There is a lot of controversy over when to wean babies. Years ago when I was a baby, it was 3 months, then it moved to 4 months and now many organisations suggest 6 months. The reasoning behind this is that whether you start weaning at 4 or 6 months, your baby still gets all of his/her nutrients from breast milk and/or formula until they are 6 months old. However, introducing basic puréed food to your baby’s diet from 4 months will not do them any harm. In my opinion, this new 6 month guideline has been put into place to safeguard babies with parents that do not have the common sense to not give their 4 month old McDonald’s. Tongue in cheek? Yes, but I have heard of someone blending KFC and giving it to their baby! Yikes.
The advice is to take it slowly if weaning your baby at 4 months and introduce foods for taste purposes and as a means to learn the physical process of eating. Guidelines state that the earliest that that one should give a baby ‘solid’ food is 17 weeks, this is when I gave Lola baby rice for the first time (picture above). She loved it. I have done a lot of research into the matter and I made the decision to begin weaning at 4 months, but you will need to do what is right for you and your baby. Below you will find the basics of weaning at 4 months.
Other signs that your baby may be ready for food include;
- They have doubled their birth weight
- They can hold their head steady and sit up supported
- They have lost their tongue-thrust reflex
The first step is baby rice once a day as it is very similar in taste to formula and is unlikely to cause any allergic reactions. Follow the instructions on the box, Cow and Gate suggest one spoonful of rice to 10 spoonfuls of formula/breast milk. It is important that you use a specialised weaning spoon designed for 4 months plus as the spoon end is soft. One should also consider the time of day and how hungry your baby is. Ideally, your baby will have just had a nap and be due a feed in around an hour so that she/he will be peckish but not starving. I fed Lola in the morning so that she had all day to digest the food, just in case of any digestive issues. Your baby needs to be sat upright, either on your lap or in their car seat. I use a Bumbo with a tray attached. Gently spoon a mouthful of baby rice into your baby’s mouth. They may be a little surprised at first and don’t expect much of the rice to actually reach your baby’s stomach. A wipe down bib is a must! I found that I also needed to put a normal bib underneath. This process is all about learning HOW to eat.
Some sources suggest doing baby rice for 1 week and then moving on to puréed vegetables. I decided to do just baby rice for 2 weeks to get Lola used to having a spoon put in her mouth and trying to move the food to the back of her mouth with her tongue. Luckily, Lola loved the baby rice from the first time she had it.
The next step is puréed fruit and vegetables, I will write about this next week once I have tried Lola with a couple of different things and will report back. Wish me luck.
It may surprise those of you who do not live in London, but we do not all make banker salaries. Sadly we are on only marginally higher salaries than those working in other cities around the UK. Frustratingly this is not reflected in the cost of housing. It is important to point out here that all of my below figures and observations are focused on cities as it would not be a fair comparison to compare London to a village in Somerset. My husband is certainly not on a bankers salary and we have absolutely no chance of buying a house in the next 5 years at the very least. Before anyone asks, yes, this is taking into account the possibility of moving further out of London into one of the home counties within a commutable time for my husband to get to central London. We still can’t afford to buy a flat, let alone a house for our growing family.
I have put together the below chart showing the average cost of a terraced house in each of the major cities across England (statistics used only represent England, not the full UK), compared to the average salary in each of these cities. You will see that the average salary in London is only 31% higher than the national average when the average cost of a terraced house in London is 184% higher than the national average. How is this fair??
Those of us who are in the middle, as opposed to a tenant in a council house or on a bankers salary, we are royally screwed. Most local schemes are for those on a low income, which although we are not on a massive income, we are not considered to be on a low income. The government have attempted to address the housing crisis with various Help to Buy schemes, however with the ridiculous cost of housing in London, they are of little help to the average family. Below are my responses to a few of the supposed Help to Buy schemes;
Help to Buy ISA – This is actually the one policy that I agree with wherever in the UK one lives. The ISA is designed for first time buyers saving for a deposit. For every £200 saved into this specialist ISA available from most banks, the government will give a bonus of £50, up to a maximum of £3, 000.
Equity Loan – The government will lend you up to 20% of the cost of a newly built home (up to 40% in London) to be paid back either when selling the property or when re-mortgaging, so that one would only need a 5% deposit and a 75% mortgage to make up the rest.
This is great in theory but when looking at new builds in London, the cheapest 2 bedroom property (we have a daughter so has to be at least 2 bedrooms) I could find was a flat advertised from £517, 000 in Deptford. Ignoring the fact that this is a small flat without a garden in a non desirable part of London; we would have to save a deposit of £28, 850, borrow (40% of property price) £206, 800 from the government and get a mortgage of £284, 350. On one salary we would not be able to borrow this much, and many mortgage companies are not willing to supply mortgages on these schemes anyway.
So what if we look at new builds outside of London?! Using the Help to Buy East and South East website (as only certain houses are part of the scheme), the cheapest 2 bedroom property within a commutable distance for my husband is a flat (again no garden for our daughter) for £372, 750. Using the same maths as above apart from the Equity Loan being 20% as the flat is outside of London; we would need a deposit of £18, 637, borrow £74, 550 and get a mortgage of £279, 562. Again, we would not be able to get a mortgage for this much.
The scheme also does not take into account the impossibility of saving for a deposit while paying the ridiculous rents in London; according to HomeLet the average rent is £1, 472 a month, this is over 50% of the net salary (after tax and NI) of someone earning the average £34, 729 (£2, 231 a month net)
Shared Ownership – I thought that this would be a total goer. In partnership with the Local Housing Association (LHA) in the relevant area, one may purchase a percentage of a property (typically 25-75%) and pay rent to the LHA on the part that they own. The rules specify that one must be a first time buyer and have a household income of less than £80k.
It is a great way to just get a foot on the ladder. However. When looking into the scheme, pretty much every property had a rule that the person purchasing the property had to work or live in the area. Therefore all of the areas that we would like to move to and/or are of a commutable distance from my husband’s work are off of the table as an hour’s drive does not constitute as ‘local’. As we are unable to afford even a share in a property in the area that we currently live in, then this scheme is also a complete let down for the average family in London.
The question is what is going to be done about it? Everyone always says “the house market will have to crash at some point”, but I don’t think it is going to ‘crash’ enough for the average family in London to be able to buy a property in the near future. The government need to consider capping the number of properties a landlord can buy up within Greater London and a higher tax needs to levied on second homes in London. The city is also in desperate need for new homes, but where is the space and the money to do this? A policy should also be enforced where all new builds need to be purchased by people who will actually be living in the property; no buy to let and no second home. Harsh I know, but this is the only way that the average family are going to get the helping hand they need instead of just handing money to people who already have money, to make more money.
The London Mayoral Election is on 5 May. All of the candidates say that they will provide more housing but how they will do this is often not explained. I will wait with baited breath to see who will be taking on this task along with Cameron’s gang, but I sadly don’t hold out much hope.
There are risks associated with taking psychotropic (mood altering) medication in pregnancy and during breast feeding, but then ANY medication can carry risks to a pregnant woman.
It is important to note that no psychotropic medication is licensed to be used by women who are known to be pregnant.
If a woman has taken a psychotropic medication with known teratogenic (can cause congenital malformation of the embryo/fetus whilst in the womb) risk at any time during the first trimester then the following should be considered;
- offer additional screening for fetal abnormalities and counselling regarding whether to continue with a pregnancy or not.
- explain to mother and those supporting her that there will be a higher level of monitoring compared to an expectant mother who has not taken psychotropic medication.
At one’s booking appointment (circa. 10 weeks gestation in the UK) where one’s pregnancy is confirmed by a midwife and the mother’s medical history is discussed, it is absolutely vital that the mother discloses any mental health issues, past and/or present. If the mother’s condition falls into the severe mental illness category (bipolar,schizophrenia etc.) then I would strongly recommend that you make an appointment with your GP as soon as you get a positive pregnancy test. This way, the mother can be referred to a Perinatal Psychiatrist (a psychiatrist who specialises in the treatment of women both antenatal and postnatal) straight away.
As previously mentioned in my last blog, lithium is the most commonly prescribed medication for bipolar. When taking lithium in pregnancy it is important to note the following;
- there is a risk of fetal heart malformation
- lithium levels may be high in breast milk with risk of toxicity of baby
- lithium levels will be monitored more frequently during pregnancy
If a woman is pregnant and currently suffering from the effects of bipolar whilst taking lithium, the medical team should consider one or more of the following;
- Switch gradually to another psychotropic medication.
- Stop taking lithium during the first trimester and then reintroduce again in the second trimester.
- Continue taking lithium for the mother’s safety and closely monitor her.
As for the effects of other medication prescribed for bipolar previously mentioned in last week’s blog, see below table. Information has been taken from British National Formulary, a pharmacology hand book used by the medical professions in the UK.
The above may seem a little daunting, but as long as you have a good support network (family, friends and professionals) you will be able to minimalise risks. We must also remember that drug companies are terrified of being sued, and therefore they will always cover themselves by telling us the worst, even if statistically it may be very unlikely.
Do not cease taking any medication without the support of your GP and/or Psychiatrist.
It may also be a good idea to speak to you GP or Psychiatrist before trying for a baby and have an action plan of how you and your support team are going to handle each hurdle as it comes along. As mentioned in previous blog, I was supported by a Perinatal Psychiatrist throughout my pregnancy and I am still under her supervision now as my baby is 18 weeks today and she will support me until Lola is 1 year old.
Unlike unipolar depression, bipolar will almost always need to be treated medically as it is a biological imbalance of the brain that needs to be corrected.
There are various different medications that can assist in treating bipolar, as every person is unique, every treatment is thus unique. The three main categories of bipolar medications are; conventional antipsychotics, atypical antipsychotics, antiepileptics. The below table shows what phase of bipolar each of the medications is usually prescribed for;
Although mania is what usually defines bipolar, it is often the depression that will effect individuals the most (like myself – especially as I have depressive bipolar). There have been minimal studies on antidepressants prescribed to bipolar sufferers, the main concern here, is taking an antidepressant can trigger rapid-cycling (when an individual has four or more mania or hypomania episodes in a year). The reason behind this is that an antidepressant is designed to bring you out of depression by giving you a false high (the aim is to feel ‘normal’ not low or high), however as a bipolar sufferer, one already experiences ‘highs’ when an individual has a period of mania, this means that the antidepressant can cause a more frequent cycle of mania or hypomania.
As you will see from the table above, the only medication that is currently used for all 3 phases (mania, depression and maintenance) is Quetiapine. I am lucky that this was what I was prescribed when I was FINALLY diagnosed with bipolar 2 years ago after 16 years of mental illness. In the year before pregnancy whilst taking Quetiapine, my life became more ‘normal’ than I ever thought possible as I had been in and out of the mental health system for 16 years previous to this. Unfortunately during pregnancy I was not so stable, this is not surprising when you think of all of the hormones involved in pregnancy competing with the hormonal imbalance of bipolar. It is important to point out, that this is merely my experience, as mentioned previously, we are all different, therefore, our reactions to different medications could be poles apart. Since the age of 16, I have been on 10 different medications over the years at varying doses, and only recently have I found the right one for me. If a medication is not working for you, do not be afraid to ask your psychiatrist and/or GP for a different one. It is your body and only you know if a medication is working or not.
Lithium is the most commonly prescribed medication for bipolar sufferers, it is best used for mania and bipolar maintenance, however is not as affective in its usage against bipolar depression. As discussed above, Quetiapine is used for all 3 phases of bipolar, therefore it is helpful in the treatment against mania, depression and the maintenance of bipolar overall. Olanzapine is another medication that is useful in the treatment of both mania and depression. The rest of the medications shown in the table above are more often (but not always) used in the treatment of the mania phase of bipolar.
Quetiapine is one of the bipolar medications that is considered ‘OK’ to take when pregnant. My next blog will detail the pros and cons of each of the above mentioned medications in relation to pregnancy and breast feeding.