chatwithketch

A: When we eat, the food moves down from the mouth, to the esophagus and into the stomach. There is a sphincter or valve at the lower end of the esophagus just before the stomach. This valve usually allows food to move in one direction: from the esophagus to the stomach. However, in people with Gastro-Esophageal Reflux Disease (GERD), this valve called Lower Esophageal Sphincter allows food to also move back from the stomach to the esophagus. This food, which contains acid from the stomach, causes burning sensations in the esophagus described as heart burn. A condition called hiatal hernia increases the chances of GERD and is usually seen in obese people, pregnant women and during situations that increase the pressure in the abdomen like coughing, sneezing etc.
Lifestyle factors that play a role in GERD include certain foods like fatty, fried foods, alcohol, minty foods etc, smoking, eating huge meals, lying down immediately after a meal etc

To avoid these eat smaller meals and try not to lie down until about 3 hours after a meal, keep your weight within normal limits and give tight clothes a rest 😀 Avoid foods that act as triggers and stay off smoking. Elevate the feet of your bed by using blocks under the bed. Do not use pillows to achieve this as it just increases pressure in the stomach and worsens the problem.
Other treatment modalities include medications and surgery. Your doctor will advise as to what works best for you.

Good night, people 😀

Q: Good day Doc. I love your articles on EBF (Exclusive Breast Feeding) thing. Am a serving Corper, my maternity leave will finish come 1st week of December and my baby will be 3months and 11days by then. I really want to practice EBF to 6months(to prove my mum wrong) but my baby sucks too much within the night that when I express in the morning I only get 50-70mls of BM (too small for a feed) Considering that I have to get to work before 8am and to be back by 3pm. I kill myself with fluid within the night to boost milk supply but d baby sucks all. Please help me; what should I do? Will formula milk be bad if I introduce it by then (not minding if my mum mocks me by den). Is it too early to put the baby in a creche. Should I burp my baby when he falls asleep during feed. Thank you. Thanks for writing in…and yes, it’s absolutely possible to prove your mum wrong. Sorry mum 😀
A: Breast milk is the best food for baby, generally speaking. The supply of breast milk is based on its demand. And so, if demand for it is high, supply will be high and vice versa. The more efficiently milk is removed from the breast, the more milk production is stimulated. And so, you need to make a conscious effort to get baby to suck more.
Now, in most places in Nigeria, nursing mothers, do not start work until about 9am or slightly later. You appear to be getting to work with everyone else. Those extra minutes/hours in the morning could be very helpful. Find out from your HR department what you’re entitled to.
Here are other tips that could help increase milk supply:

• Be sure that baby is attached properly and get him to suckle on the breast very often. Remember that breast milk production is a function of the breast milk let down reflex which is activated when baby sucks.
• If you can find a private space within your office where you can express milk, go for it.
• Increase the number of feeds per day. You could work with a timetable of a feed every 2 to 3 hours. In your case, as many times as is possible when you get back from the office.
• Switch breasts during a meal time. Let the first breast ‘empty’ before switching baby to the other breast. This can be repeated several times during a feed.
• Massage your breast and stroke towards the baby
• Perhaps over the weekend, room in with your baby and get him to feed as much as possible. The let down reflex will be greatly stimulated and so, you could even pump some for when you will be at work and freeze.

Personally, I found that using my hands to ‘milk’ my breasts produced sufficient amounts of breast milk for my always-hungry-can’t-seem-to-get-enough-food-baby. You may want to try that.
Have a good night, y’all 😀

Q: Thank you ma’am. Follow-up question ma’am, if super- fetation occur,what will happen during child delivery? Can they be called twins?

Q: Good evening Dr. I am pregnant now and I don’t like having sex. I hope am not causing problem to myself and the baby. Secondly, is it true that having sex will help my vagina to be open during child birth for easy delivery? Thanks

A: And to round off our discussion on sexual intercourse during pregnancy and super-fetation, I will take on the last set of unresolved questions.

Are the children called twins if superfetation occurs? Yes. It’s just that when born, one may look slightly older than the other. Remember that the dates of conception are different and so the obstetrician has to take a decision as to the best time to deliver them so that both of them have equal chances of survival.

The issue of having sexual intercourse has been exhaustively treated. You’re not causing any harm to the baby but it’s possible that you may be creating a distance between yourself and your hubby if your decision or reason for it have not been well communicated to hubby. Communication is VERY important, not just in this issue but all other marriage issues 😀

Will having sex help your vagina stay open for easy delivery? No. With or without sex, a woman would deliver vaginally if she has no conditions that might make her more likely to have a C-section.

So, there you go. Have a good night y’all 😀

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Q: Hi Doc, please is it normal for a baby to sprout the upper teeth first?

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! 😀 Let’s encourage our children to ‘stand out’ and not ‘blend in’

For more on teething, please click on the links below:

Daily Health Tips: Is It Okay To Give My Baby Teething Powder At 3 Months?

Daily Health Tips: Is My Baby Teething Too Early???

Daily Health Tips: Teething in babies

Daily Health Tips: Baby Bottle Tooth Decay

Please remember to visit my blog http://www.chatwithdrketch.com to search for any wellness topic you might want answers to. For instance, if your question is on teething, just type teething into the search box and you will be presented with all my posts on the subject. That should answer your question(s). If it doesn’t, please be sure to bring it here! 😀

Have a great weekend y’all. Have you noticed how the rest of the year appears to be quickly racing by? Is it just me? 😀

Q: Good day Dr Ketch, I had c-section last year December and I just realized I’m a few weeks pregnant this month. Is it safe for me to carry this baby and also deliver normally? I’m so disturbed, please advice accordingly. Thank you.

A: Thanks for writing in. This is a common question amongst women who have had a Caesarian Section. How soon can I get pregnant again? This is an especially important question as the argument about how much time the body needs to heal rages. It only makes sense that the longer the body is allowed to heal, the stronger the better the wound healing. Different schools of opinion exist from 6 months to 1 year to at least 2 years. However, generally, a gap of 6 months is considered fair to have given the body sufficient time to heal. So, is it safe for you? You are around 10/11months since your last baby and so, technically you’re fine. I strongly recommend that you register for Antenatal classes as soon as possible to ensure a problem free pregnancy.
Can you deliver normally? I prefer to ask, ‘can you deliver vaginally? There is nothing abnormal about having a baby through Caesarian Section. You’re as normal as the woman next door and you feel the same maternal urge as she does…maybe, even more 😀 It’s because we think C-section is abnormal that women who would benefit from this procedure turn it down and then end up dying because they wanted to do it ‘normally’! We need to change this mind set! For women who think ladies who had C-section are lesser mortals than them because they had a vaginal delivery, try cutting up yourself with a knife and then sewing it back up and you would know who’s more super-human! By the way, just in case you wondered, I’m not taking it personal because I had a C-section. I had all three of my children vaginally but would most certainly have opted for a C-section if I was advised to do so. But I digress….

So, can you deliver vaginally? Absolutely! Unless there are issues that may have led to your having a Caesarian section (indications) even if you hadn’t had one before. 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 😀

Now, these are general rules of thumb. Your specific medical history may be different, requiring a different approach. So, be sure to discuss the options open to you with your doctor.

And please, remember to discuss contraception/family planning options with your doctor during your 6 weeks appointment if you’ve had a baby. I’ve had quite a number of people writing in to ask if breast feeding protects against pregnancy and if it was possible for them to get pregnant even before their periods return or if it was safe to breastfeed a baby while pregnant (The answers by the way, are yes to getting pregnant while breastfeeding, yes to possibility of getting pregnant before periods return and yes to breastfeeding while pregnant); this means that there are probably a couple of people getting pregnant earlier than they had planned. Let’s take the right decisions.
Don’t forget to visit my blog, http://www.chatwithdrketch.com to search for any health/wellness topic you want information on. If you can’t find the answer you need, bring it here 😀

Good night, y’all 😀

Q: Thanks Dr for answering our questions. Please, Doctor my baby of about one month plus has a kind of inflamed and reddish rash around her vagina which I thought was a diaper rash. I have been applying baby Tribotan for the past few weeks but no improvement. Please help me with what I can use. I’m a first-time mum and I’m really worried.

A: Congratulations on your new baby and don’t worry, it just looks harder than it really is. In a few months now, you’ll be dispensing motherly advice to other new mums 😀

Diaper rashes are common in babies and they could happen on the butt or anywhere around the area including the lips of the vagina as you have observed. The causes include
• Prolonged contact with urine or stool
• Diapers that are too tight
• Harsh detergents, soaps
• Baby wipes.
• Sensitivity

Prevention essentially focuses on the causes. So,
• Change your baby’s diaper as soon as you realize it’s wet or soiled
• Be sure to buy the right size of diapers and avoid harsh soaps and detergents.
• Keep baby’s butt open to air dry as long as practicable 😀 I hear some of you mums groaning…I know, you’re taking a huge fat risk that he or she will do their business while you’re trying to air dry them 😀
• Ensure that baby’s butt is dry before closing up the diaper after a change
• Pat baby’s butt dry especially if he/she already has a diaper rash to prevent irritation
• Always have a diaper rash cream handy. Creams that contain zinc like Sudocrem or Desitin are good examples. I used the latter for my babies and it always worked like a charm.
Diaper rash that does not ‘sneak’ away after a couple of days (about a week) may be due to a yeast (candida) infection. And before you raise your eyebrows, yes this can in babies and may be due to yeast overgrowth in babies taking antibiotics or breastfeeding babies whose mothers are on antibiotics, poor hygiene when cleaning baby up after a poo (such that baby is cleaned from the back to the front), the moist and warm environment provided by unchanged diapers etc These rashes are usually well defined with raised borders.

If the rashes develop some pus like fluid, then this is the sign of a bacterial infection (impetigo) and needs to be treated with antibiotics.

So rule of thumb is change your baby often to prevent prolonged contact with poo or urine and keep the area clean. Use barrier (nappy rash cream) at the first sign of a rash and if this does not improve after a few days, she should be ideally seen by her doctor to confirm whether this is a fungal infection. Note that other rare causes of rashes are eczema, psoriasis etc

In the case above, I assume that you had used a barrier cream initially (or maybe not) before using the antifungal cream. Since the rashes are not getting any better, please take your baby to see her paediatrician.

For more on diaper-related issues, please click on the links below:

Daily Health Tips: My Baby Is Having A Reaction To Her Diapers!

Daily Health Tips: More Diaper Tips

Daily Health Tips: Diaper Bag Essentials

Daily Health Tips: Diapering your baby

Have a good night, y’all 😀