chatwithketch

Q: Hello doc. Good day. Please doctor can you talk about low thyroid in pregnancy and the causes and the remedy, please. God bless you Doc.

A: In hypothyroidism, the body does not produce enough of the thyroid hormones due to an underactive thyroid gland. The symptoms include tiredness, weight gain, constipation, increased sensitivity to cold, depression etc

Causes of hypothyroidism include autoimmune diseases (when the body turns on itself, producing antibodies that attack and destroy the thyroid gland), inadequate iodine in the diet, radiation therapy to the neck, thyroid surgery (in which some or all of the thyroid is removed) etc. Other factors associated with this condition include pregnancy, certain drugs etc Risk factors for hypothyroidism include white race, growing older, having prematurely graying hair etc.

The major issue causing the symptoms is the lack of thyroid hormones and so treatment is targeted at that. Synthetic thyroid hormones will be prescribed to help combat these. Effects on fatigue may be observed as early as two weeks after treatment is started.

So, please see your doctor for a proper examination and he/she will make a diagnosis after which a course of action will be determined.

Have a good night, everyone 😀

Q: Hello Dr. Thanks for the wonderful works you’re doing on social media. Please, in addition to breast milk, what can I give to my 3 months old son because my wife is finding it difficult to cope with her business

A: Congratulations on your new baby!

Breast milk is the best food for baby for the first six months, generally speaking. I’m a great advocate and will be telling you how your wife can make it work. The supply of breast milk is based on its demand. And so, if demand for it is high, supply will be high and vice versa. The more efficiently milk is removed from the breast, the more milk production is stimulated. And so, there needs to be a conscious effort to get baby to suck more.

If your baby sucks, the let-down reflex ensures that your wife’s breast fills up with breast milk. Flat nipples can appear to be a challenge for breast feeding, especially for first time mothers but remember that babies are supposed to latch on to the areola (the black area surrounding the nipples) and not on to the nipples. Your wife should try pressing on the areola with thumb on top and fingers underneath and push back against her chest wall while pressing in with her thumb and fingers. This helps elongate the areola and so, provided she positions the baby properly on the areola, breast feeding can go on with no issues.

Here are other tips that could help increase milk supply:

• Be sure that baby is attached properly and get him to suckle on the breast very often. Remember that breast milk production is a function of the breast milk let down reflex which is activated when baby sucks.
• If she can find a private space within her office/business space where she can express milk, encourage her to go for it.
• Let her increase the number of feeds per day. She could work with a timetable of a feed every 2 to 3 hours. In her case, as many times as is possible when she gets back from the office.
• She should switch breasts during a mealtime. Let the first breast ‘empty’ before switching baby to the other breast. This can be repeated several times during a feed.
• She should massage her breast and stroke towards the baby
• Perhaps over the weekend, let her room in with your baby and get him to feed as much as possible. The letdown reflex will be greatly stimulated and so, she could even pump some for when she will be at work and freeze.

Personally, I found that using my hands to ‘milk’ my breasts produced sufficient amounts of breast milk for my always-hungry-can’t-seem-to-get-enough-food-baby. She may want to try that.

Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

I hope y’all had a great day! 

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‘Every day, retinal specialists are asked about the risks from blue light emitted from electronic devices. (Retinal specialists treat conditions affecting the retina, a thin tissue at the back of the eye that is responsible for vision.) Many people ask whether blue light will increase their risk of age-related macular degeneration and blindness.

I s the answer yer or now? Read to find out!
https://www.health.harvard.edu/blog/will-blue-light-from-electronic-devices-increase-my-risk-of-macular-degeneration-and-blindness-2019040816365

Q: Good day Dr. I have a problem. January this year, a condom burst but I got morning after pill the following day. In the very same month, I had my periods; also the following month (February). Then in March I only had my periods for 2 day and had drops. Normally it’s 4 days. I bought almost 5 pregnancy tests and they were all negative. Last month I went to the clinic and did another pregnancy test. It was negative so I took 2 months contraceptive injection. So now I am having back pains and every time I squeeze my right breast liquid comes out. Is it possible that am pregnant

A: The morning after pill which can be taken within 72 hours (some can be taken within 5 days) of unprotected intercourse, can help prevent pregnancy. But it does not protect you against sexually transmitted infections (STI) and this is a key concern given the recent history of burst condoms.

Please don’t forget that there is a simple ABC that guides these affairs. The first is abstinence. Honestly, this is your safest bet. If you’re not ready to deal with the responsibilities of having a baby, please leave well alone. You can’t have an STI, HIV/AIDS, or otherwise if you don’t have sex. And of course, you can’t get pregnant. Now, if abstinence is a problem, be faithful to one partner…who hopefully is being faithful to you too. If you can’t swear on this, revert to plan A. Finally, if all else fails, ensure that you use a condom to prevent STIs and pregnancy. As you have found out, this can also fail!

Contraception is a good option but the answer to proper contraception is not popping a pill in panic whenever you happen to have sexual intercourse. Emergency contraceptives have their place but they are not meant to take the place of regular contraceptives, as they are less effective than the regular ones. Regular use of these emergency contraceptives may cause your periods to become irregular and unpredictable. Is this the case with you? Have you been using the emergency contraception a little too often? It could explain your symptoms.

I think that you have probably thoroughly ruled out pregnancy now with the battery of pregnancy tests that you have done but perhaps, you should consider going to the hospital for a hospital-run pregnancy test and a general check, especially for STIs given the history of burst condom.

Breast discharge can be due to other causes other than pregnancy and breastfeeding and they include:
•  Stimulation of the nipples during sexual foreplay or even pressing the nipple by people who are worried about the nipple discharge or friction between fabric and nipple can lead to nipple discharge.
• Breast abscess or infection
• Hormone imbalance
• Injury to the breast
• Some medications
• Cancer of the breast

To determine cause, the doctor may do a scan, take tissue sample to examine (biopsy) etc
Treatment depends on cause. If due to pregnancy or breastfeeding, it will eventually stop. If due to stimulation, the discharge will continue as long as the stimulation is present. If due to injury, it will also stop with healing. If the discharge is due to medication, stopping the medication is sufficient to bring this to a stop.

Bloody discharge, discharge from one breast only and discharge that happens spontaneously without the breast being touched or pressed is likely to be abnormal. These should be checked out as soon as possible in the hospital.

If the discharge is present during a menstrual period and persists into the next cycle, please see your doctor too.

All the best!

Q: Greetings Doc, please my two-month-old exclusively breastfed baby cries much whenever he wants to poo and when he poops at last, it will be strong. Please what should I do?

A: In exclusively breastfed children, there can be episodes of lots of days without defaecation. This is not described as constipation. In children, the focus is more on the texture of the faeces when the child eventually defaecates as opposed to how often he goes. The ‘long duration’ in between stooling for exclusively breastfed babies is because the nutrients of breast milk are usually, practically all absorbed, leaving nothing to be excreted. Provided the eventual stool produced is not hard, then your baby should be okay.

I’m curious about the fact that you said your baby’s stool is strong. Is that because he cries before he poops? You should know that babies cry to increase pressure in their tummies, which helps push out the stool. It’s not about constipation. Where in doubt, it never hurts to see your baby’s doctor.

For more on constipation in babies, please click on https://chatwithdrketch.com/2014/10/15/daily-health-tips-is-my-2-month-old-baby-constipated/

Have a great night, y’all and a fabulous week ahead 😀

Q: It’s been two weeks now and my poop is green. What does that mean?

A: This question reminds me of an old show I used to watch, ‘You are what you eat.’ It involved amongst other things, an examination of stool to determine ones diet and body. I found it fascinating…useful but also disgusting! 😀  

Stool can take a variety of colours depending on diet and the quantity of bile in the faeces. Bile is initially bright green in colour and gets progressively darker/brown as the bile is acted on by chemicals and bacteria on its journey through the intestines.

Let’s take a look at different colors of poop and what they mean – this sounds absolutely disgusting! 😀

Brown – Normal stool colour. Bilirubin in blood, when broken down, ends up in the intestine. It is then acted upon by gut bacteria, which turn it brown.

White – No bile in stool or the patient could be taking some of those chalky anti-diarrheal medicines

Green – This could be due to food moving too quickly through the intestines and therefore the bile pigments not being acted upon by bacteria and other chemicals in the gastrointestinal tract. A good example of this sort of situation is diarrhea. However, eating a lot of green, leafy veggies, eating food with green colouring, taking a course of antibiotics (which changes the normal type of bacteria found in the gut and consequently, the stool colour) and some bacteria like Salmonella, can also turn stool green

Red – This signifies bleeding from the lower gastrointestinal tract or the presence of red food dyes in drinks and/or food. In situations like haemorrhoids where blood is ‘splashed’ on the stool, there are typically complaints of red stool colour

Black or dark brown – This could be due to bleeding from the upper gastrointestinal tract and/or use of iron supplements

Yellow – Excess fats and/or infections of the small intestine

I hope this helps.

All the best!

Today is World Malaria Day and the theme is ‘Zero Malaria Starts With Me.’ Every two minutes, a child dies from malaria…did you know that? What part are you willing to play to help end malaria?

The question for today focuses on malaria in this vulnerable age group.

Q: Good day Doc. My baby is 4 months old. Can she take anti-malaria? Mosquitoes have been biting her face,
A: Thanks for writing in.
When you have a brand new baby, one of the investments (which thankfully does not require a lot of money) you should make is to buy a mosquito net. This protects your very vulnerable baby and prevents malaria which can be quite severe in this age group.
Children become especially vulnerable to malaria at about 3 months of age when the immunity they received from their mothers start to reduce.
First tip is, do not treat your baby at home. Take your baby to the hospital. The doctor needs to confirm that what your baby has is indeed malaria. This involves running a test to check for the presence of malaria parasites.
The treatment of choice is still Artemisinin-based Combination Therapy (ACT). Be guided by your doctor for dosage and duration of treatment.
For more on malaria, please click on the link: https://chatwithdrketch.com/…/kill-a-mosquito-with-a-sledg…/
Have a good night, everyone 😀

Q: I’m sorry for coming to your inbox late in the night. Thank you for the sacrifice you are paying to educate all your fans. My nightmare is about my little daughter, who I delivered in late December 2017. She is one year and almost four months now. She didn’t crawl at all, and up till date, she only walks with the aid of the table and the bed side. I stopped breastfeeding her a month ago, because she is so much attached to me, that she doesn’t allow people to carry her. She is too fond of me. Whenever I drop her with my grandma, and she doesn’t see me, she will play with other people. However, when she sees me, she starts crying profusely, if I don’t give her my total attention. Like I must not stand up beside her or even go to the restroom. The ‘biggest’ of my trouble with her is her consistent crying in the night. I am almost fed up! I am affected by these challenges, health-wise. I want to know Doctor, is there anything happening to her, stopping her from walking medically? What drug or supplements can we use, to help her? She fears a lot, she doesn’t want to fall down. That is what I have been observing as the reason why she can’t take her hands off the table and walk without being guided. Please help doctor. I will be expecting your reply Doctor. Thanks a million.

A: Thanks for writing in…and please don’t be fed up. Trust me! This too shall pass 😀

First point to note is that although children develop at different speeds, walking is not considered to be delayed until the child is about 18 months and hasn’t started walking. Your baby is not there yet and from all indications, may have started walking by the time she hits that age. So, don’t borrow tomorrow’s trouble for today. Encourage and cheer her on and provide opportunities for these motor skills to be developed – let’s see how it goes J

For you and other parents who worry about their children’s developmental progress, here’s an approximate guide to different milestones. Please remember that each child is different and so variation is the rule of the game! 😀

• At 6 weeks, most babies can sit with their backs curved and require support. Head control developing. In ventral suspension (when held above couch with examiner’s hand supporting the abdomen) can hold head at level of body briefly.
• At 3 months babies have enough upper body strength to support their heads and chests with their arms while lying on their tummies
• At 6 months, typically babies can sit with support and when lying face down, can lift themselves up on forearms. When pulled up to sit, the backward flopping of the head that used to occur (head lag) would have stopped
• At 9 month, babies can get into sitting position alone and sit unsupported. Baby can also crawl but it’s important to point out that there’s a wide variation in the age of crawling for children and some of them never crawl. They totally skip this stage and walk 😀 Sound familiar to you? Your baby appears not to be interested in anything except the real deal, ‘walking!’
• At 10 months babies can pull themselves into standing positions and maintain that position holding on to supports
• At 12 months, babies can stand and walk with one of their hands held. They can stand alone briefly and/or walk alone.
• At 18 months, most babies walk well, run and can climb stairs while holding on to rails
• At 2 years, most babies can kick a ball and climb up and down stairs with two feet per step.
• At 3 years, babies can now climb stairs one foot per step and are able to stand on one foot for a few seconds.

When it is diagnosed that there is a proven delay in walking, it is important to determine the cause. Apart from the fact that this ‘supposed delay’ may just be a variation of the normal, delays could be due to the under listed: Delay in motor maturation

• Learning disabilities in which there is a delay in all developmental areas, with language and social skills being the most affected.
• Delayed motor maturation in which some children, otherwise normal in every other aspect, just walk late. This tends to run in families
• Cerebral palsy
• Reduced muscle tone as in Down’s syndrome
• Infections – eg meningitis
• Head injury.
• Malnutrition.
• Maternal antenatal infections or toxins.

If the paediatrican is convinced there is a developmental delay, then treatment will depend on the cause(s).

So, right now, you don’t need to worry. If you, however, do worry, please take your baby to see the paediatrician for appropriate history taking, examination and diagnosis.

All the best!

Source: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/infant-development/art-20048012