chatwithketch

Q: Hello Doc, I just want to ask some remedies for baby’s oral thrush

A: Believe it or not, our bodies are filled with different micro-organisms, all of which are searching for relevance and dominance 😀 These good and bad micro-organisms usually maintain a delicate balance until something happens (like when one takes some medications like steroids, uses antibiotics, has a depressed immune system as occurs in extremes of age: very young and very old and also if one is infected with HIV, has cancer or Diabetes Mellitus) to disturb this delicate balance. When this happens, fungal organisms which were minding their own business before, have an opportunity to overgrow in the mouth and cause problems.  This condition can also happen in the vagina causing vaginal thrush or even in infants causing diaper rash.

What does this look like? It looks like creamy white patches on the tongue, on the inside of the cheeks, gums, tonsils, back of throat etc. They look like you can just scrape them off but any attempt to do that would usually lead to bleeding. People with this condition may also experience pain when swallowing or eating. Children with this condition are usually irritable and fussy.

Treatment of this condition is with the use of anti-fungal drugs which would usually have to be taken for about 10 to 14 days. Your baby’s doctor will advise on the right medicine. For nursing mothers, there may be a need for antifungal cream applied on the breasts as the baby and the mother may pass the infection back and forth to each other. Talk about joy in sharing 😀

I don’t know how old your baby is but irrespective of age, to prevent this:

• Practice good oral hygiene: brush your baby’s teeth twice a day being sure to spend time brushing the surface of the tongue
• Rinse out your mouth after every meal, if you can’t brush, especially if you have just taken a lot of sugary foods.
• Limit intake of sugary foods
• For those who use dentures, take them off before you go to bed
• And for those who smoke (definitely not your baby :D), don’t reduce the number of sticks you smoke. Just quit! 😀

Have a great night, people 😀

To conclude World Breastfeeding Week, I revisit another breastfeeding question

Q: How can I store expressed breast milk?

A: Expressed breast milk has to be handled in a very hygienic way. It is important that it does not form the means by which germs find their way into your baby’s body so utmost care must be taken.

What should you do? I reproduce a post I had made on this a while back;

To express milk for your baby, first, you have to be committed to be hygienic because you don’t want to introduce germs into your baby, do you? Always scrub your hands with soap and water whether you are using the breast pump or your hands.

Having expressed the milk, when stored at room temperature, be sure to use up the milk within 6 hours.

When stored in the fridge,
• Ensure that the temperature in the refrigerator is below 5 degrees centigrade.
• Do not store on the door of the fridge. Please store on the shelf towards the back of the refrigerator where it’s cooler
• At this temperature, you can store milk for up to 5 days.

When stored in the ice compartment of the refrigerator, you can store milk up to 2 weeks

When stored in the deep freezer, you can store milk up to 6 months.

To thaw frozen milk, please put it in the fridge. When it’s thawed, you may feed your baby with it but if your baby prefers it warm, you can run some warm water over the bottle until it’s just right. Do not microwave it as this may create some hot spots in the bottle which may cause scalding of your baby.

Once thawed, please don’t re-freeze the milk as this might encourage the growth of micro-organisms.

Make sure that the container used for storing milk is sterilized to prevent any potential introduction of germs into the milk. Use small containers that hold just about the amount that your baby finishes per feed.

If you express a lot of milk, be sure to label the different containers and use the oldest pack first. Please stick with the duration of storage guideline we’ve given.

Now, it goes without saying that you should not store milk close to contaminants like meat, fish or even strong smelling foods like onions 😀

All the best!

Still celebrating Breastfeeding Week 2019….

Q: Good day Dr. Ketch, please my question is…what supplements can a nursing mother take to enable free flow of breast milk? Is coffee good while breast-feeding?

A: How can we help mum to establish or re-establish breastfeeding? To answer that I’ll reproduce part of a post I had made on this subject.

Mum needs loads of support from her medical team (be that the nurses that provide support for lactation or the doctor who does same). This support can range from teaching her how to latch baby on properly to the doctor prescribing medications that encourage milk production. Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

Effective breastfeeding 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. It is thought that some of the galactogogues ‘improve’ the taste of breast milk making the baby spend more time on the breast.

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 six (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.

On coffee…

Coffee and other foods and drinks that contain caffeine should, definitely be avoided when breastfeeding as much as possible. Caffeine in coffee energy drinks, some soft drinks etc. This makes the baby irritable and by extension, makes sleep difficult for the baby.

Other foods to avoid or limit their consumption while breast-feeding

Alcohol: This should be avoided at all costs.

Cigarette (yeah, yeah, I know it’s not food) should also be avoided as it reduces the production of breast milk.

If baby reacts to what the mother ate, efforts should be made to pinpoint what the mother ate before the incident started and then eliminating that from the diet to see if the diarrhea or allergy stops.

Make sure that you eat well: lots of fruits and vegetables and complex carbohydrates. Cut out the junk that will not help you achieve your weight loss goals and in addition have empty calories. In addition, drink sufficient fluids daily.

Be careful before taking any drug as most find their way into your baby.

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?

All the best!

Want to eat healthier? Want to know what one serving of bread or rice or pasta or indeed any other food is? You should read this! https://www.health.harvard.edu/blog/the-dash-diet-a-great-way-to-eat-foods-that-are-healthy-and-delicious-2019072517326

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