chatwithketch

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. 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!

I don’t swim. I would love to swim but I just don’t 🙂 I remember when my children were younger and I would take them to swimming classes. I would settle down by the side of the pool to study for my MBA and later my MPH. It was during one of those study-swimming time that my son almost drowned, but for my watchful mother’s eyes! He removed his floaters, because he wanted to prove he was a big boy…and even though he was in the shallow pool, he could do what the big kids in the big pool could do. He didn’t make a sound, but somehow, I felt compelled to look up and found my son with terror in his eyes struggling in the water. My mother’s instincts kicked in! I jumped into the pool with my jean trousers and picked him up. It never crossed my mind that I couldn’t swim and I was putting myself and him at even greater risk. Thank God, the pool was shallow……

Anyways, as my children grew older, they begged me to learn and all wanted to teach me. Again, I have never taken them up on their offer 😀 One of the key issues that stopped me and which I keep warning them about is not to go swimming in just any pool. I worried about what germs lurked in the water just because of the anonymity people had to do stuff inside the water and not be seen, like blow their nose in there, urinate etc. 😦 Maybe, I have an overactive imagination! Or maybe not! If you’re checking into a hotel and planning to go swimming, please be careful. You may be at risk of ‘catching something’ Read!

https://www.health.harvard.edu/diseases-and-conditions/hotel-pools-and-hot-tubs-may-bring-health-risks

Q: Good day doctor. Can you please help me? I need clarity. If you had an implantation bleeding and found out that you are pregnant, how do you calculate weeks of pregnancy? Do you start from last period or the day of implantation day? Please help. Thank you

A: Implantation bleeding is typically a small amount of light bleeding that occurs about 10 to 14 days after conception. This is thought to be due to implantation as the fertilized egg implants itself in the uterus (womb). This usually occurs in early pregnancy, close to or about the same time as the menstruation would be seen and is thus often mistaken for a period. But, it is usually lighter than menstrual…typically without clots. It would stop on its own and does not require further treatment. If the bleeding is heavier, associated with cramps or any other complication, please see your doctor. As a rule of thumb really, any bleeding in pregnancy should be investigated as they may be due to more serious conditions like ectopic pregnancy, miscarriage and infections.

Now, as to dating pregnancy, this is best done with the use of the last menstrual period – that is the first day of the woman’s last normal menstrual flow. However, if she is not sure of her dates, then a scan can be used. To date pregnancy, a first trimester scan gives the most appropriate approximation. The earlier it is, the more accurate it is likely to be.

I hope this helps 🙂

Do you have belly fat? You should do something about that, quickly!

https://www.health.harvard.edu/blog/belly-fat-linked-with-higher-heart-disease-risk-2018072614354

In honour of World Breastfeeding Week 2018, I will dedicate the rest of the breastfeeding week (up till 7th of august) to breastfeeding posts. So, send in more questions on breastfeeding and I will get to as many of them as possible

Q: Hello Dr. How many years/months should a mother breast her baby? Thanks

A: A mother should breastfeed her baby with breast milk ONLY for the first six months. After that, she can add other foods while still breastfeeding her baby. She should actually continue breastfeeding until the baby is 2 years old.

Q: Hello Doctor Ketch please I need your help! I have a 3 months old baby. I stopped breast feeding her because I had a very big boil on my breast! After the boil was treated I wanted to try breast feeding her again but it just was not flowing. At the moment it’s dried up! I’m worried! What can I do for my breast milk to flow well so I can continue breast feeding her?! I feel so bad knowing that I can’t breast feed her! Please reply me soonest!

To respond to this question, I reproduce the contents of a post I had made on this same subject.

A: My dear, even if you’re exclusively breastfeeding, you still stand a chance of getting pregnant. Please use some method of contraception if you do not wish to get pregnant again, now.

For more on this, please click on this link: https://chatwithdrketch.com/2015/01/08/daily-health-tips-contraception/

Q: Good ma’am. Thanks for being there for us. Please help me out, this is my first child. I planned to breast feed him for 6 months but sickness did not allow me for one month. I am ok now and I want to feed my baby with breast milk but it is not coming out. Please, what will I do? Can I still feed him with breast milk? If I see him sucking his finger, it makes me shed tears. Please, help me.
A: Hello dear, thanks for writing in. Being a first time mother can be overwhelming especially when we cannot fulfill all the dreams we had dreamed for our babies. I’m sorry you could not breastfeed your baby earlier. But all hope is not lost. Re-lactation (re-establishing the process of breastfeeding after it had been stopped) may not be the easiest process but can still happen.
First, you have to let go of all feelings of guilt. Breast milk is the best food for baby, but if you couldn’t breastfeed because you were ill, then there’s really nothing that could have been done. Trust me, you’re better off to your baby alive than incapacitated in any way! So, chin up 😀 Smile…

Now, you will need loads of support from your medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching you how to latch baby on properly to your doctor prescribing a medication that encourages milk production. Drugs and foods that encourage milk production are called galactogogues and for the foods, a number of local foods have been touted to help eg Pap (akamu, ogi)
This process requires loads of patience. You have to put baby to the breast as often as possible (at least every 3 hours) or failing that, use a breast pump to extract as much milk as possible. Remember that the sucking process/nipple stimulation encourages milk let-down. Being relaxed and thinking about you and your baby in a nice cozy environment, breastfeeding and bonding may also help this process along.

You may want to assume the regular position you used to adopt when baby was breastfeeding and ensure that baby gets skin to skin time with you. It may be easy for baby to immediately go back to breastfeeding, other times, it may take a while. You need to know when the baby is sucking and indeed whether he’s getting enough. Your baby should make at least 6 wet nappies per day. If baby is not getting enough breast milk at the beginning of this process, you may have to supplement with formula. Use a cup and spoon to avoid nipple confusion.

Be sure that you are getting enough fluids yourself and eating nourishing foods.

For more on breastfeeding, please click on the links:
https://chatwithdrketch.com/2014/07/13/daily-health-tips-can-my-breast-milk-get-sour-if-i-dont-express-it-and-my-baby-refuses-to-feed/

https://chatwithdrketch.com/2014/09/12/daily-health-tips-im-a-breastfeeding-mother-who-just-developed-a-painful-lump-in-my-breast-could-it-be-cancer/

https://chatwithdrketch.com/2014/09/01/daily-health-tips-breastfeeding-challenges/

https://chatwithdrketch.com/2014/04/22/daily-health-tips-please-help-my-breasts-still-feel-engorged-though-i-stopped-breastfeeding-some-days-ago/

https://chatwithdrketch.com/2014/05/27/daily-health-tips-what-should-i-do-after-having-my-baby-if-my-breast-milk-doesnt-come-in-immediately/

Have a great night y’all and an awesome week ahead 😀

It is World Breastfeeding Week (WBW) again. It’s celebrated every 1^st to 7^th of August annually. As a mother, it’s a time I take stock of the many challenges I passed through to ensure my children were breastfed. My first daughter, who I almost breastfed for 2 years (which is the standard teaching :D) turned 16 years in May and graduated high school, a few months back. I cannot but be thankful for this milestone in her life even while I consider the impact of breastfeeding in her journey. She was never a sickly child, always a bundle of energy and joy. And we have always had a great bond which was a combination of the breastfeeding bond-building but also the fact that she was my constant companion in her first few years of life. I gave up work for those two years to exclusively breastfeed while looking for a job that would allow me bring my daughter to work J

With my second child, I realized that while in theory, the world liked the idea of women practicing exclusive breastfeeding, businesses were not willing to take the chance to employ one and give her an opportunity to breastfeed and bond with her baby. Therefore, I decided that if I couldn’t beat them, I would join them. And so, breastfeeding was for a short period and daycare was my saving grace. I went job hunting and threw myself into work. Mind you, I was not an absent or bad mum. No! I didn’t even have a house help so, my day was split between office and house work. But my second daughter was quite sickly and always pale as a child. Happy to report that she’s grown out of this and we have a great bond, but it was a source of concern at that time. I could never stop thinking that it was partly because I did not breastfeed her for long.

With these two experiences behind me, when I had my last child, I knew what I wanted and what I did not want. I wanted to work but I also wanted to breastfeed. Therefore, I made plans to do just that. First, I got help. I do not know why we think that we get a halo of sainthood when we over-stress ourselves trying to take on everything by ourselves. Nobody gives you an award. If anything, you will get called out for letting the ball drop on stuff. In addition, I got a driver and a breast milk pump J At work, I would retire to a private place to express breast milk and my driver would take it home for my house help to freeze. My son grew up really well-adjusted and today, I am amazed at the strapping young man developing before my eyes, and about to hit the magical teenage number this year 😀

Why do I go down memory lane to commemorate WBW annually? It’s because I see that a lot of women deprive themselves of the joys of breastfeeding because they don’t believe it’s cool, think they are overwhelmed, believe it’s not as healthy as formula feeding etc. As a doctor, I was taught that breastfeeding was the ultimate but personally, I have tried different scenarios and can speak to what works…and it tallies with what research findings supporting breastfeeding say 😀

So, as we celebrate WBW week this week, with the objectives of 1) informing people about the relationship breastfeeding and good nutrition, food security and poverty reduction and galvanizing action to advance this; 2) anchoring breastfeeding as the foundation of life and 3) engaging with individuals and organizations for greater impact, I share some key tips for mothers who wish to breastfeed even when working. It is difficult but possible. Here’s how!

First, get some help at home. Don’t let anyone shame you into thinking you’re lazy if you do that. You don’t owe any of them any explanation ;D Get a washing machine or someone to do the laundry. If you don’t want a live-in help, get a daily. But whatever you do, get help! You’ll be a lot happier. Trust me, I know!

As a working mum, you will have to express breast milk often. To express milk for your baby, first, you have to be committed to be hygienic because you don’t want to introduce germs into your baby, do you? Always scrub your hands with soap and water whether you are using the breast pump or your hands.

Having expressed the milk, when stored at room temperature, be sure to use up the milk within 6 hours.

When stored in the fridge,
• Ensure that the temperature in the refrigerator is below 5 degrees centigrade.
• Do not store on the door of the fridge. Please store on the shelf towards the back of the refrigerator where it’s cooler
• At this temperature, you can store milk for up to 5 days.

When stored in the ice compartment of the refrigerator, you can store milk up to 2 weeks

When stored in the deep freezer, you can store milk up to 6 months.

To thaw frozen milk, please put it in the fridge. When it’s thawed, you may feed your baby with it but if your baby prefers it warm, you can run some warm water over the bottle until it’s just right. Do not microwave it as this may create some hot spots in the bottle which may cause scalding of your baby.

Once thawed, please don’t re-freeze the milk as this might encourage the growth of micro-organisms.

Make sure that the container used for storing milk is sterilized to prevent any potential introduction of germs into the milk. Use small containers that hold just about the amount that your baby finishes per feed.

If you express a lot of milk, be sure to label the different containers and use the oldest pack first. Please stick with the duration of storage guideline we’ve given.

Now, it goes without saying that you should not store milk close to contaminants like meat, fish or even strong smelling foods like onions 😀 You don’t want your baby’s milk smelling fishy 😀

Have a great evening y’all and encourage someone today to start or continue breastfeeding 😀

Q: Hi Dr. Ketch, is there diet that make a baby in the womb grow tall after birth?

A: A person’s final height is as a result of a combination of factors: genetics (if your parents are short, you are more likely to be short), nutrition (during the critical growing up years and especially before birth), general health and hormones (growth hormone, thyroid hormone and sex hormones). Having said these, there’s no hard and fast rule really, as some ‘short’ parents give birth to tall children and vice versa.
As I mentioned above, the fastest period of growth is experienced before the baby is born. Thereafter, another growth spurt is experienced during puberty with boys generally growing more than girls. During this period, the growth plates (areas of growing tissues located at the ends of long bones. These are the areas where bones grow) are very active until they end of puberty when they mature, fuse and stop growing. Once the growth plates are fused, growth has been concluded and height cannot be increased. There is no specific age at which this occurs really: people who start puberty early will probably stop growing before others who started later.
‘Normal’ when used to describe height can vary from place to place with differences in ethnic groups, cultures and continents. Sometimes, there may be a medical condition associated with height variations (short or tall statures), but most people are normal and just at the lower end of normal (for the short) and at the higher end of normal (for the tall).

If the cause of ‘shortness’ is a medical problem or a hormone deficiency, this can be rectified. For instance, if there is a deficiency of growth hormone, this may be administered. However, this can only be done in children…before the growth plates fuse (at about 14/15 years for girls and at about 16 years for boys). Once this has happened, no drug can increase height. Surgery in which the legs are cut apart and then gradually separated to increase height is an option, with attendant possible complications of infection and of course, fracture. Not really advisable.

So, to your question, from the time the baby is born, focus on the right feeding. Start with breast milk. Breast milk, beyond being cheap, temperature regulated and readily available 😀 is formulated with everything your baby needs for each stage of his growth. It’s chock full of immunoglobulins (which makes them resistant to illnesses), vitamins, minerals, proteins, fats and oils. So, it is indeed a complete meal! It also helps the womb to return to normal size after childbirth. From six months, baby is ready to be introduced to some other food.
For a long time, the standard teaching had been to go for rice cereal as the first add-on meal because it is bland and babies tolerate this well. Other studies question this wisdom now and suggest that foods like meats with lots of essential nutrients like iron may be a good place to start. What should you do? You can boil beef/chicken very soft and blend it up for baby. If baby tolerates this, then by the next week, you could try adding some rice cereal. Try not to introduce more than one food per week so that you have time to study how your baby adapts to it and of course, look out for/isolate food allergy. And, to start off, only one meal of the complementary feed should be given daily. The rest should be the usual…breast milk 😀 This will, of course, as baby tolerates.
From one year of age, you can add cereals and it’s also okay to introduce cow milk at this time. Full cream cow milk is advocated at this time for proper brain development. Thereafter, please switch to skimmed/1%/2% milk as full cream milk has a lot of saturated fat which may contribute to poor heart health. Grains, green leafy vegetables, cow milk, honey, whole eggs can generally be introduced after the baby turns 1 year old.

Generally, other weaning foods that can be introduced include:
Boiled egg yolk (egg whites contain substances that baby may react to), sweet potatoes, fish, chicken, beef, fruits like banana, avocados, boiled beans (with skin removed if possible etc
Simple recipes include, blend some chicken or beef with the stock or mash a banana and add to baby’s cereal.

Our local cereals can also be used and fortified with some breast milk or formula.

As baby tolerates these meals, you can get a little more adventurous.

Boiled carrots mashed with some coconut oil or a little yoghurt with mashed banana may not go amiss too.

I hope this helps!

Have a good night, y’all 😀

What sort of plastics are harmful? Why is it better to use glass rather than plastic in the microwave oven? What about canned foods and drinks? Are the containers safe and good for your body? You should read this!

https://www.health.harvard.edu/blog/common-food-additives-and-chemicals-harmful-to-children-2018072414326

As a christian, I live by the dictum, ‘why worry when you can pray?’….and then work, because the bible says, ‘faith without works is dead’. What helps keep your sanity and maintain your balance between worry and anxiety? Read what this Harvard Health blod says:

https://www.health.harvard.edu/blog/do-i-have-anxiety-or-worry-whats-the-difference-2018072314303