chatwithketch

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

https://www.instagram.com/p/BR-pg2HlqoN/?taken-by=ddrketch

Q: Good evening Dr. I really need your help. I’m six weeks pregnant and my system or rather stomach is so dirty in our language we call it (nyoko). So I’m struggling I feel like throwing up every day and nothing comes out. My lips gets dry I feel disgusted at everything I can even stomach anything unless if it’s chilly and the disadvantage is I get heart burns. PLEASE HELP ME WHAT MUST I TAKE TO CLEAN MY STOMACH WITHOUT DISTURBING THE PREGNANCY. I CAN’T KEEP SPITTING SALIVA OUT ALL DAY. MY STOMACH IS DIRTY PLEASE HELP .I CONSULTED BUT THE DR DOESN’T WONNA PRESCRIBE ANYTHING FOR ME. PLEEEEEEEEEAAAASSSEEEE HELP ME

A: Hello, thanks for writing in. I had responded to this question a couple of weeks ago but because I wondered how many people believe this ‘nyoko’ thing, I will repost.

Please understand that pregnancy comes with various symptoms, typical of which is throwing up or feeling that you want to throw up. Your heart burn is due to the hormones of pregnancy and your lips are dry, probably because you are not taking enough fluids.

Please see below, normal symptoms of pregnancy and 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. 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.

Heart burn 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! J

Now for the red flags…these have to be heard and 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. So, 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

So, kindly do not clean out your stomach not now or in the future. With your pregnancy, please see your doctor if you have any concern(s). When you have your baby, the same rules apply. For my thoughts on a related topic, please click on the link below:

https://chatwithdrketch.com/2014/04/03/daily-health-tips-how-do-i-cleanse-my-kidneys/

Have a good night, everyone J