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Community pharmacy teams are a great resource for new mums, offering accessible advice and product recommendations that quickly become essentials in every changing bag.
From before birth until after the baby arrives, there is plenty that team members can do to help manage a host of common concerns.
Morning sickness
Nausea and vomiting during pregnancy is known as morning sickness and is very common in early pregnancy. In most expectant mums, the symptoms clear up at around 12-20 weeks of pregnancy, but they can be unpleasant while they last.
Thulasi Rahul, pharmacist and healthcare medicines partner at John Bell & Croyden pharmacy in London, says: “There are some lifestyle measures you can take to help manage morning sickness.”
Advice includes eating little and often, and opting for small, frequent meals made up of plain, high-carbohydrate and low-fat foods such as bread, rice, crackers and pasta.
“Avoiding strong smells and greasy foods can also help, as can keeping well-hydrated by taking small, regular sips of fluid throughout the day,” says Thulasi.
When it comes to over-the-counter products, Thulasi says it is important to always refer to the pharmacist when the customer is pregnant. If the pharmacist assesses it as suitable, possible ways to ease morning sickness include ginger capsules or teas, and vitamin B6.
“Rehydration sachets can help replace electrolytes following vomiting, while acupuncture bands or bracelets may also offer relief, as there is some evidence that applying pressure to the wrist can reduce symptoms,” says Thulasi.
If further support is needed, customers should be referred to the pharmacist as they might need an anti-sickness treatment that is safe to use during pregnancy.
While most morning sickness gets better as the pregnancy progresses, some mums-to-be may develop a severe form of morning sickness known as hyperemesis gravidarum.
The Princess of Wales was admitted to hospital with this during all three of her pregnancies.
If a pregnant customer is experiencing severe or persistent vomiting, she should be referred to the pharmacist as she may require further medical care.
Cramps
Stomach cramps are common in pregnancy and are usually nothing to be worried about. They often occur when the uterus expands, causing ligaments and muscles to stretch.
Self-care advice includes keeping hydrated, taking warm baths, and gentle exercise and stretching.
Jacquie Lee, medication safety officer and information pharmacist for Numark, explains that pregnancy-safe supplements containing magnesium or calcium can be used alongside heat patches for targeted, soothing pain relief.
Back pain
Heat pads can be especially helpful for back pain during pregnancy, which is extremely common. It can be caused by several factors, including hormonal changes loosening ligaments and joints, and the weight gained due to the growing baby.
“Products which may help include maternity support belts, warm compresses or heat pads and paracetamol to help with pain,” advises Jacquie. “Pharmacy teams can encourage good posture, gentle movement.”
Refer to the pharmacist if the customer is experiencing persistent pain.
Spotlight on skin
Cracked nipples
Cracked, sore nipples are common during the early days of breastfeeding. They can feel painful and may bleed slightly.
The most common cause is poor positioning or attachment of the baby, which puts extra pressure on the nipple rather than the breast tissue.
“Nipple cream with ingredients such as lanolin, olive oil, shea butter, calendula extract and so on can be soothing,” says Thulasi.
“Hydrogel nipple pads can be used for cooling and healing, and breast shells to prevent clothing rubbing on sore nipples”.
Nappy rash
Nappy rash is a common skin irritation that affects babies and young children. It happens when the skin is exposed to moisture, urine, faeces, friction or irritants for too long, causing skin to become red, sore, and sometimes spotty or broken.
“Useful products include barrier creams, fragrance-free wipes or cotton pads with water and nappy-free time essentials (bed protectors, mats),” advises Jacquie.
“Leaving off nappies for times during the day can help relieve some of the soreness. For more severe cases, signpost mums to their GP for mild steroid creams.”
Baby eczema
Eczema is a common skin condition that causes dry, itchy, red and sometimes sore patches of skin. It often appears on the face, scalp, arms and legs.
“Eczema can flare up from time to time, but with the right skin care, most babies’ symptoms can be well controlled,” says Thulasi. “Recommended products include emollient creams or ointments for daily use, and soap substitutes and bath emollients.”
Parents should be referred to the pharmacist if the baby’s eczema is not improving with regular moisturising, or if it becomes very red, weepy, crusted or itchy. Also refer if the baby seems to be in pain, or if there are any signs of infection, such as oozing, swelling or fever.
Cradle cap
Cradle cap is a common, harmless skin condition in babies that causes greasy, yellow or white scaly patches on the scalp. It can also appear on the eyebrows, ears, sides of the nose and in skin folds.
“Although the cause is not fully understood, it is not caused by poor hygiene and is not contagious,” says Thulasi.
“Products that can help include cradle cap shampoos or treatments, soft baby brushes or combs, emollient oils for softening scales, and unperfumed and medicated shampoos.”
An estimated 60 per cent of babies experience eczema in their first year, with symptoms often affecting the cheeks, forehead or scalp.
“Cradle cap is not caused by poor hygiene”
Indigestion
Heartburn and indigestion can occur as the baby develops, putting pressure on the stomach and forcing stomach acid to flow back into the oesophagus.
Hormonal changes during pregnancy may also relax stomach sphincters, the muscular valves that regulate the movement of food, liquids and acids within the digestive tract.
“Self-care advice includes eating smaller, more frequent meals, avoiding trigger foods, and staying upright for an hour after eating,” says Jacquie.
“Examples of useful products include over-the-counter antacids or alginates suitable for use in pregnancy. Sugar-free chewing gum can also help as it increases saliva production to neutralise stomach acid.”
Incontinence
Incontinence or bladder weakness is the unintentional leaking of urine. It is common during pregnancy and after childbirth as pregnancy hormones and the growing baby put extra pressure on the pelvic floor muscles and the bladder.
Many women notice leaking when coughing, sneezing, laughing or exercising. For most, these symptoms improve after the baby is born as the body recovers, but some may continue to experience problems.
There are a number of lifestyle measures that can help to manage incontinence. “Regular pelvic floor exercises are key,” says Thulasi.
“Alongside avoiding constipation by eating plenty of fibre and drinking enough fluids, as a full bowel can strain and weaken the pelvic floor muscles. It is also important to stay well hydrated, as reducing fluid intake can actually worsen bladder symptoms.”
Maternity or incontinence pads can help deal with leaks, and the pharmacist can advise on the suitability of fibre supplements if constipation is contributing to symptoms.
Exercising throughout pregnancy can help to ease pain,
aid sleep and improve pelvic floor strength.
Fatigue and exhaustion
Feeling unusually tired is very common during pregnancy, especially in the first and third trimesters. Hormonal changes, the extra work the body is doing to support the baby, disturbed sleep, and the physical and emotional demands of pregnancy can all contribute to fatigue.
Many women notice their energy improves in the second trimester, before tiredness often returns later on.
“Pregnancy multivitamins containing iron and folic acid, and iron supplements if advised can help, as low iron can worsen fatigue,” says Thulasi. “Pregnancy pillows can improve comfort and sleep quality.”
Exhaustion can occur both before and after the baby is born, but self-care advice can help. This includes a good sleep routine, sharing baby care responsibilities and sleeping when the baby is sleeping.
However, Jacquie highlights that ongoing exhaustion may be “a red flag for postnatal depression”, so anyone who reports feeling like this should be referred to the pharmacist.
“Ongoing exhaustion may be a red flag for postnatal depression”
Colic
Colic is common among babies and is characterised by excessive crying without an obvious cause. Self-care advice includes winding the baby after each feed, tummy massage, and soothing and settling them – for example, using white noise or carrying the baby around in a sling.
“Products which can help with colic include simethicone drops, gripe water and probiotic drops formulated for infants,” says Jacquie.
Fever
A fever is when body temperature is higher than normal. The ‘normal’ temperature in babies and children can vary slightly from child to child, but a high temperature is generally accepted to be 38°C or more.
It is often a sign that the body is fighting an infection, such as a cold or other virus.
Fevers are common in babies and children and usually ease in between one and four days. If the baby is distressed during this time, age-appropriate paracetamol or ibuprofen can help.
If it doesn’t improve, or the parent is worried about their baby, they should speak to the pharmacist.
Self-care advice includes giving plenty of fluids, breastfeeding as normal, being alert for signs of dehydration (e.g. lack of wet nappies, a sunken fontanelle). Parents worried about their baby being dehydrated should be referred to the pharmacist.
Constipation
Constipation in babies can be caused by several things, from dehydration to changes in their developing digestive system.
It is relatively common, especially in formula-fed babies and during the transition to solid foods.
Any advice offered in the pharmacy must be given under the guidance of a pharmacist.
Thulasi says: “For occasional use, infant glycerin suppositories may be appropriate, although it is best to speak to a pharmacist first.
“Infant-friendly osmotic laxatives such as lactulose should only be used on the advice of a pharmacist or doctor, and probiotics for infants may also be considered if recommended.”
Teething
Teething (when a baby’s first teeth start to break through the gums) usually begins at four to seven months of age, but timing can vary.
It can cause sore, swollen gums, drooling, and increased chewing or biting. Some babies may become fussier or have disturbed sleep.
“While teething symptoms can be painful, teething rings, unsweetened rusks or chilled raw fruits and vegetables, such as apples, celery and carrots for babies over six months, can provide relief,” says Jacquie.
“Products which can soothe symptoms include teething gels containing local anaesthetics, chilled teething rings and infant paracetamol or ibuprofen for severe discomfort.”
Teething can mean babies become agitated and uncomfortable, but teething rings and infant analgesics can help.
Signposting for new parents
- Maternal Mental Health Alliance is a coalition of organisations helping women across the UK get accessible mental health care and support during pregnancy and in the year after giving birth: maternalmentalhealthalliance.org
- Your Mamahood offers maternal mental health support and services: yourmamahood.co.uk
- Baby Basics UK is a network of baby banks across the UK supporting families with practical essentials for children from pre-birth to five-years-old:
baby-basics.org.uk - Daisy First Aid runs practical first aid courses for parents and carers: daisyfirstaid.com
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In Conditions