chatwithketch

Are you pregnant and eating for two? Well, you need to read this!

I’m sure everyone has heard the ‘eating for two’ fable 😀 It is indeed, an old wives’ tale because if you were eating for two, the assumption would probably be that you should double your calorie requirement for a day….so for a woman that probably means you can get away with taking in as much as 4000 calories per day!!! That’s a recipe for disaster.

Pregnancy is associated with increased cravings and of course growth of the baby, but you do not need significantly more calories to cope with this state. The recommended weight gain for pregnancy is 8 – 16 kg in all (with an average of 12kg).
Let me break it down for you.

During your first trimester, you actually do not need more calories than when you were not pregnant. You can continue with the activities you used to do before including exercise. However, exercise should be toned down from vigorous to moderate. Moderate exercise is any physical activity that you perform that but you’re still able to carry on a conversation without running out of breath…that’s as simple an explanation as it goes 😀 It includes walking, swimming, dancing, pregnancy exercises (these are taught in some antenatal classes), stretching and relaxation exercises. Remember that you must never start on any exercise regimen without discussing with your doctor who knows your specific medical history.

Please remember that you should never exercise to the point of exhaustion, not to over-heat yourself and not to carry on any jumping etc…partly because you are prone to injuries of the ligaments (like sprains)and because, it’s just not safe at the time. I always used to know I was pregnant whenever I sprained my ankle…it happened in 2 out of 3 pregnancies! It may not be an exact science, but it worked for me :D. Just kidding…don’t try this at home 😉

During your second trimester, your calorie needs start to increase. This is when you need some more calories. How much more calories do you need to ensure your baby is well nourished but not overly so…and that keeps your weight in check? 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!

Whenever the weekend comes along, people get up to speed with cooking and laundry. Have you ever wondered whether you’re doing your laundry right? Think your family is protected because you wash everyday…or every weekend? Let’s do a reality check.

Here are our top tips to prevent the spread of germs through laundry.

• Wash dirty clothes as soon as possible. The longer the germs are allowed to breed on the clothes, the more difficult it will be to get rid of all of them in one wash. This is even worse for damp clothes like towels for obvious reasons and underclothes too. Panties should be washed after wearing once (which is usually from morning to evening)…and this rule also applies to guys 😀

• Sort the laundry before washing. Apart from ensuring that the clothes are sorted according to colour and thus, do not run the risk of staining other clothes, this also ensures that delicate clothing are separated. Panties, underpants, children’s clothes and towels should generally be washed differently: do not wash adult clothes with children’s clothes and do not wash undies with regular clothes.

• As much as possible use warm water (about 40 degrees centigrade) to wash your clothes. This provides an impossible temperature for the germs to thrive.

• Lots of people of people would wash their hands after handling very dirty laundry for the simple reason that their hands feel dirty afterwards. But would it readily cross your mind to wash your hands after handling your load of just washed laundry…supposedly squeaky clean? No. But there are still germs swimming all around the surface, which ordinarily should be ‘killed’ as the clothes dry…so you should get your hands washed.

• Ensure that your clothes dry thoroughly before you wear them. Apart from the dead rat smell of those damp clothes people wear 😀 germs are likely to still be on them. In fact, this is one of those places where modern technology appears to win the competition with old tested and trusted. Using a tumble dryer gets the clothes dry faster and reduces the time available for germs to multiply. Air drying on the other hand promotes the growth of germs as the clothes remain damp for a longer time before drying.

Have a great weekend, y’all 😀

Q: Please ma’am, I delivered my first baby in 2012 through Caesarian Section, due to placenta previa, type 2. After 10 months, I conceived. I had another Caesarian Section because the baby is too big….and after 1 year, I am pregnant again and I’ve worked on how to achieve a small baby. Please, I want to know…are there any chances of me delivering through the vagina?

A: Hello dear, thanks for writing in. I’m a bit curious about how you are working on achieving the small size for your baby! I hope you’re not one of those funny ‘lemon and ginger’ or ‘tea only’ fad ‘diets’. They are absolutely useless! Eat well…nutritious, balanced diet with more fruits and vegetables. Remember that causes of big baby include diabetes, excessive weight even before pregnancy etc

For more on this subject, please click on this link: https://chatwithdrketch.com/2014/02/17/daily-health-tips-help-im-pregnant-and-my-doctor-says-my-baby-is-too-big/

Can you deliver vaginally? Yes, you can. A few years back, having had one C-section meant you could still try for a VBAC (pronounced Vee-Back and means Vaginal Birth After a Caesarian) but once you’d had two C-sections, you could only have subsequent children with the same procedure. That thinking has changed now and having had 2 C-sections may not be an automatic sentence to the knife, anymore 😀 However, there are a few factors that influence the decision for or against a VBAC. An important factor is that people who have had a transverse cut C-section (Lower Segment C-Section in which the cut on the abdomen is made from in the lower abdomen running from left to right) are more likely to be successful candidates for VBAC than those with vertical cuts (classical C-section in which there is a longitudinal cut on the abdomen). So, be guided by your doctor and remember that just because your doctor has said it is okay to try for a vaginal birth after a Caesarian Section does not necessarily mean that it will be successful. The woman may very well still end up having a Caesarian Section if a vaginal delivery is tried and it fails.

Generally, there’s really no specific number of C-sections that a woman is meant to have (especially in centers with significant technological advancement), though about 3 used to be the mark. There are women who have had than 3 and are alive to tell the story. Having said that, the more the number of sections, the more the risks and complications the woman is exposed to.

Common risks and complications include:
• Weakening of the wall of the uterus wall with risk of uterine rupture!

• Healing after a C-section comes with development of scar tissue which may subsequently cause adhesions as they cause abdominal organs to stick to each other. This may lead to obstruction of the bowel or even block the fallopian tubes, leading to infertility. These adhesions may develop between the uterus and the bladder making it easier to injure the bladder with subsequent C-sections.

• Placental problems may occur in people who have had C-sections as the placenta may be implanted too deeply into the womb or there may be placenta previa. In these instances, removing the placenta presents a challenge and may result in profuse bleeding which requires blood transfusion.

For more on placenta previa, please click on these:

Daily Health Tips: Can Placenta Previa Recur In My Pregnancy?

Daily Health Tips: Placenta Previa

Have a good night, y’all 😀

Q: Hello Doctor. During the time of breastfeeding (0 – 6 months), is it okay to feed the baby with other milk? And according to medical recommendation, when is it the right time to start mixing other kinds of milk like Lactogen with breast milk?

A: Thanks for writing in. Is it okay to feed your baby with other milk during the first six months? No! During the first six months, your baby should be getting pure, unadulterated breast milk. After this period, you can now include infant formula. Remember that your baby should not get regular cow milk until he/she turns 1 year old.

For more tips on breastfeeding and weaning, please click on the following links:

Daily Health Tips: Should I Exclusively Breastfeed My Baby Beyond 6 Months?

Daily Health Tips: Storage Of Breast Milk Re-Visited

Have a great night, people 😀

Okay, the most popular question I’ve received over time is how to lose the pregnancy belly whether after vaginal birth or Caesarian Section. Honestly, I’ve got no easy answers. It’s diet and exercise….oh and breastfeeding. But breastfeeding is not very helpful if one is not exercising and watching their portions. Again, the dictum of feeding for two here doesn’t count.

Exercise should focus, initially on pelvic floor exercises especially if you’re 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 and 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’re ready for your exercises.

Want to know the diet to focus on, what exercises to engage in, when to start, the role of breastfeeding in your weight loss program after having a baby etc? 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 linkhttp://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 what someone who has read the book had to say: ‘Hey Doc! I finally got your book!!!! Great read. I think it would be sold in every hospital, women’s ward& it makes for great wedding gift& baby shower gift.’

Have a great week ahead y’all 😀

Over and over again, I have had breast feeding mothers tell me that they don’t make enough breast milk to feed their babies. Or they would say, their babies get hungry too often and so it is difficult to keep up with the crazy schedule of ‘feeding on demand’ that breast feeding requires of you.

Breast milk is very important to new born babies and really no child should be deprived on the many benefits of breast feeding exclusively. There are some mothers who, by reason of specific health conditions, cannot breast feed their babies. However, the greater majority of mothers are able to make enough breast milk to keep their babies satisfied.

Here are our top five tips for breast feeding properly:
o Patience: You’ve got to have loads of it. Sometimes, your baby feeds and then stops a bit just to gaze into your eyes. Give him/her the time needed to bond with you.
o There are two types of milk in the breast milk: the fore and the hind milk. You have to be sure that your baby gets both during each feeding session.
o Give the fore milk to quench thirst. The fore milk is mainly water and low in fats. If you observe, it’s bluish in colour. Its high water content is the reason why you don’t need to give your baby extra water. It’s also rich in protein, carbohydrates and vitamins.
o Be sure to give the hind milk. Now, if you finish giving just the fore milk and stop, the baby will be hungry thereafter as she has essentially only taken water. The milk that comes after the fore milk is thicker containing fats and has a whole lot of calories. The baby needs this to be very well nourished and to satisfy the hunger pangs. The longer a mother waits between meals, the more foremilk is produced and it takes your baby that much longer to get to the more filling hind milk.
o Let your baby feed on demand and each session should last until the breast ‘feels’ empty. I say ‘feel’ because the breast never really empties out After this, change to the other breast.

Remember that breast milk is the best and cheapest food for your baby. It also helps fortify your baby against diseases…so, now you have the right tools to get this done right.

Go for it and have a great weekend, people 😀

Q: Ma’am, I have pain in my right leg but it usually comes and goes. This time, however, as I started to learn driving the pain came back and this time, it’s really serious to the extent that I fell down. Please ma’am, what can I do?

A: Thanks for writing in. The pain in your right leg which has worsened may need further evaluation.

There are quite a number of causes of pain in the leg. Pain in one leg may be due to an injury, a fall or hitting the leg against an object. This pain may be felt immediately after the incident that caused it and subside after a few days, with the proper care. It can also linger for some time, if perhaps there was a break in the bone which was not properly taken care of and affected some nerves.
Other causes include arthritis, leg swelling from different causes like infection, vein abnormalities, diseases like heart problems, diabetes, and liver problems. In long standing hypertension, or diabetes that is not properly managed, there could be nerve problems, often described as a cramp, feeling of lack of blood, or a feeling like pins pricking the feet. The pain could also result from a muscle cramp, which typically occurs at night and may last a few seconds to minutes. There is also condition known as familial recurrent knee dislocation, in which there is repeated dislocation of the knee, followed by a fall, due to lack of stability. It runs in families and can be very painful too. There are also some cancers that can give similar symptoms.

I would advice that you reduce stress on your legs as much as possible, i.e. avoid standing for too long. You could also start some mild exercises focusing on the legs. These may help to strengthen any lax ligaments and improve blood flow, thereby helping any nerve disease, if that’s responsible.

Good diet, rich in proteins and vitamins are also important. You may occasionally take a mild pain relief to reduce the pain (but do not make it a habit). If the pain worsens or continues despite pain tablets, please see your doctor.

In conclusion, I strongly recommend you see a doctor who will take a proper history and examine you thoroughly, and proffer a line of management for your symptoms.

Hope this helps, Best wishes

****The answer to this question was contributed by a doctor guest blogger.

Have a fab weekend, y’all 😀