chatwithketch

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

Q: Doc. I am 41 years of age and My hands and my head is shaking uncontrollably, what can I do to remedy the situation. I heard it’s called Tremor.

A: There are a few causes of shaking or tremors as they are called medically. Tremors may be familial i.e. runs in families, with the shaking noticed more when stretching out the hands or carrying out an activity; in this case, there are usually no other problems associated with it.

Tremors could also be a sign of some abnormalities in the body’s functioning – endocrine abnormality. In this case, there is shaking (especially in the hands), fast racing heartbeat, which the individual can hear/feel, sleeping problems, excessive sweating and possibly a neck swelling.

Other causes include:

• Certain drugs
• Liver, kidney or long standing lung diseases
• Alcohol intoxication
• Withdrawal from hard drugs
• Parkinson’s disease (a disorder of certain substances in the brain)
• Anxiety or panic attacks (fear of places, situations or circumstances, which exceeds that which can ordinarily be explained)

Remember when you had to write an exam, which was all important to you and your parents, or present something in front of the class or assembly for the first time…shaky, weren’t you?

I may not be able to identify the cause of your symptoms, but I would advise you take some time off. Stress, if you are undergoing any form of it, (physical, emotional, or psychological) could also be the source of this problem. It’s time to sit back, identify the likely causes and address them from within you to the outward.

For those things/issues you cannot resolve immediately, remember the serenity prayer:

God grant me the serenity to accept the things I cannot change;

Courage to change the things I can;

And wisdom to know the difference

Exercise is also a good way to relax and relieve stress. But most importantly visit your doctor who would evaluate you, identify the possible cause of the shaking, and recommend appropriate treatment.

Hope this helps. Best wishes.

***** This post was contributed by a doctor guest blogger.

Have a great week ahead, people 😀

Q: Good evening Dr I have been following your teachings please I need you to help me out, am confused. Parents are AS and AS and their son is AA, the son then married a wife who is AS please as husband and wife with AA and AS can the grandparents genotype make them have a child with SS?

A: Your question is quite interesting but the answer is really simple. Parents with AA and AS have a 50% chance of having children with AS and 50% chance of having children with AA genotypes. They cannot have a child with SS genotype, except one of them had  had a bone marrow transplant. So, something could be wrong with the testing, reading and/or reporting of the test results of the grandparents and/or the parents. Sometimes, the presence of the beta thalassemia gene could also be the reason for this confusion. 

So, I suggest that the parents visit go to a tertiary center like a specialist hospital or a Teaching Hospital or even a specialized sickle cell center. The services and specialties there, including genetic counseling, are more specialized and you should be able to get to the root of the real genotypes here. 

I strongly recommend this be done before typical accusations of extramarital affairs are bandied around 🙂

For related posts, please click on the links below: https://chatwithdrketch.com/2014/07/28/daily-health-tips-can-i-my-blood-group-change-from-time-to-time/

Daily Health Tips: My Fiancee And I Have AS genotype. Should We Get Married?

All the best!

Have a good night, everyone J

Q: I heard somewhere that it’s not safe to use powder on my baby. Is this true?

A: Great question! For most mothers with babies, some form of powder is a staple in the baby care pack. Powder is sprinkled all over the baby after they have been moisturized, used on the baby’s butt to prevent nappy rash, sprinkled on suspected rashes on the baby’s body etc. So, using powder on babies is pretty common due to the belief that it prevents friction and absorbs moisture

However, studies have shown that the cloud of powder ‘dust’ can be inhaled by babies and cause respiratory problems. Babies most at risk include premature babies, those born with heart disease, those with frequent respiratory problems etc.

Therefore, if you must use powder on your baby, here are a couple of tips:

Don’t shake the powder onto your baby. Move away from your baby, put some powder sparingly on your hands and then transfer to your baby’s body

Don’t allow the powder to build up on baby’s skin. Wash off residual powder on baby’s skin, especially folds, before applying another layer. If you’re trying to figure out what you can actually use to prevent nappy rashes, here are tips for you: https://chatwithdrketch.com/2019/05/09/hlwdk-daily-health-tips-did-her-diaper-cause-this/

Finally, please keep powder packs tightly closed and out of the reach of children to prevent them being accidentally knocked down and raising a cloud of powder dust.

All the best!

Tramadol has been in the news recently for all the wrong reasons. This is just an additional reason not to indulge.

Read! https://www.health.harvard.edu/blog/is-tramadol-a-risky-pain-medication-2019061416844