Daily Health Tips: Why Can’t I Get Pregnant After Having My First Baby?

Posted on July 29, 2015 by chatwithdrketch

Q: Dr. I am a lady of 28 years. After my 1st child I began to experience irregular flow. My baby will be 3 years old by March 27 this year I can’t get pregnant

A: Madam, I empathize with you. I had a similar experience following the birth of my first child. It took 3 years too, before I got pregnant again. So, I truly understand your fears and concerns.
Secondary infertility is very common, but not often talked about. Even when women present themselves to the hospital, they don’t come out straight to let the doctor know what actually brought them to hospital, and rather list a series of symptoms most often, unconnected to their primary (main) concerns. Secondary infertility is the inability to become pregnant, or carry a pregnancy to term following the birth of one or more children. There however has to be frequent (at least three times a week), unprotected intercourse for a period of at least one year (six months for women older than 35), for this definition to be complete.

The causes include impaired sperm production (quantity and/or quality), erectile dysfunction, or new disease conditions in males. In females the causes include tubal damage (that is damage to the tubes from infections or adhesions in which case certain body surfaces stick together following surgery), ovulation problems (menstrual abnormalities), uterine conditions (infections from complications during a prior delivery, retained placenta, or a miscarriage which wasn’t properly cared for), complications from previous pregnancy(excessive bleeding following delivery) and changes in you or your partners’ risk factors; like changes in age (increasing age), weight, smoking and use of certain medications or disease conditions.

Irregular menses may be as a result of a hormonal imbalance, endocrine abnormality (diabetes, thyroid dysfunction, or pituitary abnormalities), certain medications, eating disorders (too much, too little, or too poor), polycystic ovarian syndrome (asides the irregular menses, there is also male pattern hair growth, facial hair, acne/pimples, cysts in the ovaries, obesity and sometimes diabetes), may be stress induced or a sign that you may be approaching menopause.
I would advise you visit a gynecologist, who would be able to evaluate you properly, possibly identify the cause of the infertility as well as the irregular menses and then treat you appropriately. Apparently, the irregular menses may not be entirely responsible for the problem you are having with getting pregnant.

Also try to identify any of the other risk factors I have mentioned above and work on them .i.e. exercise to reduce weight, a well balanced and nutritious diet most times, lots of water, smoking cessation, treatment of other possible health conditions and avoid the use of medications, (except those prescribed by your doctor).
More importantly, get support for your emotional health, by joining groups of women who have / have had similar challenges and share their stories to inspire others, become an active member of your religious group, attend counseling sessions with a therapist/spiritual counselor, and keep yourself busy or occupied with other activities asides house chores. All these would help you pass through this phase easily and am sure you too will be sharing your story pretty soon…God willing:) Cheers!

****This post was contributed by a doctor guest blogger

Have a great night y’all 😀

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Daily Health Tips: Am I Leaking Amniotic Fluid (Liquor Amnii)?

Posted on July 28, 2015 by chatwithdrketch

Q: Good day Ma’am. I’m 27weeks pregnant with my first. For the past 1week, I’ve been noticing a white/milky watery discharge with no smell. I’m confused because I’ve heard many stories of leaking amniotic fluid (which I learnt is dangerous). Is this normal & please what can I do about it? I’m anxiously waiting for your reply. Thanks

A: Thanks for writing in dear.

Amniotic fluid is the fluid that surrounds and cushions a baby while in the womb. The fluid is contained within a sac called the amniotic sac. Usually just before a woman goes into labour, this sac ruptures and the fluid is released…that’s what is referred to waters breaking. When I had my last baby, my waters broke right in the hospital reception! And so, there was I with water all over my legs and people in the reception area watching 😀 It wasn’t quite funny on that day! But I digress…

Sometimes, this sac of fluid bursts or it could start leaking very gradually before the pregnancy is 37 weeks. This is called Pre-term Pre-labour Rupture Of Membranes (PPROM)

Question is whether what is leaking is urine, amniotic fluid or vaginal discharge.

Here are some tips to help you know:

If it’s urine, it has the peculiar smell of urine and is usually leaked when one coughs, laughs or sneezes.

If it’s vaginal discharge, it’s there constantly and may be clear, white or yellowish

If it’s amniotic fluid, it’s likely to be clear, or slightly mucoid and/or blood stained and it wets panties continuously irrespective of whether one laughs or not

The most significant issues with PPROM is the danger of infection, premature birth and the dangers associated with it.

Thus, if you develop a fever, the discharge changes to green, develops a foul smell, you experience vaginal bleeding, contractions, abdominal pain or baby appears not to be moving as normal, be sure to see a doctor immediately.

So, my advice would be to see your doctor immediately so he can examine you and make a diagnosis. He will confirm whether indeed it is amniotic fluid and then take a decision as to what step to take next. If the leakage is little, you may be asked to stay in hospital for a few hours while wearing a sanitary pad to check for whether it becomes soaked. An ultra sound scan, vaginal exam etc are also useful in making a diagnosis.

Have a good night y’all 😀

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Daily Health Tips: All About Breastfeeding

Posted on July 27, 2015 by chatwithdrketch

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:

Daily Health Tips: Can My Breast Milk Get Sour If I Don’t Express It And My Baby Refuses To Feed?

Daily Health Tips: I’m A Breastfeeding Mother Who Just Developed A Painful Lump in My Breast. Could It Be Cancer?

Daily Health Tips: Breastfeeding Challenges

Daily Health Tips: Please Help! My Breasts Still Feel Engorged Though I stopped Breastfeeding Some Days Ago.

Daily Health Tips: What Should I Do After Having My Baby If My Breast Milk Doesn’t Come In Immediately?

Have a great night y’all and an awesome week ahead 😀

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Is A Diet Of Carbohydrates Only, Dangerous?

Posted on July 26, 2015 by chatwithdrketch

Q: When you eat only eba, beans, rice and bread is it dangerous?

A: Hello healthy people, I came across a report from a Harvard review and it gives 8 principles to low glycemic eating…a principle that will help answer the question asked. Glycemic index, by the way, is a measure that ranks foods that contain carbohydrates on a scale of 0 to 100. The higher the number, the faster the food is digested, causing fluctuations in the blood sugar level and the lower the number, the slower the food is digested causing less fluctuations in the blood sugar level. So the focus should be on foods with low glycemic index. If you reduce your portion sizes and are exercising and generally doing the right things, you may sill be adding weight or not losing weight if you’re eating a lot of food with high glycemic index.

So here goes: principles of low glycemic eating:

Eat a lot of beans (any and every type), non starchy veggies (garlic, onions, leeks, chives, cabbage, broccoli, lettuce, tomatoes, peppers etc) and fruits like apples, berries, peaches and pears.

Eat a lot of grains in their natural state like natural granola, brown or local rice and muesli cereal

Reduce your intake of concentrated sweets like fruit juices (no more than half a cup daily…if you must) and other sugar loaded or sweetened drinks.

For more of these principles, get details from the book, Just For The Health Of It. You can get a copy via the shop now link on our facebook page. Or you can get it through:

1) Jumia.com. Just click on this link http://www.jumia.com.ng/jumia-books-just-for-the-health-of-it-with-dr-ketch-179486.html and get a copy. You have the option of paying when the book is delivered to you or paying online. This service is available all over Nigeria.

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island.

3) If you’re outside the country, please visit Amazon through this link http://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

Here’s to a healthier you!

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Daily Health Tips: Refresher Course On Dealing With Menstrual Cramps

Posted on July 25, 2015 by chatwithdrketch

Have you ever heard any of those stories about how you should take alcohol (lots of it) when you are on you period? The thing I’m not quite sure about is whether the alcohol is to make the flow faster…so you can finish bleeding in one day as opposed to 3-7 days? Or to make the cramps go away? Or just knock you out so you don’t have to deal with seeing the blood et al? Well, whatever it is, let’s tell you the whole truth…and nothing but the truth!

Here are some food-tips for when you’re on your period:

Alcohol: That’s right! You heard me right. The book makers and old wives got it wrong again. Alcohol actually causes your body to retain fluid and this worsens menstrual cramps and also causes bloating. So lay off the alcohol people.

Caffeine: This cause blood vessels to constrict and thus worsens menstrual cramps. So be sure to avoid all the foods that contain it like coffee, tea, kola nuts, chocolates and soft drinks, no matter how much your body craves ‘a sugar rush’ at this time. If you must, maybe just a teensy weensy bit!

Salt and salty foods: these also increase water retention and just like alcohol worsen menstrual cramps and cause bloating.
Dairy: Dairy products cause the formation of substances that make the uterus go into spasms, worsening menstrual cramps. So give them a miss when you are having your period.

Drink a lot of water and complex carbohydrates. They reduce water retention and fill your tummy without being unnecessarily heavy.

So when next someone shows up with some alcohol for when on your period, you know exactly what to tell them to do with it…that’s right! Pour it down the sink 😀

Have a great weekend, y’all 😀

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Daily health Tips: Semen Flow Back

Posted on July 24, 2015 by chatwithdrketch

Q: Hello Dr Ketch I have been married for 1 year now, yet no pregnancy. All I notice is that whenever my hubby has sex with me, his sperm doesn’t stay inside of me. It comes down even if I lie down till the next day. As soon as I stand up, I feel it coming down. Please, what could be the problem?
A: Hello dear, thanks for writing in. In answer to your question, I reproduce a post I had made on this subject.

Here goes…

Q: Good morning, Doctor. Please I have this problem with my partner such that whenever we have sex, after withdrawal the semen returns back and we have been trying to conceive. Please, what is responsible for this and what is the remedy? Thank you so much.

A: I’ve received this question in various forms from men and women alike and so it must mean that this is an important issue for a lot of people.

Lots of couples wishing to have a baby appear to believe that semen flowing out of the vagina signifies a problem and so, they do different things to stop this including, raising the female partner’s legs in the air or even performing a cycling motion. None of these need to be done, really.

A man’s ejaculate is made up of more than just sperm cells. The sperm count in ejaculate (which should be about half to 2 teaspoons in volume) is any number from 20million to several hundreds of millions! That’s a lot of sperm cells for 1 teaspoon, right? Now, when a man ejaculates, the initial force of that pushes some of the semen a significant way into the vagina. The rest of it flows back. In case you’re worried about the semen that flows back, just like the person who asked this question, the truth is that you don’t need more than 1 sperm cell to fertilize an egg.

Some sperm cells are retained at the back of the vagina, some make it all the way to the cervix and some others get into the uterus and make the trip into the fallopian tubes to fertilize an egg. And in addition, these sperm cells can remain alive and active for even up to 3 to 5 days after intercourse, depending on conditions. So, if there was no egg to fertilize at the time of intercourse, if the woman ovulates within this window of 3 to 5 days, she could still very well get pregnant.

Now, if you have been trying for up to one year to have a baby with no luck, please see your doctor and let him evaluate you and your partner. Analysis of the semen with sperm count etc will be helpful in defining course of treatment.

For more on this, please click on this link https://chatwithdrketch.com/2014/12/14/daily-health-tips-miscarriage-and-infertility-re-visited/

I hope y’all had a great day? Have an extra special night 😀

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Daily Health Tips: I’m Scared Of Getting Pregnant After Two Miscarriages

Posted on July 23, 2015 by chatwithdrketch

Q: Hello Doctor, I’ve been married for about a year now but I don’t have a baby. I got pregnant but I miscarried after six weeks. I got pregnant the second time but I miscarried after seven weeks. I am worried now and I’m afraid to get pregnant again because I’m scared of miscarrying again. What might be the problem and what can I do? Please, help me.

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 anytime you suspect something may be wrong with your baby.

For more on this topic, please click on the link below:

Daily Health Tips: What Should I Do To Conceive Again After A Miscarriage?

Have a great night, people 😀

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Daily Health Tips: Why Do I Urinate Whenever I Laugh Since I Had My Baby?

Posted on July 22, 2015 by chatwithdrketch

Q: Hey Doc. I have a nine months old son and since I had him up till this present moment, I do pee whenever I laugh, cough or sneeze. My question is, is it normal for me to still be experiencing this and also what can I do to stop it? Do I need to visit a Doctor? Thanks for always being there. God bless you always.

A: God bless you too and congratulations on your new baby, though he’s all grown up now…all of 9 months!

As a result of the pressure and stretch experienced by the pelvic floor muscles (which support the bladder and other organs) due to the pressure of the growing baby and pregnancy hormones, stress incontinence (urinating when you sneeze or cough or even laugh) happens. It is not abnormal and there is a very simple exercise that helps you deal with this. It’s called Kegel exercise.  The exercise mimics the movements we make when we want to stop the flow of urine. Try holding this for about 10 seconds and then doing about 4 or 5 repetitions per set. Try about 3 sets per day and increase this as you feel ready.

In a few cases, exercises are not enough to deal with this and a minor surgery may have to be performed.

For related posts, please click on this link: https://chatwithdrketch.com/2015/03/23/daily-health-tips-pregnancy-related-pelvic-girdle-pain/

This situation may last a few weeks to a few months or in some cases, become long drawn out. So, if you have not performed this kegel exercises since you put to bed, it’s not too late to start and by all means let your doctor know so that he’s part of the management.

Have good night y’all 😀

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Daily Health Tips: Should I Be Worried If I Don’t Have A Baby After 4 Months Of Marriage?

Posted on July 21, 2015 by chatwithdrketch

Q: Hello Dr. I have been married for four months. But each time I complain of being sick, my hubby as well as my family members always thought I was pregnant. And each time the result comes out negative, I always sensed a change in their tone. Now my question is, is it normal for them to feel that way about me? Or is it that I ought to have been pregnant by now? I’m not anxious about being pregnant but their anxiety is making me feel somehow. Please, I need your advice.

A: My darling, please do not feel ‘somehow’. It is absolutely outrageous how the African society puts pressure on newly-weds to start having children once they are married. Four months!!! Really? This is the time for you and your hubby to bond and understand yourselves. Nobody should be putting undue pressure on you. I actually expect hubby to ensure that you are not subjected to unwarranted stress over this matter.

Is it normal for them to feel that way? It’s certainly common in Africa…that does not make it okay neither should it be considered normal. While on this subject, please remember when you become a mum and your son or daughter gets married not to also put this pressure on them. I keep asking myself how come this cycle of mothers/relatives who pressure on couples to have babies never seem to completely phase out. We need to consciously make an effort to stop this!

Medicine does not even recognize that there is a problem with conception until after one full year of trying to get pregnant! And people are already counting at four months! When people are not on your case for not having a baby, then they are on your case for not having the right sex of babies…When does this all stop?
So, what to do? Hold your peace and be at rest! Eat well, take care of yourself and try not to let it all get to you. See if you can explain to hubby how this ‘unwanted’ attention puts you under pressure. Hopefully, he gets it and protects you. Gentlemen on this forum, please remember that part of your job description is to protect the one whom you swore to love…your wife 😀

I hope that very soon, we won’t have to hear of these sort of situations in our clime. For this to happen, we all need to join hands in ensuring that we do not contribute to the stress these newly-weds and other people who do not have children (for whatever reason whether by choice or circumstance) have to go through.

For related posts, please click on these:

Daily Health Tips: I Don’t Want To Lose My Home Because I Only Have Daughters.

Daily Health Tips: Am I Ovulating?

Have a goodnight, y’all 😀

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Daily Health Tips: What Do I Do About My Big Tummy?

Posted on July 20, 2015 by chatwithdrketch

Q: Dear Doctor, I have a very big tummy. Please ma’am, how can I reduce it?

A: I’ve received a lot of questions on the issue of ‘big tummies’ 😀 and so I have decided to reproduce a post I had made on this.

Q: Doctor, please I don’t take alcohol. Both my parents have big tummies. I am of average built but my tummy gives me concern. After watching you a while ago, I wanted to write you so that you tell me what to do.

A: It’s great that you are concerned about this, especially knowing that there is a family history, because genetics can be a factor in the issue of belly fat (central obesity). However, other major factors are really what we eat, how much of it and how much exercise we get.

If you ensure that your plate always has all food groups in it, you’ll be fine. First, focus on portion control. The first practical step in doing this is reduce the size of plate that you ordinarily eat with. Then, ensure that half of this plate is filled with vegetables, a quarter of it with protein and the last quarter with the carbs to be eaten. For carbohydrates, focus on the complex carbohydrates like brown rice, local rice (Abakaliki rice or Ofada rice), sweet potatoes, oatmeal, whole wheat bread, millet etc. For instance, you can have a half a plate filled with vegetables (remember to go extra easy on the oil during preparation), quarter of the plate filled with whole wheat meal and then your protein of choice, preferably fish or poultry. It is important to have more of the vegetables, because these fill you up, absorb loads of fluid and keep you feeling fuller for longer! 😀

Daily Health Tip: The trio of Diet, Exercise and Stress

Daily Health Tips: Are 3 Square Meals Sufficient?

Daily Health Tip: Weight loss (facts and fiction)

You’re also allowed 2-3 snacks daily. Remember to focus on healthy foods e.g. nuts, fruits etc. For more on this, please click on the link below.

Daily Health Tips : Healthy Snacking

Then exercise. I am always asked if people can lost weight without exercise and the answer is yes. I mean, if you went on a starvation diet, you’d lose weight, right? 😀 But it’s not sustainable. First it’s really water weight, you’re getting rid of and you’re not really imbibing the principles of a healthy lifestyle that will help you not only lose weight but keep it off. Current recommendation is for 150 minutes of exercise weekly. This should be broken down into 30 minutes on 5 days of the week or 1 hour for three days. Space these minutes out and ensure that you don’t try to get all of it done in 2 days like some weekend warriors I know 😀 Seriously though, the heart may not be able to withstand that much pressure all at once having been sedentary too long. So, please be guided! 😉

Ageing also plays a role. However, if you start early enough in life to eat right, it may not be too much of a problem later.

If you read my post on ‘The Trio Of Diet, Exercise And Stress’, remember that visceral fat, the type involved in central obesity may not be helped much by abdominal exercises, crunches et al. The right lifestyle is critical. Remember that central obesity pre-disposes one heart diseases, Type 2 Diabetes Mellitus etc So, you don’t want to be here if you can do something about it!

Have a great week ahead, fabulous people 😀 XXX

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