chatwithketch

Q: Good evening Dr, please why does my breast remain the same even while pregnant and any solution to flattened breast? Thanks

A: Thanks for writing in. Pregnancy affects different people differently, you know. Some people will feel that their bust doubled in size immediately and for others, it’s the opposite J

Please see below, normal symptoms of pregnancy and I’ve also thrown in a bonus…the red flags (symptoms that should make you show up in the hospital immediately).

Breast tenderness: this is inevitable as your breast ducts prepare for the job of lactation. Bra sizes could go up from 1 to several sizes up. Perhaps yours went up just one or perhaps even just remained the same. It is not abnormal. If it does start to increase, be sure to get a good support bra and keep going up sizes as your breast size increases. This will help reduce sagging.

Discharge: A thin milky discharge is normal during pregnancy. But if this becomes yellow, greenish or foul smelling, please see your doctor.

Heartburn and Constipation: These happen due to one of the hormones produced during pregnancy. The antenatal vitamins also play a part in worsening constipation J

Frequency of urination: As the baby grows in the uterus, it presses on the bladder making you feel like urinating more often.

Tiredness: As your body works overtime to support a growing life inside you, you would feel exhausted.

Food cravings and aversions: Well, I certainly had loads of aversions with my first pregnancy. I can’t remember any cravings as I couldn’t get any food to stay down. However, some people develop a craving for the oddest, craziest foods when pregnant. Go easy on eating for two though…the healthy living dictum of eating loads of fruits/vegetables and low calories does not change during pregnancy. The more you gorge or give in to the food cravings, the more work you have to do to get it off after the baby. However, if you find yourself craving things like clay, sand etc, please see your doctor as it could be a sign of iron deficiency anaemia.

Morning sickness/nausea: This is due to the hormones of pregnancy (again!). This may be mild or so severe that the person actually gets hospitalised. If your nausea is severe, please see your doctor. But generally, you can help push this back by eating some bland food especially in the mornings when it is worse like crackers or cheese. 

So, as you can see, most of the symptoms you have complained about can be explained away by pregnancy! 😀

Now for the red flags…these have to be checked out by your obstetrician immediately:

Significant bleeding. If you’re not sure what is significant and what’s not, please see your doctor all the same. Better safe than sorry.

Severe abdominal pain: This could be a sign of a threatened miscarriage

Severe nausea/vomiting: This could lead to dehydration which could affect the baby adversely

Severe dizziness

Too little weight gain or too much weight gain: Try to keep weight gain between 11 to 15kg during the pregnancy. Your doctor could have recommended more or less depending on your pre-pregnancy state.

Pain or burning sensation when urinating: This could be a urinary tract infection. It needs to be dealt with.

Vaginal discharge: Foul smelling, yellow or greenish colour could indicate an infection and could affect your baby.

High fever: This could signify an infection.

As for what you can do about the morning sickness, here’s a post I had done on this recently.

The standard teaching is to try eating some bland foods like Crackers biscuits or dry toast. That personally didn’t work for me. I preferred tart things…which some may want to avoid. I loved lemons during my pregnancies. They were the one thing guaranteed to ‘wake up’ my mouth and chase nausea far away. I also had a particular brand of very tart bubble gum, I indulged in 😀 These were key for me because, though I didn’t have the real bad case of morning sickness that sent you to the hospital, brushing my teeth in the morning always sent me into a bout of retching/vomiting. Therefore, I always had a ready supply of the gum or lemon/lime to pop into my mouth once I was done brushing/retching! Not a very pleasant memory ;D

So, if lemons work for you to prevent nausea, go for it. Remember that moderation is key. A few drops (one or two) in a glass of water are enough to provide that tart kick that sends nausea far away. There is a catch here though…remember the heart burn associated with pregnancy. The acid content of lemon might make the heart burn and any pre-existing gastro-esophageal (stomach and esophagus/gullet) problems worse. So, this is all the more reason to be very moderate or stop if it exacerbates an already bad case of heartburn. Wherever and whenever in doubt, please be sure to see your doctor.

Other tips:
• Eat little amounts of food frequently as an empty tummy increases the likelihood of throwing up. Remember this is not an excuse to binge and over eat 😀
• Avoid fatty and greasy foods.
• Avoid smells that trigger nausea
• Cold foods may be preferable to hot as the former does not give off smells that may cause you to feel queasy.
• Get loads of fresh air and rest
• And drink sufficient fluids daily

Have a great day, everyone 😀

Q: My son is a month and two weeks old. Ever since he was born, he grunts, fusses, kicks, punches, makes cry face and other funny faces when trying to pass gas and poop. He does it every day throughout the day. For example, he was just lying with me, he started stretching his legs out, making cry/fussy noises and pushing hard, all of a sudden, i hear the loudest fart and then he stops. I feel bad for him and I feel like since newborn poop is watery, it should not be a challenge to him. He also rubs his face, pulls his legs, stretches them out too as well as his hands, and makes groaning noises in his sleep. Please are these normal???

A: Thanks for writing in dear. The first thing to do when you are not sure what is wrong with your baby is to go see the paediatrician (the baby’s doctor). It is better to be safe than sorry.

The good news is that your baby makes stool and farts (?) normally.

The stomachaches that babies have (colic) can be very distressing for a parent to watch but perhaps understanding what it is about may be helpful. Colics usually start occurring in some children between 3 to 6 weeks of age and disappear between the 3rd to 4th month of life, without any treatment. So, your baby fits right into this age group. Unfortunately, we still do not really know what causes these colics and why some babies suffer from it while others do not. However, it has been found to occur more in first born babies (whether boy or girl), formula-fed babies and can also be associated with the diet of a breastfeeding mum.

Some modifications may help reduce their severity:

§  Be sure to burp baby after each feed

§  Hold baby and gently rock her after a feed

§  Hold your baby upright during her feed

§  Check your diet: reduce caffeine-containing foods and sometimes, it may be the dairy in your diet that you baby is reacting to. Taking dairy off your diet for a week or two may lead to improvement in symptoms.

Remember to see your doctor where in doubt, especially if this continues past the time noted above.

Just a note about gripe water which a lot of people want to give their babies when they have this condition….honestly, the benefits are more in our imagination than in actual fact 😀

So, with or without gripe water, this colic shall pass

Have a great night, y’all 😀

Q: Hello Doc. This will be my third message to you. I hope u reply this. What should I actually do after delivery to make my body return to normal. Ave been giving several advice and now am confused. Please, take me through what to do.

A: Hi dear, thanks for writing in. The first thing people worry about is if they don’t take pepper soup with special spices, then they might have problems conceiving later. But there’s no truth to that! 😀 These are, usually, spices used to make Nigeria’s specialty pepper soup for women who just delivered. I understand the spices are meant to increase blood flow and help the tummy return to its normal size. The good news is, you don’t need the soup to have good blood flow or for your tummy to return to normal size.

Exclusive breastfeeding, usually, is for 6 months after which other feeds are added. Aim to do this for your next baby…except there’s a medical reason why this cannot happen. Breastfeeding helps the process of the womb contracting and returning to its normal size (involution). This process takes about 6 to 8 weeks and the womb (uterus) should be back to its pre-pregnancy state. Note that I said that breastfeeding speeds up this process, but even without it, the uterine involution continues. Trust me, I did not have the Mbaise udah and aju and I managed to have three children with no issues 😀

Having said that, the major things that help your body return to normal are diet and exercise….oh and breastfeeding, as I mentioned above. However, breastfeeding is not very helpful if one is not exercising and watching their portions. Again, the dictum of feeding for two here does not also count.

The diet to focus on is the very same one we talk about all the time: fruits, veggies and complex carbs with focus on healthier cooking methods (less frying etc). Exercise should focus, initially on pelvic floor exercises especially if you are leaking urine when you cough or laugh. To locate your pelvic floor muscles, try holding your urine when you feel pressed. If you are successful, then you have located the muscles you need. Then empty your bladder and lie on the floor. Contract those same muscles, hold the contraction for about 5 seconds, and then relax it for about 5 seconds. Gradually build this up to holding the contraction for 10 seconds. Repeat this about 3 times a day. Once you no longer leak, you are ready for your exercises.

Have you noticed how it is usually easier to lose the baby weight after your first baby and harder afterwards? 😀 Focus on building up your stamina gradually especially if you were not very active in pregnancy or before. Please always remember to contact your doctor before starting any vigorous exercise program. As you get into the groove, get down with your aerobics, strength training and sit-ups et al.

This is where breast-feeding comes in, if you’re exercising and eating right, breastfeeding can help lose weight…as much as 300 calories per day. Does tying a wrapper tightly round your waist help flatten tummy? Honestly, I have heard people who swear by that technique. So, what I will say is, if it works for you, why not? Just do not tie so tight as to stop blood flow 😀

How soon to start exercise after having a baby? Well, it depends on how active you were before and during pregnancy. If you were very active, you can start some light stretches as soon as you feel able. However, generally, we advise 6 – 8 weeks after birth to allow for a post-natal check to have been done. Again, start small and allow your body to get into the groove.

I hope this helps.

Good night y’all 😀

Q: Good evening ma’am. Please Doctor, can taking of COLD WATER prevent someone from conceiving? Thanks. God will continue to strengthen you in all your endeavors.

A: There are so many stories and taboos surrounding pregnancy that we need to address, really. Some pregnant women are practically banned from drinking cold water during pregnancy for this and other unclear reasons. There’s no medical basis for any of these stories. If you have a cold and you’re staying off cold water and filling up on warm fluids, I get it! 😀 However, if it’s for any of the ‘traditional reasons’ kindly ask for an explanation if you’re uncertain. Your doctor is always a great and useful resource.

So, in simple language, ‘no. drinking cold water cannot prevent conception.’ And it cannot cause a problem for your baby when you’re pregnant. Whenever I am pregnant, I not only drink cold water but actually take a lot of ice cubes because I can’t just seem to get cool enough! I’m constantly sweating and generally feeling hot! 😀 And I can tell you for a fact that none of my children were born asthmatic or with pneumonia! Having said that, as with everything else, moderation is key!

What you may notice though when you drink cold water is 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.

Here are a couple of other pregnancy myths and our take on them:

Advice 1

You must always have a safety pin on your person; otherwise evil people may steal the baby from your tummy.

Verdict: Fiction

I’m not sure how else to qualify this, except by saying it is beyond weird!

Advice 2

Do not let people cross your leg when you’re sitting down. If they do, your baby will look like them.

Verdict: Fiction

Seriously guys! 😀 This has no basis in reality and even in mythology. If you don’t like people crossing over your legs, that’s fine…but don’t get it twisted. It has nothing to do with how the baby looks.

Advice 3

Do not spend too much time or shout at people you don’t like or your baby will look like them.

Verdict: Fiction

Anything that gets you to stop screaming is a great idea. But let’s do it for the right reasons. Your baby’s looks are determined by genes and not your likes or dislikes 😀

Advice 4

If you scream during labour for your first child, you will scream throughout all your other labours.

Verdict: Fiction

Honestly, if you’d like to give your lungs a work-out during labour, be my guest. Go for it. I really don’t see any problem in it…certainly no documented medical one. In my case, to make up for the two times I tried to keep it all in, as I’d mentioned, I screamed the whole neighbourhood down when I was having my last baby!

But then again, you really don’t need to scream. You can put to bed in a center where you can receive epidural anaesthesia so that the whole process is easypeasy, lemon squeezy 😀 

In Africa, we like to think that if we don’t have our babies the long, painful way, it makes us less of women. But that is not true. The woman who had her baby with anaesthesia and the woman who didn’t both have babies to show for their efforts and I assure you that in both cases, the maternal instincts are not affected.

Advice 5

‘If the doctors tell you that the best option for you is having your baby through Caesarian section, reject it. All the women in our families have had their babies ‘normally’; you can’t be an exception to that rule.’

Verdict: Fiction

Every woman’s story is different and so is their medical history. The history of your mum is not necessarily yours and so, judging what will happen to you at labour and delivery but what happened to your family before you, may be putting you in danger. In some instances, there may not even be a problem with the woman’s ability to deliver the baby, but because the labour is prolonged with the baby in distress, the doctor takes a decision to section the lady. Going against this advice (which is an option open to the woman as the doctor will not force his medical opinions on her) may endanger both mother and baby. So, please be guided.

 Advice 6

If you eat a lot of snails, your baby will spit a lot when born!

Verdict: Fiction

The fact that the snail is slimy has nothing to do with whether baby drools or not. Remember also that if your baby starts drooling when he’s teething, it has nothing to do the snails you ate when pregnant but everything to do with the process he’s going through…bringing forth teeth!

Advice 7

A breast feeding mother cannot get pregnant.

Verdict: Fiction

This actually used to be used as a birth control method called the Lactational Amenorrhea Method (LAM), because the hormones involved in lactation provide some protection against pregnancy-related hormones. However, we have seen again and again, women get pregnant while breastfeeding to know that this is not a reliable method of birth control! 😀

Advice 8

A pregnant mother must not breastfeed.

Verdict: Fiction

Much as it would have been a great idea to be completely done with one baby before starting on another one, the breastfeeding does not affect the baby in the womb. So, do not deprive your born baby of his/her 6 months of exclusive breastfeeding 😀

Advice 9

Pregnant women should not sleep on their backs as this may damage your baby’s eyes

Verdict: Fact and fiction

In the first trimester, if you’re used to sleeping on your back, you can continue. However, as you get into your second trimester, it is fact that pregnant women should not sleep on their backs especially close to term. However, the reason is not because of damage to baby’s eyes. It’s because the woman may feel dizzy as the growing uterus puts pressure on the vein that returns blood from the body making the woman feel dizzy on getting up and the baby may also not get enough nutrients from the placenta in that position Advice 10

If a pregnant woman drinks cold water, her baby may get pneumonia

Verdict: Fiction

Seriously?! It’s fictional enough the fact that we think that in real life, cold water drinking exposes us to pneumonia; but an unborn child….seriously?! This is as fictional as it gets. No basis in truth.

I hope this helps.

Have a good night y’all 😀

Today’s post is dedicated to new mums 😀

What do you need to have in your baby’s diaper bag, especially when planning to go out?

• Diapers: The standard packing rule is that there should be one diaper for each hour you will be out and a few extra.
• Wipes
• Hand sanitizers
• Changing pad
• Plastic bags

Now for tips that help you do the job right!

• Get the right diaper that fits your baby snugly around both the waist and around the legs to prevent leakage, but not be so tight that it leaves marks on the skin and the materials should not rub or irritate the baby’s skin. Avoid the really perfumed brands of diapers as they are very likely to cause irritations.
• We are all aware that we should wash our hands thoroughly after changing a diaper but you should wash up beforehand too. You should try to keep your hands clean anytime you’ll be handling a baby, especially a newborn. Keep a hand sanitizer around the nappy changing area and in the diaper-changing bag. Just give your hands a quick cleaning before the change. Always remember to wipe baby from front to back and of course, wash-up when you are done!
• Newborn poop is called meconium and it is black, sticky and hard to remove. After each diaper change, just slather some petroleum jelly on baby’s bottom. This keeps baby’s buttocks nice and clean from meconium. The next time baby poops, the poop will slide right off!
• If baby’s bottom is irritated, try rinsing it off with a slightly warm spray of water from the sink or shower instead of using baby wipes, which can actually irritate their little butts even further. Always have a good supply of a diaper ointment on hand as it will work wonders and makes baby feel better every time! If your baby doesn’t like to have the ointment applied to their skin, or fusses when you put it on, try putting some right onto the diaper in a strategic location so it will connect with the irritated area once you close the diaper J
• Never leave your baby unattended on a changing table or any elevated surface where you are changing them, even if you are using the safety straps. Keep them safe and secure and let them know that their diaper changes are normal. Never tell a baby they are stinky or yucky. Having a negative attitude toward diaper changing can actually cause a baby to feel shame about their bodies and can hinder potty training, and I’m sure you like all parents, want your child potty trained as soon as possible!

To all you FTMs, I hope this helps! 😀

Have a great week ahead!

Q: Greetings Dr. Please help advice me. I am 21 weeks pregnant. I had a cervical stitch at 15weeks because of threatened miscarriage. Now I usually have stomachache especially when I lie on my left and right sides but a bit comfortable when I lie on my back but of which I know it is not the best position. Dr. is the regular stomachache normal or it will cause a problem? And what about lying on my back?

A: Hi dear, thanks for writing in.

Abdominal pain in pregnancy may or may not be serious.

Harmless causes include:

·      Constipation

·      Gas

·      The growing womb (uterus)

·      Braxton-Hicks contractions (these are ‘fake’ contractions preparing the womb for the main even :D)

Serious causes of pain during pregnancy include:

·      Ectopic pregnancy. To learn about ectopic pregnancy, please click on this link https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/

·      Pre-term labour. To learn about this, please click on this link: https://chatwithdrketch.com/2015/07/28/daily-health-tips-am-i-leaking-amniotic-fluid-liquor-amnii/

·      Miscarriage. To read more on miscarriage, please click on this link: https://chatwithdrketch.com/2015/07/23/daily-health-tips-im-scared-of-getting-pregnant-after-two-miscarriages/

·      Placental abruption. To learn more, click on this link: https://chatwithdrketch.com/2015/03/26/daily-health-tips-placental-abruption/

·      Urinary tract infection. To learn more, please click on this link https://chatwithdrketch.com/2016/02/19/daily-health-tips-re-visiting-chronic-utis/

·      Pre-eclampsia. To learn more, please click on this link: https://chatwithdrketch.com/2015/10/23/daily-health-tips-protein-in-urine-during-pregnancy/

Having said all these, you probably have no way of knowing what is harmless or not. So err on the side of caution and see your doctor if ‘it just doesn’t feel right’.

You should see your doctor immediately so you can stop lying on your back In the first trimester, if you’re used to sleeping on your back, you can continue. However, as you get into your second trimester, it is fact that pregnant women should not sleep on their backs especially close to term. This is because the woman may feel dizzy as the growing uterus puts pressure on the vein that returns blood from the body making the woman feel dizzy on getting up and the baby may also not get enough nutrients from the placenta in that position.

I hope this helps.

Have a great weekend ahead, y’all 😀

Want to lose weight? Want to know what habits to adopt? You should read this! https://www.health.harvard.edu/heart-health/5-habits-that-foster-weight-loss

Q: Good morning Doc, I had my baby in January and started menstruation in August. To my surprise I didn’t see it in October so I bought a pregnancy kit to see what was wrong. It was then I got to know I am pregnant. Should I stop breastfeeding my baby? She’s just 8months 2weeks

A: Hi dear, thanks for writing in.

The ideal situation would be to give some time after you’ve had a baby before having another one. It gives your body time to heal and replenish its stores of essential nutrients before taking on another pregnancy. This is the reason why new mums should ensure that they use some form of contraception after they have had their babies, even if exclusively breastfeeding. And for all of you who are dying to ask, yes, you can get pregnant even before your period ‘returns’.

Having said that, it’s generally considered safe to continue breastfeeding in pregnancy. In fact, some mothers would even breastfeed the new baby and the older one, concurrently. This is called tandem nursing. However, given the requirements of breastfeeding and of pregnancy, this mum must ensure that she is eating healthy and drinking sufficient fluids.

If your already born baby can talk, he may comment on the fact that the taste of your breast milk has changed especially towards the end of pregnancy and a few days after the birth of the new baby as colostrum is produced.

For more posts on colostrum, please click on this link: 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/

For the mum, she may notice more breast tenderness…sorry J And also, milk production reduces as pregnancy progresses.

However, you need to check with your doctor if you have a history of pre-term or premature contractions because nipple stimulation (either during sexual intercourse or breastfeeding) may lead to pre-term contractions.

Your 81/2-month old baby can take other foods now too. You can give her freshly squeezed fruit juices (this basically means you’re buying the fruits and squeezing out the juice yourself or blending up a smoothie). Remember that your baby must not have any cow milk until the baby turns 12 months…well, unless it’s in yoghurt (unsweetened, flavor-free yoghurt). You can add some bananas to the yogurt and blend it up.

For more on weaning and preparation of yoghurt, please click on these links: https://chatwithdrketch.com/2014/12/29/daily-health-tips-weaning-foods/

https://chatwithdrketch.com/2014/10/27/daily-health-tips-recipe-for-and-storage-of-yoghurt/

I hope this helps.

Have a good evening, y’all 😀

Q: Good morning Dr. Please regarding the rhesus factor issue, since I am A+ and my husband is negative, can it still affect us? Can Rhesus factor occur? Because 2 weeks ago, I lost a 6-month pregnancy. Scan said the baby had brain damage. Thanks.

A: Condolences on the loss of your baby! I can’t imagine what it must have felt like going through this experience twice.

But….don’t give up! You can still have a baby.

Unfortunately, often times, the cause of a miscarriage is not identified. You need to understand this so that you don’t blame yourself unduly. Having said that though, first trimester miscarriages are mainly due to problems with the baby/fetus. These problems could be due to problems with the placenta. This is how the baby receives its nutrients in the womb and so, if this organ cannot deliver, a miscarriage might occur. There may also be a problem with the baby’s chromosomes, such that a baby may receive too many or too few genetic materials or there may be a damaged egg/sperm. Other associated risk factors include smoking and drinking alcohol, being overweight, malnutrition, increased maternal age, trauma and drug abuse. By the way, trimester is 3 months of pregnancy. So, first trimester refers to the 1st three months, 2nd trimester, the 2nd three months and 3rd trimester, the last three months

To try for a pregnancy again, remember to ensure there is unprotected sexual intercourse at least three times a week with ejaculation of sufficient amounts of semen. You should start with folate supplements as soon as you can to prepare yourself and baby for the journey ahead.

To prevent a recurrence, focus on ensuring that you stay healthy and do not indulge in harmful habits like smoking and excessive alcohol drinking. Other helpful tips include eating healthy, keeping weight within normal parameters, avoiding trauma and not abusing drugs.

In addition, as soon as you get pregnant again, register for antenatal as soon as possible and keep to your appointments religiously. You should also contact your obstetrician, even if you’re not due for an appointment, if at any time you suspect something may be wrong with your baby.

For more on this topic, please click on the link below:
https://chatwithdrketch.com/2014/06/02/daily-health-tips-what-should-i-do-to-conceive-again-after-a-miscarriage/

The good news is, since your husband is the one who is Rhesus negative, none of your babies will be affected by Rhesus incompatibility.

Have a great night, people 😀