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First steps for a healthy life

P3 Pharmacy, 01 Sep 2023 · 1 Min read

In OTC
First steps for a healthy life

The pregnancy and baby care category can be confusing for new parents. Community pharmacy teams are well placed to guide them through pregnancy testing and breastfeeding support to weaning, teething and beyond.

In 2022, the baby care market was worth an estimated £23.9 million, a slight drop on the previous year, according to Statista research.

The sector’s value reached £26m in 2020. With products from skin care to nappies, wipes, and formula, it’s a sector that can be overwhelming to navigate as a new parent. How can pharmacies make it easier, and provide advice and support for concerned parents?

Pregnancy

Pregnancy, especially the first time, can be a worrying time for women. Being able to access reliable advice from pharmacists about some of the most common conditions associated with pregnancy will help mums-to-be navigate the stressful side of expecting a baby. 

The first port of call for any pregnant woman looking for advice on medication during pregnancy is likely to be a pharmacy or GP, so making sure that your team knows where to find resources and information is vital. Some medicines are known to affect the development of babies in the first trimester of pregnancy, and the gov.uk Drug Safety Update contains up to date information for healthcare professionals on safety issues for medicines in pregnancy. The NCT (National Childbirth Trust) also offers a helpful guide on some of the other worries and discomforts that can arise during pregnancy, and what needs further attention. 

Nutritionist Pamela Mason from the Health & Food Supplements Information Service (HSIS) suggests that women should take a folic acid supplement of 400 micrograms daily throughout their reproductive years.

“This reduces the risk of having a baby with a neural tube defect like spina bifida. A daily multivitamin/multimineral supplement also helps to fill nutrient gaps in the diet,” says Mason. “Supplements should contain the NRV [Nutrient Reference Value] of each vitamin or mineral, avoiding large doses particularly during pregnancy and breast feeding. Make sure to include 10 micrograms daily of vitamin D.” 

Pregnancy tests

More than 12 million pregnancy tests are sold in the UK annually, and the majority are midstream tests. When Hoopsy founder Lara Solomon underwent IVF, she realised how many pregnancy tests women used when trying for a baby – three tests on average each time. “I couldn’t believe that there wasn’t a sustainable midstream test, so I designed the Hoopsy Eco pregnancy test, made from 99 per cent paper with over 99 per cent accuracy,” says Solomon, claiming that the tests take just months to break down in comparison to 30 years for an average plastic test. 

To help with promoting pregnancy test sales, she suggests: “Most women prefer a midstream test. A multi-pack is the best option for most as they will usually want to double or triple check the result.”  

Pregnancy testing myths

Digital tests are more accurate 

Inside each digital test is the same kind of strip of paper that’s in an analogue test, along with electronics that describe in words instead of lines whether or not the result is positive or negative.

Certain brands are more accurate than others 

If users follow the instructions correctly, they will get the correct result. On the day a period is due, most tests are over 99 per cent accurate.

This is very important in our pharmacy as there are a lot of young families in Tonteg. The most common questions we get asked are around the safety and efficacy of medications and their appropriateness with regard to pregnancy, breastfeeding and baby care. Popular brands include Aveeno and Childs Farm skin care, and Gaviscon infant sachets. I’ve noticed that parents are more conscious of using steroids and are looking for alternatives for baby eczema care. Place this category in a prominent position and have products near the front counter so parents can ask questions when required.

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Marisa Maciborka, Well Pharmacy, Hirwaun

Breastfeeding

In one 2022 study by US researchers, community pharmacists agreed that they play a significant role in breastfeeding support, with over 90 per cent self-reporting that they build trusting relationships with breastfeeding parents. 

They reported:

  • Checking the medication history of breastfeeding patients at every visit
  • Providing information on how to limit the transfer of medication through breast milk
  • Following up on medication use
  • Providing information about the safety of medicines while breastfeeding
  • Stressing the importance of following medication guidelines
  • Offering mental health support to breastfeeding women
  • Advising women to visit a doctor if they showed specific symptoms.

National Breastfeeding Week is 18-24 September, and a new social media toolkit is available from the Department of Health and Social Care (DHSC), along with a suite of free resources and campaign materials to help support planned activity and signpost people to breastfeeding support tools such as the Start for Life Breastfeeding Hub. These include an Off to the best start breastfeeding leaflet and wallet card, and a range of digital assets and leaflets.

There is no ‘best’ type of formula milk, according to experts at the NCT. Their advice for new parents concerned about feeding choices is that there’s no best formula for a healthy, full-term baby; every milk on the market must meet the same nutritional and safety standards and all are relatively similar in composition. 

It may be helpful to refer parents with queries about formula feeding to the First Steps Nutrition Trust, an independent organisation that offers advice and information about the different brands of formula milk available in the UK, their ingredients, and manufacturers’ claims.

Weaning

In the first six months of life, the best way to respond to a baby’s increasing need for milk is to feed them more often, if that’s possible. If parents are formula feeding, they can give their baby more milk feeds, taking care not to exceed the maximum daily recommended amount.

There are various signs that indicate when a baby is ready to move on to solid foods. These include:

  • Being able to sit up with support and hold their head steady
  • Picking food up and trying to put it into their mouth
  • Swallowing food – a baby who isn’t ready will push food out of their mouth.

A hungrier baby isn’t necessarily ready for weaning – it could simply be a growth spurt.

Vitamins and supplements

The DHSC recommends that all children aged from six months to five years are given a supplement containing vitamins A, C and D. Children have different nutrient needs to adults, so parents and carers need to make sure that any product they buy is suitable for the age of the child. Some supplements containing iron, for instance, may be unsuitable for babies and young children.

Babies who are having more than 500ml of infant formula a day don’t need vitamin supplements, as the formula will already be fortified, while breastfed babies can be given vitamin D from birth. Mason suggests: “It’s very important to follow the DHSC advice. Young children can be quite picky eaters and be short of vitamins. It’s also vital to begin focusing on nutrients when children are young, to help set them up for good health throughout life.”

Supplement brand Centrum surveyed parents and children on what they want in a vitamin product, with the findings indicating that immunity and support for bones and teeth are important to parents, while their children just preferred berry and orange flavours. 

Queries we get about pregnancy are mostly about what vitamin supplements women should be taking. For baby care, we often get asked about nappy rash and teething. With breastfeeding, it’s normally queries about treating sore and cracked nipples that customers want advice about. The top seller for pregnancy for us is Vitabiotics Pregnacare. For baby care, Sudocrem is our best seller for treating nappy rash, alongside Metanium and Bepanthen. For teething, Bonjela and Dentinox both sell well for us. For breastfeeding, Lansinoh cream is very popular.

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Afua Thompson, H.E Matthews Pharmacy, Sutton

Teething

Most babies start to cut teeth when they’re around six months old, although some get their first teeth earlier. Parents may need advice on how to manage teething, and community pharmacies will likely be one of the first ports of call. 

“Pharmacies have always been part of the community, but the Covid pandemic probably made the public appreciate their role far more than ever before, as they stepped up to the plate when people were unable to access doctor’s surgeries, dental practices, midwives, and other health practitioners,” says Dominique Tillen, founder and MD of Brush-Baby. 

She adds: “Pharmacies can build upon their role, especially in a trusted advisory capacity, which can only help them with customer acquisition, relationship-building, sales, and supplementary sales.”

Colic

Parents may also ask pharmacists for advice, worried that their baby won’t stop crying. If a baby cries for long periods of time, especially in the late afternoon or evening, it could be colic, which is most common in babies from one to three months. 

Sometimes, soothing a crying baby helps calm them temporarily, but parents can be at a loss to know what to do to stop the crying, according to the charity Cry-sis. “The crying can be impossible to soothe at times, but this isn’t the parent or carer’s fault.” 

Tips from Cry-sis

  • Offer a feed
  • If the baby might have wind, sit or hold them in an upright position and gently massage their back
  • Holding the baby close, in an upright position can be helpful, whilst quietly talking, shushing, or humming 
  • Movement, gentle rocking, walking around, swaying, or gently patting can help
  • Try different background noises – white noise or calming music.

Cry-sis advises that if possible, the baby can be taken out in the fresh air. “Take a break and don’t be afraid to ask for help from family or friends,” says Cry-sis, adding that if a parent or carer feels very stressed, they should: “Put baby down in a safe place, move away and take a few minutes to calm down. It’s normal to feel stressed and overwhelmed, but the crying is not your fault.”

Claire Bailey, resident health visitor from baby products manufacturer MAM suggests a soother as another option. “Soothers can help to soothe an unsettled baby,” she says, “as one of the most natural and soothing things for a baby to do is suck.”

Parents should seek medical help urgently if a baby shows any of the following symptoms:

  • Not taking feeds
  • Frequent vomiting or projectile vomiting
  • Listlessness, floppiness or becoming unresponsive
  • Breathing difficulties
  • A fit (convulsion)
  • A spotty red-purple rash.

Typically, patients will ask whether a medicine is suitable for them during their pregnancy/whilst breastfeeding/for their baby and what lifestyle changes they can make. I find that vitamins and supplements sell very well. For example, many pregnant women buy folic acid 400mcg tablets as these are recommended to be taken daily. They also buy vitamin D 10mcg. I would recommend having a pregnancy, baby care and breastfeeding section in the shop where you can display any recommended vitamins, supplements and nutrition for relevant patients.

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Jainil Patel, Hollowood Chemists, Manchester

How to spot sepsis and meningitis

There are 25,000 cases of childhood sepsis every year in the UK, according to Sepsis Research. Everyone should know the signs of sepsis and meningitis, and suspected cases should always be treated as an emergency. 

Warning signs

  • Rapid breathing and/or shortness of breath
  • Cold, mottled, pale skin
  • Very high or low temperature
  • Bluish skin or lips
  • Poor feeding
  • Vomiting or diarrhoea
  • Lethargy/difficulty waking
  • Little or no urine output
  • A non-fading rash.

The early signs of meningitis can be mistaken for a cold or flu, but children with meningitis can become seriously ill quickly, so it’s important to know the signs:

  • Fever with or without cold hands and feet
  • Headache
  • Vomiting
  • Diarrhoea
  • Muscle pain
  • Stomach cramps
  • A rash that doesn’t fade under pressure can be a sign of sepsis or meningitis. The glass test can help determine whether the rash is a medical emergency or not.

The glass test

Press the side of a clear glass firmly against the skin. The spots/rash may appear to fade at first, so keep checking. On dark skin, spots or rashes can be harder to see, so check lighter areas like the palms of the hands, soles of the feet or the roof of the mouth. A fever with spots or a rash that won’t fade under pressure is a medical emergency and parents should seek immediate medical attention.

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