chatwithketch

Q: My 8 months baby is purging and I don’t know why whether it’s because of teething

A: Two key symptoms that are often associated with teething are fever and stooling.

It is thought that the inflammation of the gum around the area where the tooth will erupt from may cause low grade fever which is why the babies may experience some fever.

There’s no conclusive research that has shown any link between the process of erupting a tooth and diarrhoea. If anything, it has been found that this is the same period when children start picking up things and of course the natural ‘tourist’ destination for anything they pick up, is their mouths! 😀 What happens? When they pick up dirty stuff and suck on it, it would ultimately lead to diarrhoea. Others think that the excessive saliva produced at this time, end up in the intestines and lead to loose stools. Whatever the cause, more than ever, this is a time to be watchful and ensure that the children are not stuff their mouths with rubbish and ensure their toys are cleaned.

Having said that, how can I help my baby through teething what with the itch and discomfort they feel around the ‘erupting tooth’ area? Even the drooling? Well, here are a few things you could do:

Rub over the teething area with your finger (thoroughly scrubbed and clean, of course :D) or use a finger covered with clean gauze or even the baby’s wash cloth. If this is cool to touch, this is even better. Massage the teething area with this…it helps to soothe the discomfort.

Teething rings are great ideas too and you could also refrigerate these to provide more comfort. Please do not freeze them.
Clean off the drooling saliva as this could cause irritation around the baby’s mouth, worsening his crankiness.

Over the counter analgesics like paracetamol could also be helpful provided it’s given in the appropriate dose for the baby’s age. This will also help with the fever. Please avoid Aspirin as it causes a disease called Reye’s syndrome.

Several studies have been conducted on the efficacy of gripe water though it is liberally used by parents and doctors alike, and it has not really been found to be particularly useful in teething. Older formulae contained alcohol, which were thought to be perhaps, responsible for the soothing effect it had. Other components like the herbs etc may not go down well with all children.

If fever continues, please take the baby to see the doctor to rule out other causes of fever. Dehydration is the more critical issue. If your baby is still stooling, fluid needs to be replaced. Please take him in to see his doctor to determine if the fluid loss is serious enough to warrant replacement. In the meantime, keep breastfeeding.

So, there you go!

Do you find yourself starting out the day feeling super excited and energized and towards the end of the day, you feel down in the dumps, as you struggle to end your day on the same high on which you started? Do you know that your diet could help? Are you eating the right or wrong carbs? You should read this! https://www.health.harvard.edu/healthbeat/want-more-energy-heres-what-really-helps

Q: Good morning ma’am. I want to ask what to do if a month-old baby couldn’t excrete for 3-4 days. The baby only sighing, you know when a baby is making uncomfortable sound,”hmmmnnnn”. The baby is sucking as usual. He sweats normally as well. Someone suggests I parboil waterleaf and give the baby. Please, what do I do? Reply please ma’am.

A: You didn’t note whether your baby is being exclusively breastfed or not. If your baby is exclusively breast fed (as he should be from birth to 6 months of age), the baby can sometimes go days without defaecation and is due to the fact that practically all the nutrients in breast milk are completely absorbed during each feed, such that there is little or nothing to excrete. However, it is expected that when baby does poop, the faeces should still be soft in consistency as opposed to hard, dry, pellet-like stool as occurs in constipation. If the stool is hard with exclusive breast feeding (?), please visit your baby’s paediatrician. On no account, should you give your baby parboiled waterleaf fluid or any other concoction! Please don’t! Where in doubt, always consult your doctor when in doubt.

Formula fed babies, on the other hand, suffer from constipation because it is more difficult for a baby to digest formula than breast milk.

If your baby is dehydrated, perhaps from not taking enough fluids as may occur if she has a cold and is refusing feeds due to difficulty with breathing when feeding, ‘constipation’ may also occur. Other causes include food allergies and/or introduction of complementary fees as the body learns to handle these foods.

If your baby is on exclusive breast-feeding, passing out dry, hard stools is unlikely. For formula feeds, try to give your baby more water and be sure that you are adding the right amount of formula to make the baby’s meals. If this continues, please see your baby’s doctor.

For more on this subject, please click on https://chatwithdrketch.com/2014/05/20/daily-health-tips-can-my-diet-cause-my-baby-to-have-diarrhea-while-breastfeeding/

Have a great day, y’all  😀

Q: Good afternoon Dr, I give you all the accolades. God will continue to bless you with wisdom and you will live to declare his Goodness. Amen🙏
Dr please, I tested positive to pregnancy after missing my period on 12th so I decided to have a home test which came out positive. Dr. I really do not want to visit the hospital now I still want to observe myself for the next one month. Dr. please what food should I eat and avoid and also can I take folic acid or wait till I see the Doc?
Thanks so much Dr. God bless you big. N.B no symptoms at all only my breast been a bit slightly painful. I am AA and B+.

A: Hallos! Thanks for writing in and Amen to all your prayers! 😀

Pregnancy is such an awesome time. Okay, I know those of you who have a hard time with pregnancy are wondering whether to throw rotten tomatoes at me 😀 Hold your peace! But the truth is, when you’re not feeling absolutely horrible, you’re elated at the thought of the life growing in you, aren’t you. It’s such an awesome responsibility to be given…the nurturing and birthing of this child. Don’t get me started on this….

Okay, with this huge responsibility comes even more responsibilities 😀 There is the need to eat right to nurture the growing life inside that huge tummy. Eating right is not necessarily eating for two…I know we’ve all heard the feeding for two fable. Trust me, in pregnancy, your calorie requirement doesn’t increase in first trimester, increases by just 300 calories in second trimester and about 400 calories in the 3rd trimester …if you’re carrying just one baby. For multiple pregnancies this increases slightly.

Here are 5 nutrition tips for a pregnant woman:

• Eat a balanced diet with a variety of foods from different food groups.
• Be sure to include a lot of high fibre foods like vegetables, whole grain cereals etc to deal with the constipation associated with pregnancy.
• Ensure you take your antenatal medications (prenatal vitamins) in addition to eating well.
• Drink at least 4 servings of milk, other dairy products or calcium rich foods. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, drink up your milk!
• Be sure to also take foods rich in iron eg and foods rich in folic acid eg green leafy veggies and beans. World Health Organization recommends that pregnant women receive folic acid and iron tablets daily. Folic acid prevents neural tube defects which may occur during the first 28days of pregnancy. This is usually the period when quite a number of women do not even know they are pregnant. Thus, women who plan on getting pregnant should start on folic acid supplements at least 3 months before their planned date to safeguard against neural tube defects. If you haven’t started this earlier and realize you’re pregnant, start taking them as soon as possible.

Pregnancy provides an opportunity for a mother to adequately prepare her baby for life in 9 months. Make sure that you get all the nutrients that give your child a great health boost.

Have a great evening y’all 😀

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Q: Hello doctor, I am writing from Uganda. I am living a very stressful life and very worried. I really need your help. My question is that, my wife is five months’ pregnant now. She went to the hospital two weeks ago and she was found HIV positive. I have been testing and they found me negative but doctors said I may be in the window period, so is it really possible to sleep with an infected person who is not on medication and you don’t get infected? If yes what can cause that? Do you think I still have a chance of not being infected because I have been sleeping with her? I am a very poor man. I really don’t know how to handle this situation. Please help and advise me doctor. May God bless you

A: Thanks for writing in. Couples with different HIV statuses s are called sero-discordant couples. It is possible to have sexual intercourse with a partner living with HIV/AIDS and remain uninfected. Several studies have been conducted to find out why and different reasons provided for this include:

• Reduced frequency of sexual intercourse especially in the face of sexual promiscuity
• Possibility of inherent resistance to the virus
• Male circumcision
• Patients on anti-retroviral therapy with an undetectable viral load are highly unlikely to infect their sexual partners

It is important though, to go to a proper testing center to confirm that the results you have received thus far are valid. Generally, if the initial test is negative, a repeat test is done 3 months after the exposure to ‘close the window’. Some may stretch this to a further screen after 6 months. Be guided by your doctor. If you are still confirmed negative, then the focus turns to next steps.

Of course there’s always a risk in having a sexual relationship with someone who is HIV positive if you’re sero-negative. However, it is no longer the death sentence that we used to think it was and indeed, you don’t necessarily need to become infected if you follow some basic rules:

Ensure that your partner takes her anti-retroviral drugs to reduce her viral load and reduce the risk of infecting you.

However, even with the above, you still need to wear condoms while having sexual intercourse with her.

If there is an accidental exposure, like a broken condom during intercourse, be sure to use post exposure prophylaxis. These drugs used to treat HIV are usually taken daily for about 4 weeks to reduce chances of becoming HIV positive.

You can also commit to taking a tablet everyday as part of the pre-exposure prophylaxis. This prophylaxis is essentially tablets used to treat HIV and can reduce the risk of contracting HIV. Remember that this should be used alongside condoms when having sexual intercourse.
Be sure to also test for HIV and other STDS at least once a year.

The fact that you have remained negative for so long is definitely note-worthy…you are one lucky fellow! However, now that you know your partner’s status, you must take every step to remain sero-negative. Knowledge is power!

All the best J

Q: Dr. my immediate bro is masturbating and now he is ejaculating blood as sperm. I am afraid. What is really wrong with him?

A: Hi dear, thanks for writing in. It is certainly very disturbing to see blood in semen! This phenomenon, known as haematospermia or haemospermia in men under 40 years with no other symptoms related to more serious issues (which I shall discuss below) is usually not a major medical problem. Causes include:

• Inflammation of the prostate gland (where semen is produced)
• Inflammation of the seminal vesicles (where most of the fluid in the semen is produced)
• Cysts in the seminal vesicles
• Sexually Transmitted Infections like gonorrhea, chlamydia etc
• Following recent instrumentation eg after prostatic biopsy

These conditions would usually resolve on their own or require a course of antibiotics. Please be guided by your doctor.

Physical injury to the sex organs after fracture of the pelvis or injury to the testicles, excessively rigorous sexual activity or masturbation can cause blood in the semen. The latter appears to be the problem with your brother. By the way, if one is masturbating with another person, there is the possibility of an STI if objects (sex toys) are shared and/or if there is some exchange of body fluids. This now increases the chances of having blood in the semen because STIs are a recognized cause of this.

All the mails I’ve received on masturbation contain a common thread – that of feeling guilty. Some are also accompanied by a sense of low self-esteem which may have pre-dated this leading to excessive shyness and preference for masturbation, as opposed to talking to members of the opposite sex. The real challenge here is that there is nobody to talk to about these issues as we all tend to judge the people involved. The unfortunate fall out is that anxiety and depression may not be far behind if this cycle of guilt and low esteem is not addressed.

Any activity that holds one a prisoner of his/her desires has to be mastered. It has to be controlled otherwise, it rules the person’s life. Imagine being a slave to your sexual desires! :O And if this is accompanied by negative feelings like guilt, anxiety, depression etc, then it has to be decisively dealt with.

Counseling would be the way to go…I don’t know any of help groups here in Nigeria. I will make enquiries though. Or find someone who you feel you can trust and talk to. This person could be someone from home, church etc However, it’s important that people seeking help for any kind of issue, are not judged by anyone…from church or from other social circles. We all try to act as if we’re all holy and wonderful people but we all struggle with different stuff, just like every other person J Empathy is key here.

It is important to find out the why…what makes me want to do this again and again? What feeling am I trying to achieve? What am I trying to avoid? Indeed, going cold turkey and just deciding to stop could very well happen after this.

For more on this topic, please click on this link: https://chatwithdrketch.com/2014/08/05/daily-health-tips-depression-masturbation-and-over-protective-parenting/

Back to blood in semen….

Please note however that, if you develop the under-listed symptoms, especially if you’re older than 40 years, it may be a sign of more serious conditions and you should see your doctor immediately.

• Blood in semen which persists for longer than 3 to 4 weeks
• Presence of other symptoms like pain during urination
• Recurrence of blood in semen
• Presence of other risk factors for bleeding disorders, cancer etc

These more serious problems could be due to bleeding disorders, severe high blood pressure, cancer etc

So, please see your doctor and let him make a proper diagnosis.

All the best.

Q: Please Doctor, l have a problem about my breast in bring milk but I am not pregnant. Please help me

A: Some women who are not pregnant may have milky fluid come out of their breasts when they are not breastfeeding or even in women who have never been pregnant. This is called galactorrhea (pronounced gulactoria). This is not a disease on its own but a symptom of a problem. The hormone, prolactin which is responsible for lactation in nursing mothers, is usually produced in these cases.

This milky fluid can be expressed by pressing or it can spontaneously come out on its own. It can affect one or both breasts and usually there are no blood stains involved.

Sometimes, the cause of this discharge may not be known but some causes could be some medications, some drugs like cocaine, spinal cord injuries, some birth control pills, stress and even excessive stimulation during sexual intercourse.

Galactorrhea can also happen in men and new born babies! In new born babies this can happen if the mother has a high level of estrogen which crosses over into the baby and stimulates the formation of breast tissue and sometimes, some milky white discharge. Please note: this is NOT witchcraft!

If you notice this, please visit your doctor who may try to express this discharge to study. The discharge may also be clear (as in your friend’s case), bloody or even tinged yellow. These need further evaluation and the presence of lumps should also be checked for. The level of prolactin will also be assessed. This may, however, be normal in people who are overly sensitive to prolactin. In this class of people, prolactin level is normal but there is still milky discharge from the nipples.

Treatment is focused on the underlying cause if one can be found. If the problem is medication, please stop or switch to something else under the supervision of your physician (doctor). If there is a tumour producing prolactin, drugs can be taken to shrink it or surgery can be done. If no cause is found, drugs that reduce prolactin level are prescribed. Remember, that your friend could be pregnant and so a pregnancy test may not be out of place.

In the meantime, breast pads can be worn to prevent the embarrassing leaks from staining clothes, limit manipulation of breasts either by self breast examination or during sexual activity and try not to wear clothes in which there would be friction between the nipples and the material.

All the best!

We all want the perfect skin – healthy, wrinkle-free and just supple. Ever thought that coconut oil could be used as the perfect moisturizer for the perfect looking and fresh smelling armpits? And it’s all natural. No chemicals that destroy the ozone layer and damage your skin 😀 All the tips you need are all here! Read!

https://atbgs.blogspot.com/2018/08/healthy-skin_90.html?spref=fb

Q: Doc I’ve a question, If you have plus size breast and you don’t produce enough breast milk, what can you take to have enough breast milk, beside using formula milk? Thank you again

A: Congratulations on your new baby!

Breast milk is the best food for baby, generally speaking. 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, you need to make a conscious effort to get baby to suck more.

If your baby sucks, the let-down reflex ensures that your 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. Press on the areola with your thumb on top and fingers underneath and push back against your chest wall while pressing in with your thumb and fingers. This helps elongate the areola and so, provided you position 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 you can find a private space within your office where you can express milk, go for it.
• Increase the number of feeds per day. You could work with a timetable of a feed every 2 to 3 hours. In your case, as many times as is possible when you get back from the office.
• Switch breasts during a meal time. Let the first breast ‘empty’ before switching baby to the other breast. This can be repeated several times during a feed.
• Massage your breast and stroke towards the baby
• Perhaps over the weekend, room in with your baby and get him to feed as much as possible. The let down reflex will be greatly stimulated and so, you could even pump some for when you 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. You 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.

Have a great day! 🙂

Q: Doctor, please discuss cryptic pregnancy

A: There is not much medical literature on cryptic pregnancy, probably because it is an uncommon phenomenon and not really well understood yet. I will provide what information is available and advise anyone who thinks they have this condition to find a good obstetrician for active management and follow up.

A cryptic pregnancy is also known as a denied pregnancy or graviditatas ignota. In this situation, the pregnant woman unconsciously denies the existence of a pregnancy. Please note the word, ‘unconsciously’. Most times, symptoms of pregnancy (nausea, amenorrhea and abdomen swelling) are absent or greatly reduced, babies tend to be underweight and in many cases, pregnancy goes undetected by relatives and doctors

The reasons for cryptic pregnancy are not clear but some associated conditions are as listed below:

• Peri-menopause – For women who get pregnant around the time of menopause, there may be an absence of many physical symptoms of pregnancy. Just before a woman becomes menopausal, her hormones are ‘all-over-place’. The decreasing levels of estrogen mean that a woman could get pregnant and not know it. Ordinarily, estrogen helps the uterus/womb to grow, maintains the lining of the womb, increases blood circulation, and regulates the production of other key hormones. It is also responsible for those key pregnancy symptoms like spider veins, nausea, increased appetite, and skin changes. Therefore, when you don’t have them, you’re unlikely to think you’re pregnant. This could also happen in early menopause
• A low level of the hormone Human Chorionic Gonadotrophin (hCG). hCG is the hormone that is sought for when pregnancy tests are conducted. The level of this hormone could be low if the test is done too early in pregnancy. However, some believe that in cryptic pregnancies, the level of hCG is so low that it is not picked up by urine and blood pregnancy tests. As a result, the babies develop at a slower pace. Truth is, a lot of further research is needed to provide evidence for this
• Irregular menstrual periods may make it difficult for a woman to observe that she is pregnant
• Other reasons for cryptic pregnancies include inexperience, general lack of attention to body cues (usually, when these women discover they are pregnant, they start recalling incidents that should have alerted them), intense psychological conflicts about the pregnancy especially if pregnancy happens at a time when the woman is not ready (physically, emotionally etc) for a baby and other external stresses

So, I end as I started. This is a rare condition. The women with this condition would not really ‘know’ that they are pregnant and so this is probably more of an incidental finding at the time of delivery. If you do suspect that you are pregnant and it is not being picked up, then you should be seeing your obstetrician more regularly and he can advise on other specialties to involve after listening to and examining you.

All the best!