chatwithketch

Q: How are you doctor. Can l ask? Which contraceptive can l take so that l can see my menstruation while breastfeeding. Here in South Africa after birth they inject depo and l heard many people saying it’s not right. Which one should l opt for?

A: Well, a breastfeeding mother should definitely not be taking any medication without speaking to her doctor. That’s for sure! 😀 This is because drugs that you take will also end up in breast milk. Most times, the concentration of these medicines in breast milk is so small that it hardly causes any problems in the baby but in some instances, they could get very concentrated in breast milk, putting the baby at risk. So, all medication choices, be they contraceptives or otherwise, must pass through your doctor.

A very common question I get asked is if breastfeeding mums can get pregnant. The answer is yes. If you’re exclusively breastfeeding, feeding your baby on demand (every 4 hours), you’re within 6 months of your baby’s birth and your menstrual period has not returned after the birth of your baby, you stand a better chance of not getting pregnant during this period. However, this is not a reliable method.

Birth control pills can help prevent pregnancy at this time. Pills that contain estrogen may lead to reduction in breast milk supply (PS: recent research suggests otherwise and yes, combination pills contain estrogen). Therefore, it’s a good idea to avoid such pills at this time or better still be guided by your doctor. Pills that contain only progestin (like the minipill) is a better idea as it does not affect breast milk supply. Depo is a type of minipill but it’s all about the timing of the medications. It’s usually taken at the same time daily. It’s best to start this discussion about your suitability for this contraceptive before you have your baby or immediately after so that your doctor can advise as to when you should start taking the pills. Don’t go starting on the pills without your doctor’s say-so because started too early, it could have adverse effects. Barrier contraceptives like condoms, diaphragms etc can also serve the purpose of preventing pregnancy before you start on the minipill.

There are, of course, other methods of birth control available eg Intra Uterine Device (IUD), implants, patches etc also exist and you may want to discuss these other options with your doctor as you conclude breastfeeding.

Return of menses following delivery is varied between individuals. Some women would see theirs a few weeks after, some others after a few months or even a year, while in others there is no return of menses before another pregnancy begins.

Different women also report different changes with their menstrual periods after childbirth. Some report longer periods. Others report shorter periods; some others report less pain and others observe absolutely no change at all 😀

However, the pattern of your menstrual cycle prior to your previous pregnancy (if it was regular or irregular) also plays a role. The duration of your labor and the presence of complications like bleeding after delivery could all play a part in the return of your period.

Exclusive breastfeeding and presence of underlying infection could also delay the return of menses. Breastfeeding women are less likely to have frequent or prolonged bleeding on the minipill but taking the pills might delay the return of your period even longer.

Have a great week ahead 😀

‘Learn the most common sources of sodium in your diet and some easy substitutions you can make.’

https://www.health.harvard.edu/heart-health/simple-swaps-to-eat-less-salt

Q: Hi doctor! Please I need your help. My friend has this problem for a long time, all her body is itching her and when she scratches any part of her body, it gets swollen. She has used everything they asked her to use but it’s not working. Please help her, because she said that if it starts, it’s like she’s going crazy when she’s scratching her body. I will be glad if you can help us. God bless you

A: Body itching can be caused by different conditions including:

• Skin reactions to heat or allergies
• Skin conditions like eczema, dandruff or psoriasis. For more on eczema and dandruff, please click on these links https://chatwithdrketch.com/2014/03/01/daily-health-tips-what-can-i-do-about-the-eczema-on-my-skin/; https://chatwithdrketch.com/2017/05/18/hlwdk-daily-health-tips-help-with-dandruff/
• Parasitic infestations like scabies. For more on scabies, please click on this link: https://chatwithdrketch.com/2017/07/22/hlwdk-daily-health-tips-scabies/
• Fungal infections like jock itch or athlete’s foot. For more on scabies, please click on this link: https://chatwithdrketch.com/2018/03/31/hlwdk-daily-health-tips-athletes-foot/
• Hormonal changes during pregnancy or menopause
• Other medical conditions like thyroid, liver or kidney problems
• Dry, cracked or irritated skin. For more on eczema and dandruff, please click on this link: https://chatwithdrketch.com/2017/12/29/hlwdk-daily-health-tips-i-itch-after-every-bath/
• Nerve dysfunction
• Medications

Treatment of skin rashes is, of course dependent on the cause. It may include any or a combination of medications (anti-histamines), wet dressings on affected areas and phototherapy. If the itch is severe enough to affect your daily life, lasts more than 2 weeks, keeps coming back, is all over your body, is associated with other symptoms like yellowness of the eyes, please see your doctor immediately.

What can you do at home to provide relief and minimize harm to yourself? I’ll split them into dos and don’ts

Dos

• Keep your nails short so that you don’t do mortal damage if you do scratch J
• Or if you don’t want to do that, you could wear gloves to sleep at night – that way, even when you scratch unconsciously, no harm done
• Try patting the itchy part instead of scratching
• A cold compress held against the itchy part can also help reduce itching
• Wear more cotton fabrics to allow your skin breathe and not chaff your skin
• Use cotton beddings for the same reason

Don’ts

• Avoid hot baths. Keep bath water cool or lukewarm. Want to know why? Read this!
• Avoid vigorous drying off after a bath. Dab your skin dry
• Avoid perfumed products – soap, deodorants, shower gels, lotions etc
• Avoid tight-fitting clothes. They make a bad matter (itch) worse
• Avoid harsh detergents for laundry
• Avoid spicy foods – they increase blood flow to the skin and make itching worse

Have a good evening 😀

Q: Hi Dr. I’m 5months pregnant but my baby is not kicking yet – only moves. Any idea?

A: The first time you feel your baby’s movement is known as quickening and the time women feel it varies person to person. It ranges from 16 to 25 weeks but women who have had babies before may feel this much earlier. Women describe it as different things: a bubbly feeling, butterflies in their tummy, gas etc.

You would have observed that your doctor or midwife has asked you to be aware of your baby’s movement and specifically, make a note to let them know if the movements reduce. This is because reduced baby’s movements may signify baby is in distress or other problems.

It is possible your baby has kicked but perhaps, you are expecting some other kind of sensation, you have not taken note. There are a couple of things you could do to feel your baby’s kick, though J

You may notice that when you drink cold water, that baby moves around. This is, theoretically because the uterus/womb is close to the digestive tract such that the cold water in the digestive tract stimulates the baby to move. Women who feel concerned about their baby’s movements are sometimes asked to do this and check for baby’s movement. Babies also tend to move around a lot after a meal. If you’re struggling to sleep and baby is intent on finding a comfortable position, his/her movements can also get exaggerated 😀

Having said all of these, if you do believe baby’s movements are less frequent or vigorous than they should be, please see your doctor about this. Better safe than sorry.

Have a great weekend! 😀