chatwithketch

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

Q: What drug can I use to control worm in my stomach? It disturbs me after eating. My stomach makes noise after eating.

A: Hey! Thanks for writing in.

How do you know your symptoms are due to worms? Was your stool (faeces) examined? It’s important that you visit the health facility to get a proper diagnosis so that appropriate treatment can be started.

Having said that, worms oftentimes do not present with any symptoms but sometimes people with this infestation complain of non-specific symptoms of the digestive system (like your complaint).

So, what is a worm (helminth) infection? There are different types. I will explain a couple.

A) Ascariasis – This is a type of roundworm infection and is one of the most common types of worm infections. This infection is spread when a person comes in contact with ascaris eggs in soil mixed with human feces or infected water. This is common in many developing countries, with poor sanitary conditions leading to people defaecating in fields and ditches and sometimes, human feces is used as fertilizer. When children play in this sort of environment and inevitably put dirty fingers in mouths or when unwashed fruits and veggies grown in the contaimnated soil, infection occurs

Most people will show no symptoms but a heavy infestation will cause problems depending on the area of the body affected.

In the intestines, the severity of symptoms depend on the number of worms

• Abdominal pain, which could be vague or severe
• Nausea and vomiting
• fatigue
• Diarrhea or bloody stool
• Weight loss
• Presence of worm in stool or vomit

In the lungs, they cause symptoms that resemble those of asthma

• Wheezing
• Persistent cough
• Shortness of breath

Prevention is really through good personal hygiene. Wash your hands before meals, before food prep, after using the bathroom, after gardening or coming in from outside. Just make it a habit to consistently wash your hands

Then practice good food hygiene too. Wash your fruits and veggies thoroughly before use, especially those that will be eaten raw. Drink only potable water – use bottled water (especially when you travel) or boil and filter your own water at home.

Other soil transmitted helminths are hookworm (usually causes iron-deficiency anaemia) and trichuris trichuria aka whipworm.

Diagnosis is by stool microscopy and treatment with anti-helminthics, mebendazole, ivermectin or albendazole is usually effective.

Surgery may be necessary in cases of heavy infestation to remove worms and repair damage or obstruction of the intestines, remove inflamed appendix or remove bile duct obstruction

B) Another example of infection caused by worms is elephantiasis. Elephantiasis is a disease condition in which there is swelling of the limbs, genitals or other body parts making them appear swollen and puffed-up, resembling an elephant. How does this happen? It actually starts with the bite of an infected mosquito (Aedes, Culex, Mansonia or Anopheles mosquito) which transmits filarial worms that block the lymphatic system. I see the look of confusion already on your faces! JWhat’s the lymphatic system, you say “)

Well, the lymphatic system is a network of vessels and glands distributed all over the body. They help to fight infections and drain excess fluids from tissues in the body. When this system is blocked, fluid no longer drains freely from the tissues leading to collection of fluids in the tissues, resultant body swelling and fever when this fluid collection gets infected. Chronic (longstanding) infection with these worms leads to elephantiasis with swelling (lymphedema) and hardening of the limbs. It really does require years of exposure to these infected mosquitoes for elephantiasis to occur. It is important to handle the infection before it gets to this stage.

Most people, however, will not have symptoms until years after being exposed when they develop these swellings.

There is no medication that is really active against adult worms. Focus is on management of symptoms. Exercise encourages lymphatic drainage, healthy diet, good skin care to prevent infection can help. Wearing special compression stockings/garment or having a special massage by a specialist to help lymph fluid drainage are also helpful aids.

Prevention of elephantiasis is key.

• Use of mosquito nets
• Use of medications to kill microfilariae in the blood
• Antibiotics for infections
• Surgical prevention of infected tissue

C) Schistosomiasis, another worm infection, is acquired by exposure to fresh water contaminated by snails especially in sub-Saharan Africa. Infection can persist for many years after exposure and symptoms include those of:

• Chronic renal failure
• Bladder cancer
• Portal hypertension

Diagnosis is made by:

• Stool microscopy
• Urine microscopy
• Schistosoma serology

Treatmentis usually with a medicine called Praziquantel.

So, as first steps, I suggest you go visit your doctor and get a proper diagnosis. After that, the right treatment option for you will be started.

Does exercising to relax sound like a misnomer? Well, read the question and answer below from someone who wanted to know if exercise was stressful.

Q: Can there be anything like stressful exercise?

A: I’ve been asked this question a lot of times. Some people think that exercise may actually worsen hypertension by causing more stress. This is a wrong notion. Exercise is useful in relieving stress by causing the release of body’s natural ‘feel-good’ hormones. These make you feel better, happier and look at your challenges, perhaps more benevolently!

However, if you have been sedentary for a while (that is, if you have not been involved in much physical activity for a while), please discuss your planned exercise regimen with your doctor before starting out.

You should also invest in heart rate monitors which ensure that you exercise within a ‘zone’ where you optimally lose calories and do not overdo it. You should also learn how to ‘roughly’ calculate your target heart rate…this is is that heart rate at which you burn calories optimally. We will look at the calculation of Target Heart Rate subsequently. But the rule of thumb is to take away your age from 220 and calculate 60% and 80% of that figure. Stay within that while exercising. The calculation (Karvonen method) is a bit more complex though and we will get into that another day.

For more on this, please click on the link below.

https://www.health.harvard.edu/staying-healthy/exercising-to-relax

Q: Good evening Doc, I am 38 weeks pregnant. On my last ANC visit the doctor detected a trace of +1 protein in my urine and my blood pressure was high. Please ma’am what food and things can I do to reduce protein and high blood pressure?

A: A high blood pressure reading in pregnancy with protein in urine is a worrying situation. Blood pressure readings are interpreted as same, pregnancy or no pregnancy. Any level more than 140/90mmHg is seen as hypertensive. This of course has some slight changes with the new classification of high blood pressure. A woman may already be hypertensive before pregnancy and on medication. She may be found to be hypertensive before 20th week of pregnancy in which case it is believed she had previously undetected high blood pressure or she may be discovered to have high blood pressure after the 20th week, in which case it is believed that this high blood pressure is pregnancy-induced (Pregnancy Induced Hypertension: PIH). This would usually resolve within 6 weeks of having a baby. If a woman with PIH goes on to develop protein in urine, she is at risk of preeclampsia (in which protein leaks from kidneys into urine) or eclampsia (in which the woman experiences fits and seizures)

The risk of preeclampsia is higher in women who have had this condition in a previous pregnancy, first pregnancies, women who get pregnant after the age of 40 years, women who are obese and women with multiple pregnancies or those who have a long interval between babies (greater than 10 years) or short interval between babies (less than 2 years) etc

High blood pressure in pregnancy needs to be addressed as this poses a danger to both mother and baby. It may affect the flow of blood and nutrients to baby leading to slow growth or pre-term delivery. It may also lead to eclampsia or separation of placenta from the uterine wall before the baby is born.

Your doctor will determine the best course of action and may prescribe medications (to reduce blood pressure, or to even prepare your baby’s lungs for life outside the womb given the anticipation of preterm delivery), hospitalization to monitor you or delivery of the baby if the doctor believes the womb is now a hostile environment for the baby due to any of the dangers mentioned above.

There are varying thoughts about strategies thought to help prevent this condition. However, ensuring that risk factors are reduced by reducing weight, eating and living healthy may be helpful strategies. For tips on healthy eating, please click on this link https://chatwithdrketch.com/2018/04/02/hlwdk-daily-health-tips-healthy-eating/

For more on blood pressure, please click on the links below:
https://chatwithdrketch.com/2013/12/10/daily-health-tips-blood-pressure-the-fact-behind-the-figures/

https://chatwithdrketch.com/2014/06/12/daily-health-tips-pre-hypertension/

https://chatwithdrketch.com/2013/12/11/daily-health-risks-my-high-blood-pressure-risks/

Be sure to make your antenatal classes interactive….the one or two that you have left. Ask your doctor questions about your health and indeed your blood pressure readings if they are cause for concern.

All the best!

Have a great evening, y’all 😀