chatwithketch

Q: Hi Doctor what can i do to avoid sickle cell among children?

A: Interesting question!

Parenthood is a huge job. It involves a human being literally sacrificing all for another. You want to protect your children from pain, hurts, losses etc even when you know it is impossible. When they are ill, you want to take over the illness and leave them well. So imagine if you were the parent of a sickler, who has to deal with crises after crises, in pain and sickly most of the time. You’re constantly praying to God to please let this crisis pass, please reduce the pain and indeed you are in the hospital more often than not with this child.

How did this happen? Well it was when two sickle trait carriers (people with AS) decided to get married. This automatically meant that for each pregnancy, they had a 25% chance that the baby would be born with genotype SS. This is a mathematical probability and so it could very well be that none of this couple’s children would be SS or it could very well be that all or half of them could be SS! So imagine starting out on a journey of parenthood knowing that your heart is going to be broken again and again as you deal with your child’s continual visits in and out of a hospital.

Therefore, before marriage, a couple should be sure to carry out tests. I’m not talking about those carried out by churches to confirm pregnancy at al 😀 but a serious desire by couples to seek answers as they make the decision to undertake a voyage together. This should ideally be done or known by both parties early enough in a relationship before emotional investments are made on either side.

If two people are carriers of the sickle cell trait, it is only pragmatic not to marry. Before you all lynch me, I know it is not as easy as it sounds. But marrying because you’re emotionally invested is really exchanging one type of heart break for another…because your heart will surely break when you have to watch your child go through the pains of the many crises he or she has to deal with or have them die in your hands.

If I were to choose, I most definitely know what the choice would be for me. It may not be an easy choice but we’ve got to break the trend of these increasing numbers of people living with sickle cell anaemia in our communities. If ignorance is the problem, let’s spread the knowledge; if love being blind is the problem, ladies and gentlemen, please bring a flashlight along and show the light!

For more on this topic, please click on these links: https://chatwithdrketch.com/2014/06/24/daily-health-tips-my-fiancee-and-i-have-as-genotype-should-we-get-married/

Daily Health Tips: Can Parents With AA And AS Genotypes Avoid Having A Baby With Sickle Cell Trait?

Daily Health Tips: How Come My 4-Year Old Baby With Sickle Cell Anaemia Has Never Had A Bone Pain Crisis?

Have a fabulous weekend!

Are you a morning or evening person? Do you know what that means? An online dictionary defines a morning person as someone who feels awake and full of energy in the mornings. A night person? A person who prefers to stay up late or who functions best during the nighttime hours. Why do these matter? What do these have to do with breast cancer? Read!

https://www.bbc.com/news/health-46102193#=

Q: Doc how safe am I? I’m on 2 months injection. I was supposed to go on the 05th for my next injection but I went on the 7^th

A: How safe are you? Well, not safe if you had sexual intercourse during the two days you had no means of contraception. If you find yourself in that situation ever again, please abstain or use a condom. Another option is the morning after pill which can be taken within 72 hours (some can be taken within 5 days) of unprotected intercourse and can help prevent pregnancy.

Q: Please Dr. I am close to my delivery date yet no water is coming out of my breast, Please ma’am, is it OK for me or not?

A: Hi dear, worry ye not! 😀 I’m sure your breasts will rise to the occasion of breastfeeding as soon as it’s time.

You didn’t mention how many weeks or months pregnant you are. Generally, the milk glands start the job of milk production early in pregnancy (1^st trimester). Some women may notice leakage of yellowish milk from their breasts as early as second trimester but some may not see anything until after baby has been delivered.

Feeding should, ideally, start within one hour of having your baby. Your breast already has a stock of breast milk but it does take your baby sucking to make the breast milk ‘come out.’ So, the earlier you put the baby to the breast, the sooner proper breastfeeding can be established. Your baby will probably sleep away the first 24 hours or so, so it may be a challenge to put the baby to the breast. Try the best you can and make sure that your baby’s mouth covers the areola which is the dark coloured area of the nipple.

Some women who had their babies through Caesarian Section may also experience delays in breast feeding just like some other women. There’s no specific reason for this and the same advice of putting the baby to the breast often suffices. The more often you put your baby to the breast, the better your milk supply will be.

Just in case you’re worried that your baby will starve before full breast feeding is established, don’t be. Your baby doesn’t need more than a few teaspoonfuls of colostrum (which your breast already has and baby gets as he suckles) in the first few days. They contain a lot of substances that help build your baby’s immunity. If, however, by 72 hours you’re still not making breast milk, be sure to discuss with your doctor so that he can confirm that your baby is getting enough to eat. Before this time, don’t get tempted to offer glucose water or formula feeds if you plan to breast feed.

Now just in case you wondered about pap with milk and whether this helps breast milk come in faster? Well, my answer is this. If you want to take your pap, please indulge…in sizeable portions. If it helps your breast milk come in, that’s fine. I guess if the pap is watery enough, it will help hydration and you certainly need to be well hydrated for breast feeding to happen without stress 😀

Have a good night, people 😀

I visited my sister a couple of days ago and she was confused as to whether her sons (one and a half years four and a half years) needed to take the yellow fever vaccine again. I referred her to my blog 😀 I mean, after all, I spend all this time writing on it…people should read it, right?

I repeat the post below for your reading pleasure 😀

Q: Hi doc! I am kindly asking is it right to be given twice the yellow fever injection because l was given last year August which will last for 10 years.Is there a difference between yellow fever for ten years and life time? Thanks in advance

A: Hallos! Thanks for writing in.

Previously, the yellow fever vaccine was taken every ten years but since 2016, that regulation has changed. From 11th of July 2016, the WHO, on its website, states that the certificate of vaccination against yellow fever is valid for life for everyone vaccinated and that this validity refers to existing and new certificates. For the latter, the lifetime validity starts 10 days after date of vaccination. This has effectively cancelled out the need for re-vaccination.

So, there is no difference. The vaccination that used to be received and was valid for 10 years is now valid for the duration of your lifetime. If you had received the vaccination before, you don’t need to modify your certificate. The old one is still valid and will be recognized by countries that require proof of this vaccination.

I hope this helps.

All the best!

Have a good night y’all 😀

Q: Hi! I have a newborn baby. She’s 7 days old. I realized the eyes are yellowish. They said in the clinic to put her on the window when the sun appears. I’m only breastfeeding – her will that help

A: Jaundice is a condition in which there is yellowing of the eyes or the skin. It can happen in both children and adults. Usually, when old red blood cells are broken down, a yellow pigment, bilirubin is released as part of that process. The bilirubin is removed from the body through urine and stool. It is the bilirubin that gives rise to that yellow colour seen in jaundice.

Other symptoms of jaundice include deep yellow urine and pale stools.

In newborn babies, there are two types of jaundice (neonatal jaundice) that can occur: Physiological jaundice and pathological jaundice.

Physiological jaundice occurs as a natural process of life. While in the uterus, the baby’s bilirubin is removed through the placenta. Once the baby is born, he/she has to handle this bilirubin business by himself/herself 😀 (talk about responsibility immediately after touching down in planet earth!) because his organs are unable to deal with all the bilirubin released from breakdown of red blood cells. As the bilirubin accumulates in blood, jaundice results. Typically, this jaundice appears about 24hours after birth, actually gets worse until the 3^rd or 4^th day. It would usually have disappeared by the end of one or two weeks.

Pathological jaundice is due to a disease condition like infection, mother and baby’s blood groups not being compatible etc. This is typically present before 24 hours of birth.  Indeed, this is the main difference between the two types of jaundice. The one that occurs naturally is seen after 24 hours while the one due to disease is seen before 24 hours…rule of thumb 😀

Jaundice may be mild, disappearing on its own, especially physiologic jaundice. However, sometimes, the yellowness deepens, the baby may develop a high-pitched cry and/or develop arched back. These are dangerous signs and this child should be in a hospital. Indeed, if you observe jaundice in your baby after you have left the hospital, please get it checked out in the hospital just to be sure.  Most babies are able to deal with this excess bilirubin on their own without needing treatment. However, some other babies may be put under special lights called phototherapy or in more serious conditions, an exchange blood transfusion may be done (literally, this involves practically exchanging the baby’s bilirubin-filled blood with ‘new’ blood).

The main focus in jaundice is to bring down the level of the bilirubin. If this is not done, it could cross the blood/brain barrier and stain the brain leading to brain damage, a condition called Kernicterus.  More frequent feeding is usually suggested as this helps the baby get rid of more bilirubin.

Will breastfeeding alone help? You didn’t quite specify when your baby’s jaundice appeared. It is key to confirm if it’s pathological or physiological. This will determine the appropriate treatment.

Have a good evening, everyone 😀

Q: Hi can you give me advice please? I breastfed my daughter for 3 and a half years I recently stopped feeding her about 2 months ago. I still have some milk in my right boob but my left does not have milk but it feels as if it’s a blocked milk duct. Is this normal or should I be worried?

A: Breastfeeding is really an intimate activity for mum and baby and it is not strange to find both of them feeling some sense of loss as this ‘bonding’ activity comes to an end…even when it’s mummy suggesting the change 😀 And for three years?! You deserve an award! :O It is even more important for you to find time to still bond with baby like frequent cuddles, keeping baby close to you, frequent eye contact etc. Generally re-assure your baby that the fact that this activity is coming to an end does not mean you love her any less. For those who are contemplating this, be sure not to introduce this when your baby is going through any major changes like moving house etc. That might convince baby you’ve moved on to other stuff J

Then get to it! 😀 I’m not sure how you did yours, but I’ll tell the newbies how. You can stop gradually over a period of time. Replace some feeds during the day with other foods or even milk (just not from you). Usually the first and last feeds of the day are the most difficult to replace or give up as they are your baby’s sorta emotional anchors 😀 But keep at it over a period of weeks and the breast milk production will gradually ‘dry up’.

The other option is to just stop putting baby to the breast. If your baby feels it’s also a good idea to stop, then you’re good. If not, you may have to be very creative with means and ways of distracting him/her.

In both situations, you may find your breasts engorged, as in this case. If you’re stopping gradually, you may want to express some milk (don’t express until the breast feels empty) and store in the fridge. You could put that in a sippy cup and feed baby later.

If you’re stopping immediately or in your case since this has been over two months, get the right support for your breasts.

In the good old days, mothers would tell their daughters to tie a wrapper tightly across their breasts. This helps. In fact, I believe that this is still being done by lots of people 😀

If you’re more jet age, though wear a tight supportive bra. For the pain, take analgesics and also apply cold packs to your breasts.

Try not to stimulate the nipples during this period. Stimulation of the nipples can occur during sexual foreplay or even pressing the nipple by people who are curious/worried about a  nipple discharge or friction between fabric and nipple. This encourages milk production. Hubby should kindly take note.

All the best as you move to a new phase of parenting!

Have a great day y’all 😀

Is social media good or bad? Does it make you happy or sad? Does it make you want to keep up with the Joneses or leave you comfortable in your own skin? Not sure? Read!

https://qz.com/quartzy/1459609/limiting-social-media-use-reduces-depression-say-researchers/?fbclid=IwAR1nu5gyadLLLOrYMGtkAF6A-pKhJUle-I5oM2bDwfLNEux_bOFD_MrcihQ

I’m on a low fat diet! I’m on a low carb diet! I love the Mediterranean diet but there’s so much olive oil! Which diet are you on? More importantly, what works?! Read!

https://www.health.harvard.edu/staying-healthy/low-fat-low-carb-or-mediterranean-which-diet-is-right-for-you