents to use on babies.
And last, but most importantly, pharmacists are here to help you - the mum. Nothing or no one will ever prepare you for how many maternity pads you will need in those first few weeks after giving birth! Yes, that is the main reason new dads visit the pharmacy so regularly in the early stages and end up joining the Rewards Program after their 6th visit in just 2 weeks!
We can discuss medications you were taking during pregnancy and if they may be impacting your breastmilk. We may also recommend you continue to take your pregnancy multivitamin.
Mum’s physical and mental wellbeing is critical to a thriving and happy family unit. I know first hand how complicated life can be with a new baby to care for and sometimes you just need an understanding person to talk to. We are here to ensure you have the right support to help you navigate life’s greatest rollercoaster. Pharmacists are with you on this journey.
Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.