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What you need to know about starting or expanding your family during the pandemic Image Credit: Gulf News Archive

Pandemic stress, the COVID vaccine and how to tell when your baby is sick – these are just some of the issues on the minds of would-be mums, dads and new parents who tuned into the Gulf News webinar, ‘My child and me: Living a healthy life’, held on Wednesday 20 January.

Medical experts from Fakeeh University Hospital answered a range of questions on the minds of couples thinking about starting or expanding their family during the pandemic, ranging from problems with trying to conceive, to vaccination queries and nutritional and dental advice for under-threes.

The impact of pandemic stress

Stress has been a major factor in most people’s lives this past year, and inevitably was on the minds of webinar attendees.

Not only can stress make it harder for a woman to conceive, but it can have a significant impact on the outcome of a pregnancy, and on the baby’s health itself, said Dr Alaa Youness Mohammed, Specialist Obstetrician and Gynaecologist, Fakeeh University Hospital, Dubai.

“Stress hormones can have a detrimental effect on pregnancy; in the first trimester it can cause miscarriage, while in the second and third trimesters it can cause pre-eclampsia, which is hypertension associated with pregnancy.”

Dr Mohammed added: “Stress has also been linked to premature contractions and pre-term delivery, as well as to babies who are small for their gestational age. It will also negatively affect the overall immunity of the pregnant woman and she will be liable to more infection and more diseases.”

While we are all dealing with pandemic-related problems that may increase anxiety, pregnant women should do what they can to try and decrease their stress levels as much as possible, said Dr Bariah Dardari, HOD - Child Health Department, Fakeeh University Hospital, Dubai.

“Extreme stress during pregnancy affects the child’s development and increases the risk of neuro-developmental disorders” said Dr Dardari, “we really need to try and avoid it.”

Pre-conception counselling

You can have an impact on the health of your baby even before he or she is conceived, and the Fakeeh University Hospital doctors advised pre-conception counselling as a way to optimize your chances of a healthy pregnancy and child. “Ideally we do pre-conception counselling for all women who are thinking of starting a family, whatever their age and whatever their medical history,” said Dr Mohammed.

This involves being screened for various conditions, diseases and lifestyle factors that could affect your future pregnancy. “Many conditions like diabetes, hypertension, thyroid disease or psychiatric conditions that could impact pregnancy outcome could be present and we need to review these - as well as any medications and the sort of lifestyle a woman is leading - before she falls pregnant.”

If there are any modifiable risk factors - like smoking, alcohol intake, any drug intake, over the counter medications, or even herbal medications that might have an impact you aren’t aware of – these can be dealt with pre-conception.

“We check the immunisation status of the woman, and whether she has any infection like rubella, varicella or HIV that could affect pregnancy outcome and the baby. We also need to monitor the weight of the mother before pregnancy, as there can be complications associated with both being overweight and underweight.”

If a couple is struggling to conceive, pre-conception counselling can also be part of the journey to help with this. Interestingly, Dr Mohammed does not recommend ovulation tracking as a way to help couples trying to conceive, since she says this can add unnecessary stress, which can impair fertility.

Optimising the intake of vitamins and minerals prior to pregnancy is also a key component of pre-conception counselling. “A woman’s nutritional status will affect the baby’s health in the first year of life, because if the women is deficient in calcium, vitamin B or iron, the baby will also have these,” said Dr Mohammed.

How to tell when a small baby is sick

For new parents who have given birth in a pandemic environment, there was understandable anxiety about a new baby falling ill. One of the questions asked by the webinar attendees was how can you tell when a small baby is unwell?

“The initial signs can be subtle in the first few months of life – so that’s why we educate the parents on the subtle signs,” said Dr Dardari. “The most common sign is a high-pitched cry, which tends to be much higher in pitch than the hunger cry, as well as if the baby is not being consoled by eating or being carried.”

Conversely, if your baby becomes very listless and quiet this can be a reason for concern too: “When baby becomes lethargic and less active and refuses to feed, this could also be a sign something is wrong.”

It’s very important to take action on these early signs, said Dr Dardari, “because if you wait for other signs like fever or vomiting it can be a bit late by then. We encourage parents to seek medical advice if any of these subtle signs happen.”

And always follow your gut feeling, emphasised Dr Dardari: “Don’t be afraid of being labelled as overreacting - if something does not feel right, seek advice. It is always better to be safe than sorry.”

Vaccinations in the time of COVID-19

The importance of vaccinations has never been in sharper focus for parents than during the pandemic, when we’ve seen exactly what can happen when a disease that we do not have a vaccine for takes hold. “Your child’s immunisations are very important - not only for the child alone, but for the community as a whole,” explained Dr Dardari. “Now everybody is familiar with the term ‘herd immunity’ because of COVID, and it basically means that when we immunise the child, we protect the whole society at large.”

Dr Dardari continued: “Vaccine-preventable diseases are still around us, and some are re-emerging because some parents are refusing to vaccinate their children. And unfortunately some can be deadly for children, like measles and tuberculosis.”

Although it is possible to be fairly flexible with immunisation schedules, it is important to follow the schedule of the country in which you live, rather than the country you are from. This is because immunisation schedules in each country are based on disease activity in that area.

“It can be a bit flexible, and we will work with what works for the parents, but ultimately we need to protect the child,” said Dr Dardari. “We are lucky to be born in an era when most of the vaccine-preventable diseases are almost eradicated. But there is a lot of misinformation surrounding vaccination in general. This can cause confusion, so it is important for parents to get info from a trusted resource and always discuss it with you paediatrician.”

When it comes to the COVID-19 vaccination itself, although pregnant and breastfeeding women, women hoping to conceive within the next three months, and children are not currently advised to get the vaccine in the UAE according to the Dubai Health Authority, Dr Mohammed said there is no concern over men who are hoping to conceive receiving the vaccine.