chatwithketch

Still celebrating Breastfeeding Week 2019 (1st to 7th August)…

Q: Thanks ma’am for always being there. Please, my 9 months doesn’t like to take breast milk again, though she takes solid very well. But I’m not too comfortable with that. Any side effects? Please I’ll await your prompt response.A: Breast milk is the best milk and food for baby from birth till 6 months. From 6 months, breast feeding is meant to be continued but other complementary foods should be added as breast milk is no longer sufficient to take care of baby’s nutritional needs. So, it’s a good thing that your baby is taking solids, however, the fact that she appears to have stopped breast feeding doesn’t mean is weaning herself. This situation may be due to a breast feeding strike 😀 Can you beat that? A strike…from your loving baby who you’ve given up so much for? 😀 Don’t worry…it’s nothing personal 😀

Breastfeeding strikes usually happen in children between 6 and 9 months and can be due to the fact that at this stage they have discovered the world and so cannot seem to give their full attention to breast feeding any more 😀 The ills of 24 hour TV et al….sigh! Other causes of this strike may be:

• A cold which stops baby from breathing well while feeding or an ear infection which hurts when she sucks

• A change in your perfume to a scent your baby doe not like

• A decrease in the volume of your breast milk due to the introduction of complementary feeds• A change in the taste of your breast milk…may be due to the return of periods• Infection of your breast duct (mastitis) causing the breast milk from that breast to be kinda salty (who wants salty breast milk? Eeew!)

• Teething

• Long separation from mother

In the meantime, express the breast milk to prevent having a blocked duct. Then try feeding your baby when he’s sleepy…he may be less willing to fight then 🙂 Breast feeding in a dark, quiet room may also be helpful in limiting the distractions that your baby may have. Try different nursing positions and try to pay more attention to baby…keep her especially close. Remember that the solids he’s taking are great but he also needs the breast milk.

A paediatrician will help confirm if there’s an ear infection. If you’ve just changed your cream or perfume, you may want to switch back to what you were using earlier to see if it helps.

All the best!

Q: Good morning Doc.  My question is, ‘my wife is complaining of a sharp pain under her navel and she said it feels like something moving around inside her tummy’. Secondly, I found out that after ejaculation the fluid comes out of her vagina immediately she breaths. Please what could be the cause of this? Can this delay her from getting pregnant?

A: Hello! Thanks for writing in.

Pain under the navel could be due to a myriad of reasons. Below is a list of some conditions that could lead to pain around or under the navel:

Around the navel

• Obstruction of the intestines
• Stomach ulcer
• Crohn’s disease
• Constipation
• Worm infestation
• Umbilical hernia

Below the navel (pelvic pain)

• Menstrual cramps
• Bladder infection
• Ectopic pregnancy
• Ovarian cyst
• Uterine fibroids
• Miscarriage
• Pelvic inflammatory disease

This is by no means an exhaustive list and so my suggestion would be for her to go see her doctor asap for a proper examination and diagnosis.

I’ve received this question on semen flowing out of the vagina after sexual intercourse 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/

All the best!

The keto diet is mainly used to reduce the frequency of epileptic seizures in children. It has been used for weight loss and achieves results short-term, in some cases. The long-term effects and safety are not really clear. But some side effects have been documented. They include: some nutritional deficiency because you are not eating a wide range of foods, kidney problems because there is such a thing as, ‘too much of a good thing!’ and the kidney struggles to metabolize all the protein in the diet, liver problems due to the high fat content of keto meals that the liver has to process, constipation because the keto diet is low on complex carbs like grains, mood swings etc. The news is really not fantastic! But hey! Let’s hear what Harvard has to say….

https://www.health.harvard.edu/staying-healthy/can-the-keto-diet-help-me-lose-weight

Dear all, this week, August 1 to 7, the world celebrates World Breastfeeding Week. This year, the theme is, “Empower Parents, Enable Breastfeeding.” This theme reminds me a lot of what I went through trying to find a hospital with a crèche where I could work and breastfeed my baby comfortably at work. That was not to be! Want to know all about it? Read below:

A few years ago when I was pregnant for my first child, I made plans…loads of them. How great a mother I was going to be, I would make packed lunches, make her hair, teach her, school her, take her to work with me, (so I could exclusively breast feed), take her to school by myself (when it was that time), pick her up too, do her laundry by myself etc. I wanted to be super mum. All those statistics of mothers who left their children etc., was never going to be me or my child. 

And so, I birthed this child. And, I set about doing all the things I had planned to do with a vengeance! I had no help…I insisted on doing everything myself, (never mind that by the end of the day I was frazzled, at my wits end and willing to bite people’s ears off, if they so much as grazed past me, how much more touch a raw nerve!) I also started looking for that hospital where I would work with my baby. I had just finished med school, house job and NYSC at that time, and so my head was brimming with all those ideas of bonding with my baby by breast feeding and also ensuring I was giving her immune system a great boost for life…and all those wonderful reasons we were given for breast feeding. In fact, as I was leaving med school, I was convinced that breast feeding was cool and oh so, fashionable! But the whole world conspired against me and all those noble ideals I had. I couldn’t find any hospital that felt I was truly serious about working and discussing the concept of bringing my baby in and having a crèche where I could take off, now and again to breast feed and bond :D. In fact, none of those hospitals had crèches for their nursing-mother employees! Oh! Years later, I can imagine them bursting into gales of laughter anytime I left any of those interviews. ‘Can you imagine? She wants to work…with a baby?!’ ‘Is she for real?!’

And so started my reluctant stay-at-home period! It was to be for about 2 years. By this time, I had finally ‘wised’ up and figured that the society wanted mothers to breast feed their children, bond with them and reduce crime rates etc., but no one was willing to make the sacrifice to make that happen. And so, I made plans to put my daughter in school only to realise I was pregnant again. With my second daughter, breast feeding was perfunctory as I spent the period of pregnancy and immediately after birth plotting my return to the work place. 

Having tried exclusive breast feeding and partial breast feeding, the difference was clear. Where my first daughter was a pillar of health during childhood, my second baby…though not sickly, always looked pale, picked up every virus flying around in the air and wasn’t the easiest child to adapt to new diets etc.

Having experienced both extremes and becoming convinced about what made sense for me as a mother, I determined that with my next baby, I was going to work, (the housewife thing was not working for me. I was plain miserable! I doff my hat to all housewives! You’re all amazing women and you rock!) and I was going to breast feed. And guess what? That was exactly what I did! I would breast feed at home and express regularly to freeze for the periods I was away at work. It wasn’t easy but it was certainly worth it! So is it possible for a working mother? It is. 

I smile when I hear working mothers say, ‘but I work, how can I do that?’ You can, but it requires some sacrifice…actually lots of sacrifice. 

Breast milk, beyond being cheap, temperature regulated and readily available 😀 is formulated with everything your baby needs for each stage of his growth. It’s chock full of immunoglobulins (which makes them resistant to illnesses , vitamins, minerals, proteins, fats and oils. So, it is indeed a complete meal! It also helps the womb to return to normal size after childbirth.

So ladies, let’s give our children the right start. It is still fashionable to breast feed. (And even if not, who cares about what the fashion radar is saying on that, anyways?! Or better still, let’s start the fad!)

Employers please encourage this practice that is useful to society as a whole…crèches aren’t such a bad idea when you think about the fact that you would now have dedicated female employees working for you. Family-friendly policies – such as paid parental leave (including paternity leave) – encourage breastfeeding and help parents bond with their children. Breastfeeding breaks provide safe and private spaces for nursing mothers at work to express and store breastmilk. These policies have been shown to increase employee retention, job satisfaction, and result in fewer absences.

PS: Ladies get some help at home. You know that ‘super mum’ thing I was trying to do? It just exhausts you and you can’t get it all done. Get a washing machine or someone to do the laundry. If you don’t want a live-in help, get a daily. But whatever you do, get help! You’ll be a lot happier. Trust me, I know!

Here’s to a healthier, happier…and less stressed out you!

Q: Doctor, is it okay to bleed when you are on 3 months injection?

A: Family planning injections work by thickening mucous in the cervix, preventing sperm from getting into the womb (uterus) or by preventing the ovaries from releasing eggs every month (ovulation) and so the person taking the injections can’t get pregnant.

Taking these injections affect women differently. In the first few months, there be excessive bleeding during periods, followed by a period of lighter periods. This may yet be followed by a period of irregular or no periods especially in women who have taken these injections for up to a year. Irregular periods should be discussed with your doctor to ascertain the cause. It may be due to the drug or due to an infection which needs to be treated. Prolonged periods can also be treated.

When these injections are stopped, it takes a while for ovulation to be restored because these injections are long lasting. It can be as long as 2 to 3 months. In some other cases, this can last for about a year or even up to 2 years. This has nothing to do with the duration for which the injection was taken.

So, bleeding with these injections is not uncommon, but as I always advise, please see your doctor when in doubt.

All the best!

Do you know that the benefits of walking have been described as a ‘wonder drug’? Will this encourage you to walk more? Read! https://www.health.harvard.edu/healthbeat/5-surprising-benefits-of-walking

Q: Hi Dr. I’m 37 week pregnant my baby is not moving anymore. Is it normal or something is wrong?

 A: The first time you feel your baby’s movement is known as quickening and the time women feel it varies person to person. It ranges from 16 to 25 weeks but women who have had babies before may feel this much earlier. Women describe it as different things: a bubbly feeling, butterflies in their tummy, gas etc.

You would have observed that your doctor or midwife has asked you to be aware of your baby’s movement and specifically, make a note to let them know if the movements reduce. This is because reduced baby’s movements may signify baby is in distress or other problems.

You may notice that when you drink cold water, that baby moves around. This is, theoretically because the uterus/womb is close to the digestive tract such that the cold water in the digestive tract stimulates the baby to move. Women who feel concerned about their baby’s movements are, sometimes, asked to do this and check for baby’s movement at home.

So, what to do now? Go see your doctor immediately and let him examine you and speak to baby’s health. Better safe than sorry.

All the best!

Q: Hello Dr. Ketch, help a lady who’s in need. My baby is teething. He refuses to eat. He only enjoys breast milk and water. Please help! What food should I Prepare?

A: Generally, how can I help my baby through teething what with the itch and discomfort they feel around the ‘erupting tooth’ area? Even the drooling? Well, here are a few things you could do:

Rub over the teething area with your finger (thoroughly scrubbed and clean, of course :D) or use a finger covered with clean gauze or even the baby’s wash cloth. If this is cool to touch, this is even better. Massage the teething area with this…it helps to soothe the discomfort.

Teething rings are great ideas too and you could also refrigerate these to provide more comfort. Please do not freeze them.
Clean off the drooling saliva as this could cause irritation around the baby’s mouth, worsening his crankiness.

Over the counter analgesics like paracetamol could also be helpful provided it’s given in the appropriate dose for the baby’s age. This will also help with the fever. Please avoid Aspirin as it causes a disease called Reye’s syndrome.

Several studies have been conducted on the efficacy of gripe water though it is liberally used by parents and doctors alike, and it has not really been found to be particularly useful in teething. Older formulae contained alcohol which were thought to be perhaps, responsible for the soothing effect it had. Other components like the herbs etc may not go down well with all children.

What to feed baby during this time? It depends on his/her age.

From birth to 6 months, please focus on exclusive breastfeeding with not even a drop of water. From six months, baby is ready to be introduced to some other food.
For a long time, the standard teaching had been to go for rice cereal as the first add-on meal because it is bland and babies tolerate this well. Other studies question this wisdom now and suggest that foods like meats with lots of essential nutrients like iron may be a good place to start. What should you do? You can boil beef/chicken very soft and blend it up for baby. If baby tolerates this, then by the next week, you could try adding some rice cereal. Try not to introduce more than one food per week so that you have time to study how your baby adapts to it and of course, look out for/isolate food allergy. And, to start off, only one meal of the complementary feed should be given daily. The rest should be the usual…breast milk 😀 This will, of course, as baby tolerates.

Generally, foods to start off weaning should be just slightly thicker than milk and so, if it retains its shape on a spoon, it may be too thick.

From 9 months, baby can be allowed to start experimenting with regular family meals…minus the spices, of course 😀
From one year of age, you can add the cereals mentioned in the question and it’s also okay to introduce cow milk at this time. Full cream cow milk is advocated at this time for proper brain development. Thereafter, please switch to skimmed/1%/2% milk as full cream milk has a lot of saturated fat which may contribute to poor heart health. Grains, green leafy vegetables, cow milk, honey, whole eggs can generally be introduced after the baby turns 1 year old.

Generally, other weaning foods that can be introduced include:
Boiled egg yolk (egg whites contain substances that baby may react to), sweet potatoes, fish, chicken, beef, fruits like banana, avocados, boiled beans (with skin removed if possible etc
Simple recipes include, blend some chicken or beef with the stock or mash a banana and add to baby’s cereal.

Our local cereals can also be used and fortified with some breast milk or formula.

As baby tolerates these meals, you can get a little more adventurous.

Boiled carrots mashed with some coconut oil or a little yoghurt with mashed banana may not go amiss too.

An example of a recipe I make for my children is boil potatoes in a pot and place a stainless plate on top of the pot. Add your egg yolk and a drop Olive oil and when the yolk is cooked and potatoes soft, mash all together and feed baby.

Now I know we are all very busy, but weaning is no easy task and so we must commit to trying as much as to prepare these meals ourselves. Packaged meals usually contain additives that may trigger problems/allergies etc in the baby. Hygiene is also critical!

All the best and whenever in doubt, consult your baby’s doctor.

For most Africans, taking a bath, at least once daily, is normal. But it’s not the same for everybody else. Some reports state that in China, ‘about half of people report bathing only twice a week.’ 😀 Amazing!
We’re probably all aligned on why we need to bath everyday – hello! Who wants to be close to that smelly guy who hasn’t had a bath in two days?! 😀 But is there a case for why we may not need so many baths/showers? Well, you should read this!! 😀 https://www.health.harvard.edu/blog/showering-daily-is-it-necessary-2019062617193

‘ You probably don’t give much thought to your neck, unless something goes wrong and you start to feel neck pain.. This underappreciated body part has to be strong enough to support a heavy weight (your head) yet still allow you to tilt, turn, and nod your head easily. ‘

https://www.health.harvard.edu/heart-health/when-a-pain-in-the-neck-is-serious