chatwithketch

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 😀

Q: Hi Dr Ketch,is the electric blanket safe for my 4months old baby?

A: Congratulations on your new bundle of joy 😀
No, the electric blanket is not ideal for your baby because of the risk of over-heating burn or even a burn. So, please don’t use it. Focus more on dressing baby warmly, avoiding clothes with long strings that may pose a strangulation risk. Whatever you do, make sure baby’s head and face are not covered. If you can get a baby sleeping bag, that would be perfect.

Now, I’ll give you some extra tips to help you and baby sleep comfortably…tonight 😀

During night time feedings, keep lights low. Night lights stop you and baby from coming fully awake and so you can go back to sleep after the feed…effortlessly.

Commit to sleep and make it a priority in your life. The advice frequently given to new mothers to get some sleep when the baby is asleep, may appear clichéd and ‘an old wives’ tale, but is useful.

Give yourself permission to let some things go and don’t feel the pressure to catch up on all your emails, text messages, house shores when he’s asleep.

Remember that good sleep starts before you’re actually trying to fall sleep. Ensure you start winding down your day early enough so you can get to sleep early at night. Ensure you’re not getting too wound up during the day and inhibiting your ability to sleep at night

Be intentional about sleep. As a new mother, you’ve got so many things pulling at you: night time feeds, your other children, if you’ve got them, their home work, your husband etc. So ensure that your sleep equipment – pillows, mattress pad/topper and mattress – provide the right support and comfort. Get a good pillow and comfortable mattress…it’s a worthwhile expense

Be open to alternative remedies. Create a personal spa at home: use aromatic oils at bath time and in your room. Lavendar has been found to be very helpful by some.

Feed during the day: Aim to give your baby most of his milk feeds during the day, so he doesn’t make up for it at night (and end up waking for cuddles too!).

Teach him to go to sleep by himself: Put him down when he becomes sleepy but is still awake – about 15 minutes before his usual nap time – so he learns to fall asleep without you comforting him. If you always feed, rock or cuddle your baby to help him sleep, day or night, he’ll learn to expect this.

Give him a comforter: This will act as a transitional object to help him feel secure when you’re not around. It could be a muslin square or light baby blanket – just make sure you have two for when one is in the wash!

Use music: Play lullabies or nature sounds at nap times and when your baby wakes up in the night, so you can all get your rest.

Now you’re empowered 😀 Go catch up on some much-needed sleep!

Have a good night y’all 😀