chatwithketch

Q: Good day Doc. Please I am 9 months pregnant approximately 40 weeks old. I was given a drug at hospital to take at night which the doctor said will cause contraction and diarrhea. My EDD from hospital is 27th march while scan gave me 7th April. Is it proper to induce labor through this drug at this stage or to allow labor on its own? What’s the effect of this drug on my baby and me? Please ma’am, help a confused mum to be. Thanks

A: Usually pregnancy lasts for 40 completed weeks plus or minus 2 weeks. Generally though, from 37 weeks, your baby is good to be born…all things being equal. And so, if a woman gets to 40 weeks without any sign of labour, she is tentatively given 2 more weeks, especially if there are no other risk factors present in the pregnancy. This is called watchful waiting and during this period, the baby’s kicks are counted, baby’s heartbeat is monitored and indeed, baby’s growth and other parameters are monitored. From the 41st week, if she does not spontaneously go into labour (without help), then there is a plan made for induction, having fully informed the woman of all possible scenarios. Some women do not like the idea of induction and so, having discussed with the medical team, may opt for a sweep of the membranes. This involves the separation of the membranes (the ‘bag’ in which the baby lies) from the lower part of the womb (uterus). This releases prostaglandins, which help stimulate labour.

When a pregnancy goes beyond the Expected Date of Delivery (EDD), which is 40 weeks, it is called a post-dated pregnancy. If the pregnancy lasts beyond 42 weeks, it is called post term. It is not really clear why some pregnancies become post-dated but some associated risk factors include previous post-dated pregnancy, first pregnancies, mothers with high BMI and advanced age.

The main challenge with allowing a baby to remain in the womb beyond the 42nd week is that of the placenta no longer being able to supply sufficient amounts of oxygen to the baby. This can lead to brain damage or even death of the baby. The second issue is the threat of the baby having its first poop inside the womb and then aspirating (breathing in) it. The baby may also become bigger (fetal macrosomia) with potentials for complications like genital tract tears during vaginal delivery, prolonged labour etc.

You still have a couple of days before your 42^nd week deadline. Perhaps, your medical team is prepping you for that week or perhaps, there are some other factors that make an induction critical now. I suggest that you have a long chat with your medical team. Ask all your questions and make sure they understand your fears and explain everything to your satisfaction. Discuss all options available and the one(s) you are comfortable with.

Remember that you can also ask for a second opinion if you are not comfortable.

All the best! Let’s know when the baby is born! Lots of love and hugs.

Have a goodnight everyone 😀

Q: Hello Doc, my baby is around 5 weeks now. From birth I have been feeding her formula and breast milk. Should I still be giving her water. If yes, should it be warm water.

A: Hi dear, congratulations on your new baby! She will be a blessing to her generation.

Now, if you’re a regular follower of this page, you will know that I am ‘almost’ fanatical about breastfeeding. You should be giving your breastfeeding only from birth to 6 months with no water at all. Breast milk contains all the required nutrients and sufficient water for your baby.

Having said that, if you’re giving your baby formula feeds, the same dictum also applies. You have to ensure that that you follow the instructions properly so that you don’t make feeds that are too thick (and likely to cause constipation) or make feeds that are too watery (and likely to deprive baby of needed nutrients).

There are very few times when you need to give baby extra water, other than her feeds. If she’s stooling, she will need to be rehydrated but please be guided by her doctor. Ensure that you have the ORS (Oral Rehydration Salt) sachets at home or at least learn how to make the Salt Sugar Solution as a first aid before going to the hospital. On rare occasions, it may get very hot or baby may be constipated and so you may feel water is needed. A teaspoon or two of boiled, room temperature water won’t hurt but it is important that as much as possible, you stay away from giving your baby water until she is 6 months…or worst case, 4 months. This is because water ‘occupies’ the place that the baby’s feed should occupy and so baby loses out on getting valuable nutrition. The second reason is that babies are susceptible to a condition known as acute water intoxication. In this situation, baby is given too much water leading to dilution of sodium (salt) level. This could lead to seizures, brain damage and even death. We don’t want that!

So, in summary, it is really best to delay giving baby water until she starts taking solid foods. However, wherever in doubt, please see your baby’s pediatrician.

Have a good evening, everyone 😀

Q: Doc is there something wrong if a child starts teething on his upper jaw? What are the effects on a child who starts teething upper teeth?

A: When it comes to teething, there are varying grades of normal. The usual time for babies to start teething is between 4 to 10 months. However, some may have developed some teeth as early as three months and some as late as one year. Indeed, some children are born with teeth (neonatal teeth) and that is absolutely not witchcraft as I always say whenever I write on this 😀 If you have more than one child, you would have also noticed differences in the speed or rate of development from one child to the other. Each child is different 😉

In the same way, the bottom central incisors (teeth at the middle of the mouth) are usually the first to sprout. But your baby could very well decide to do it differently and sprout the top incisors first. There’s absolutely no problem with that. The bottom incisors are likely to follow almost immediately after.

So enjoy your baby and his/her uniqueness. Remember this lesson when he/she grows up and don’t try to make him/her to be like any of your other children or heaven forbid, your neighbour’s child! J Let’s encourage our children to ‘stand out’ and not ‘blend in’

For more on teething, please click on the links below:
https://chatwithdrketch.com/2014/09/14/daily-health-tips-is-it-okay-to-give-my-baby-teething-powder-at-3-months/
https://chatwithdrketch.com/2014/02/15/daily-health-tips-is-my-baby-teething-too-early/
https://chatwithdrketch.com/2014/01/06/daily-health-tips-teething-in-babies/
https://chatwithdrketch.com/2014/01/28/daily-health-tips-baby-bottle-tooth-decay/

Have a good evening, everyone 😀

Q: Evening Dr. Please I want you to tell me what to do. My baby is five months and three weeks and two of her teeth are coming out but the problem is she has not been defecating very well since the upcoming of the teeth. What should I do, Doctor. I am scared and she was eating very well                                                                                                                                                                                                                                                                                                                            A: Babies start teething at different times. On the average, most children start teething at 6 months. Some start earlier than 4 months (as early as 2 months) and some others may wait up to a year or even after, to start the journey. Some children are even born with one or two teeth. These are called natal teeth. Some children also develop their own teeth within the first four weeks of life. These are called neonatal teeth. Natal and neonatal teeth can cause problems with feeding and may even be swallowed. The pediatric dentist will decide whether to remove them or leave them alone based on factors like whether the teeth are loose, excess etc. So, your child is well within the expected time to develop teeth.

Now as to not defecating….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 defecation 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 pediatrician.

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.

Have a great weekend, everyone 😀

Ever thought of a footballer’s life? He gets paid doing something he loves…something he could very well do for free! That’s his strength…his amazing ability to play soccer. What is your strength? Find it, leverage it and live/work more positively.

Read more here: http://www.health.harvard.edu/healthbeat/leverage-your-strengths-for-a-more-positive-life

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