Medical App & Medical Advice with Hello Doctor

Could your baby have Hirsprung’s Disease?

Hirschsprung’s disease is a condition where the large intestine makes it difficult for stool to pass through it. It’s usually found in babies and is present at birth.

Between the fourth and twelfth week of pregnancy, the foetus develops nerve cells in the digestive tract. When these cells don’t grow sufficiently past a specific point in the intestine, digested food and stool can’t move through that part of it.

After this happens, Hirschsprung’s Disease develops, and your baby becomes constantly constipated and unable to have normal bowel movements.

This condition is found in approximately one in five thousand births. Males are more vulnerable than females and children with Down syndrome are at high risk.

Symptoms of Hirschsprung’s Disease differ depending on the severity of the condition. Signs commonly show after birth but may also appear later.

Common symptoms in a newborn:

  • Not having a bowel movement within 48 hours after being born
  • A swollen stomach
  • Vomiting
  • Constipation or gas

How is it diagnosed?

Abdominal X-ray
This is to check if the baby’s bowel area is blocked.

Contrast enema
The large intestine is examined with an X-ray to check for abnormalities. The rectum is coated with a substance so that the intestine will be seen on the X-ray machine.

Rectal biopsy
For this procedure, a sample of the cells in the rectum is examined under a microscope. The aim of this exam is to check if the cells in the intestine have developed properly. This isn’t a painful process and a suction rectal biopsy can be done while your little one is in bed.

How is it treated?

As Hirschsprung’s Disease is a life-threatening one, it needs treatment, usually in the form of surgery. Surgery involves removing all or part of the colon and is called a colectomy.

There are different kinds of colectomies:

Pull-through procedure
The surgeon removes the part of the large intestine where nerve cells are missing and connects it to the healthy parts of the anus. This procedure is usually done very soon after a baby is diagnosed.

Ostomy surgery
This procedure changes the route that the stool takes to exit the body when a piece of the bowel is removed. This means that a part of the intestine is brought through the abdominal wall so that stool can leave the baby’s body without going through the anus. After surgery, a removable collection pouch, called an ostomy pouch is worn outside the baby’s body to collect stool. Parents will need to empty the pouch a few times a day. Ostomy surgery is often done with babies who have a severe case of the disease and need to get better before having the pull-through procedure.

Good to know:

  • After having a colectomy, a baby will need time to heal.
  • Stools may be loose and frequent at first after surgery. Clean the anal area carefully to remove any loose stools.
  • Apply rash creams or lotions to help prevent irritation on your little one’s skin.
  • For older children, they may struggle to understand when they need a bowel movement. Talk to your doctor about techniques that can be used to help them to become more aware of this.

References:

My child is choking! What do I do?!

Kids are always on an adventure of self-discovery, experimenting with everything in their path. As part of this learning process, children between the ages of one and five often put objects in their mouths. This is a normal part of exploring their surroundings.

But what happens when the adventure turns into a nightmare, and your child starts choking?

Important facts 

According to Injury Facts 2017, choking is the fourth leading cause of accidental death. The number of children who choke on food is particularly high because of the size, shape and consistency of certain foods which make them likely choking hazards. The best way to prevent accidents is to make sure that small objects stay out of your child’s way.

If you suspect your child is choking, act immediately:

  • If he suddenly starts coughing, hasn’t been sick and has a habit of putting small objects in his mouth, there is a good chance he’s choking. Support him in a position where he’s face down. Hold his head in one hand, with his upper body on your forearm against your thigh.
  • Give him about five back slaps between the shoulder blades with the heel of your other hand.
  • If the object doesn’t come out, roll his face up and support the back of his head with your hand.
  • Put two fingers on the breastbone just below the nipple line.
  • Give five chest thrusts, about one per second.
  • Continue cycles of five back slaps and five chest thrusts until the object comes out or when your child becomes responsive.
  • If your child is still not breathing or only gasping, start CPR.

Cardiopulmonary resuscitation (CPR)

CPR is the lifesaving method to recover someone who shows no signs of life, meaning they’re unconscious and not breathing.

Before you perform CPR on your child:

  1. For infants, flick the bottom of the foot to get a response.
  2. If your child doesn’t respond, call an ambulance immediately.
  3. Open the airway by laying your child on his back. Tilt his head back slightly and lift his chin.
  4. Check for breathing. Listen carefully for a breathing sound of no more than 10 seconds. Occasional gasps aren’t breathing.
  5. Deliver two rescue breaths if your child isn’t breathing. With the head tilted back slightly and the chin lifted, pinch the nose shut, make a complete seal by placing your mouth over the child’s mouth and breathe into his mouth twice. For infants, use your mouth to make a complete seal over the infant’s mouth and nose, and then blow in for one second to make the chest clearly rise. Now, deliver two rescue breaths
  6. Keep going. Continue the CPR steps until you see obvious signs of life, like breathing or until paramedics are available to take over.

References

Does your child have Electronic Screen Syndrome?

Believe it or not, a child’s nervous system can become overstimulated by regular screen exposure that comes from cell phones, computers, iPads and other digital devices. These devices can cause chronic stress on the brain, which may result in various different learning and behavioural disorders.

Electronic Screen Syndrome (ESS) is considered an unrecognised modern-day disorder. The interaction with screens can shift the nervous system into fight-or-flight mode, which causes dysregulation and disorganisation of different biological systems.

Once in this state, your child’s mood, behaviour, and focus can be affected. ESS isn’t limited to teenagers obsessed with digital devices; toddlers can be affected too.

The latest research suggests that around 90% of children can use an electronic tablet by the age of two. What’s worrying about this statistic is that each time a child picks up a device, changes happen in the brain that can lead to overstimulation and hyperarousal.

According to Dr Victoria Dunckley, author of Reset Your Child’s Brain, ESS symptoms typically include poor focus, irritable mood, and disorganised or disobedient behaviour. Children with ESS are easily frustrated, tearful and angry. They tend to have meltdowns over minor incidents. They often struggle in school because they can’t get their work done and may display immature behaviour that’s off-putting to their friends.

Technology is known to have a hyper-arousing effect, as it can raise dopamine levels – the feel-good neurotransmitter that also plays a role in forming addictions. Children with ESS tend to lose interest in anything that isn’t electronically based and may show little imaginative play or creative expression.

ESS risk factors

Children with ESS are drawn to their screens – so much so that it becomes hard to pull them away.

The following factors may increase the risk of ESS:

  • Younger age
  • Males
  • Behaviour disorders (like attention-deficit hyperactivity disorder or autism)
  • Psychosocial stressors
  • Addiction tendencies
  • Sensory dysfunction

Help your child

As a parent, the first step to help address this syndrome is to recognise the signs. If the following questions apply to your child, he may have, or be at risk for, ESS:

  1. Has your child progressively become defiant or disorganised?
  2. Does your child have full-blown rages?
  3. Does he have meltdowns over minor frustrations?
  4. Do they become irritable when told to stop playing video games or to get off the tablet/computer?
  5. Do you ever notice your child’s pupils are dilated after using electronic devices?
  6. Does your child have a hard time making eye contact after screen time or in general?
  7. Do you ever feel your child isn’t as happy as they should be, or isn’t enjoying activities as much as they used to?
  8. Does your child have trouble making or keeping friends because of immature behaviour?

Try to remove screen stimulation from your child’s routine. This will allow for your little one’s brain to get deep rest and will assist in rebalancing their brain chemistry and hormone levels, while at the same time, restoring their mental energy. This can help to improve his mood, focus, and behaviour in a matter of weeks.

References:

Teach your child to love vegetables

Vegetables are incredible. They’re high in fibre and packed with essential vitamins and minerals. To a child though, they’re usually seen as “yucky green stuff” that should be avoided at all costs!

Getting your child to eat vegetables is frustrating and may seem like an impossible task but understanding why they don’t like vegetables can help.

Why do kids hate veggies?

Quick bursts

Children are generally more active than adults and so, need more energy. Foods high in sugar glucose are the body’s preferred sources of energy, which means they’d rather reach for sweet treats than nutritionally-dense veggies. What’s more; some vegetables are so low in calories and high in indigestible fibre; that you could use more energy to digest it than it contains!

Bitter bites

If you take a bite out of a green leaf from your garden, you’ll probably cringe at its bitter taste. The same thing happens when kids eat most vegetables and particularly, leafy greens. The bitter taste is caused by the calcium content, as well as compounds like isoflavones, flavonoids, terpenes and glucosinolates. Children taste this bitterness more strongly than adults, so they tend to avoid it as far as possible. Children have not yet developed a capacity for detoxification. The bitter taste sets off alarm bells in their little bodies, indicating that what they’re eating may be toxic. Adults (usually) don’t have the same aversion to vegetables as we have learnt from experience that vegetables are useful and won’t cause us harm.

Negative associations

When you eat a specific kind of food and it constantly makes you feel sick, you’re likely to stop eating it altogether. Over time, you start to associate the food with negative memories and feelings. This is called paired associative learning, and it plays a key role in the reason that kids are averse to munching vegetables. Paired associative learning is when a stimulus is tied to a specific response (a feeling). For example, children generally associate foods like cake and ice-cream with birthday parties, i.e., happy times. Vegetables are usually associated with negative memories like them being forced to eat their vegetables or nagging parents. turnover time, junk food is seen as a reward and vegetables as a punishment.

Perk up those veggies

When children eventually become adults, their associations often change, and vegetables are no longer the enemy. Here are a few ways to get your little ones to take a liking to greens.

1. Reduce the bitterness

Spices can make bland food taste better. Prepare your child’s veggies differently every night to vary their tastes. For example, pickling, braising, caramelising or even sautéing vegetables reduce their bitterness. Adding fat, sugar and salt tones down the bitterness, but avoid drenching out the flavour of the veggies altogether!  You can also use cinnamon, spices and herbs to enhance flavours.

2. Serve it with a dip

Dipping is fun, and sauces spice up even the blandest of foods! Serve your child dip with his vegetables for a fun twist on dinner. This is especially helpful if you’re getting him to try a new veggie. Skip dips that are packed with refined sugars, oil and preservatives and stick to those that use whole ingredients. Serve homemade hummus, guacamole, salsa and even natural peanut butter. Yoghurt-based dips like ones made with Greek yoghurt are also tasty and healthy.

3. Try and try again

Exposure is everything when you’re encouraging your child to eat vegetables. This doesn’t mean you should force them to eat an entire bowl of broccoli. Instead, incorporate a variety of different vegetables into their meals. After about 10-15 tries they should be able to properly decide if they like a certain food. Soon, they’re likely to start enjoying vegetables or at least, decide which ones they prefer.

4. Create good memories

Don’t use food as a reward or punishment as this can cause extreme associations. Rather offer vegetables alone without other foods when your child is hungry, so he’s more willing to eat them. Avoid nagging and fussing if he refuses to eat certain vegetables. Gently encourage him to try new foods instead, and praise him when he does. If you show your child that you enjoy vegetables and they constantly see you eating them, they may also be less likely to form a negative outlook.

References:

Vaccines: declaring chemical warfare on diseases

Every day our bodies fight off germs, viruses, and other microbes that, if left unchecked, would keep us in a constant state of illness. But there are times and certain diseases that slip past these natural defences. That’s where vaccines come in.

What are vaccines? 

There are several different types of vaccines but they all act in the same way: by “teaching” your body how to fight off a specific germ. Vaccines are weakened or dead forms of diseases that, when injected, start a series of biological reactions that build our immunity against the specific germ they contain. Vaccines are mostly given during childhood, but some are common in adulthood, especially when travelling to disease-affected areas. Common vaccines include those for measles, chicken pox, the flu and polio.

How vaccines work

Basically, vaccines stimulate the body’s immune system to develop the necessary defences against specific diseases. Because the vaccines contain weakened or dead forms of germs, they do not cause illness, but the body, when infected by the live or stronger germs, remembers how it fought off the previous versions. This results in a far less severe infection. Essentially, vaccines give your body’s immune system a practice run, preparing it to fight the real enemy.

The cells involved in this “learning” process are lymphocytes, commonly known as white blood cells. When they detect disease, they produce specific proteins called antibodies. These are the cells that fight the offending antigen, be that germs, pollen or toxic chemicals. When an antigen is one that the body has met before, as in the case of a vaccine, it produces the same antibodies that worked against it before. The antigen is fought off, and a life is saved.

Each antibody your body produces against a specific disease is unique; it can only fight off that germ. Your body produces millions of unique antibodies to fight the millions of germs out there.

Why are there vaccines for some diseases but not others? 

Science isn’t all-knowing, and there are billions of germs that act very differently to each other. We can’t formulate vaccines for all, so we prioritise research into the most harmful. Some viruses, like the influenza virus, change endlessly. Each new strain is so different from the previous that the antibodies created from last year’s flu vaccine won’t recognise it. Others, like HIV, attack the immune system itself.

We do need vaccines against all diseases. But it’s impossible to develop vaccines for every single disease. And if you live in an area where a disease has been eradicated or doesn’t exist, it isn’t necessary, or cost-effective for you to have a vaccination. Vaccines that are easier to develop, store and distribute are the ones most often used, while priority is also given to existing vaccines for diseases that are particularly rife in an area. Governments and health departments must juggle affordability, the severity of the disease, what vaccines are available, and whether a disease exists in their region to give people the best possible access to vaccination programmes.

Necessary vaccines

The South African government has a complete vaccine schedule, available for free at all public hospitals and clinics. Most children begin vaccinations from birth, as babies are particularly vulnerable to diseases. Vaccination continues until age 12.

Here is the Department of Health’s Extended Programme of Immunisation (EPI SA).

Source: Parent24

Age

Vaccine Also known as

Protects against

Birth TOPV 1 (Trivalent) Oral polio vaccine Polio
Birth BCG Bacillus Calmette Guerin Tuberculosis
6 weeks TOPV 2 (Trivalent) Oral polio vaccine Polio
6 weeks RV 1 Rotarix Rotavirus
6 weeks PCV 1 Pneumococcal conjugate vaccine: Prevenar Pneumococcal diseases
6 weeks DTap-IPV//Hib 1 Pentaxim (5-in-one) Diphtheria, tetanus, acellular pertussis (whooping cough), inactivated polio vaccine, haemophilus influenzae type B
6 weeks Hep B 1 Hepatitis B vaccine Hepatitis B virus (HBV)
10 weeks DTap-IPV//Hib 2 Pentaxim Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B
10 weeks Hep B 2 Hepatitis B vaccine Hepatitis B virus (HBV)
14 weeks RV 2 Rotarix Rotavirus
14 weeks PCV 2 Prevenar Pneumococcal diseases
14 weeks DTap-IPV//Hib 3 Pentaxim Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B
14 weeks Hep B 3 Hepatitis B vaccine Hepatitis B virus (HBV)
6/9 months Measles 1 Measles vaccine Measles
9 months PCV 3 Prevenar Pneumococcal diseases
12/18 months Measles 2 Measles vaccine Measles
18 months DTap-IPV//Hib 4 Pentaxim Diphtheria, tetanus, whooping cough, polio, haemophilus influenzae type B
6 years Td 1 Diftavax Tetanus, diphtheria
9 years HPV 1 (girls) Human papilloma virus
9.5 years HPV 2 (girls) Human papilloma virus
12 years Td 2 Diftavax Tetanus, diphtheria

 

References:

10 Tips to keep your kids happy this holiday

Kids look forward to the holidays all year long. Amid all the fun and merriment, keep their brains exercised and engaged. Here are a few ways to prevent the summer brain drain.

1. Switch off the TV and go live

This holiday, give the television a break too. Instead, take your kids to watch theatre shows or outdoor concerts. Live shows teach children the value of audience participation and boost their confidence. Introducing them to different forms of storytelling (other than movies) is also good for their cognitive development.

2. Get out!

Encourage your kids to play outside. Set up sports-related activities, treasure hunts and obstacle courses. If it’s raining, set them up inside… as long as you encourage the kids to move. The World Health Organization recommends that children from ages five and up stay active for at least 60 minutes a day. Exercise is important for your child’s growth as it helps to develop and strengthen muscle and bone tissue.

3. Exercise mental muscles

Develop your child’s critical thinking skills with visits to a museum, the aquarium, planetarium or nature reserves. Being exposed to different educational environments allows children to engage in active learning experiences, while at the same time applying what they have learnt in the classroom, to a real situation.

4. Hide the phone 

Give your child’s cell phone some time off. Break out the board games or make up new games with rewards as incentives. Replace playing games on the phone with age-appropriate fun that help develop problem-solving skills, logical reasoning, interpersonal skills and increased concentration span.

5. Cook up a storm

Make nutrition and exercise fun by allowing your children to be part of creating their own healthy snacks. Take your little one shopping for groceries and teach them how to read food labels. Allow them to make healthy food choices on their own. This way, they will be less likely to be fussy about eating healthy food. Did you know that grocery shopping and cooking are also good ways to develop kids’ maths skills?

6. Create a masterpiece

Arts and crafts are good ways to build strong family bonds. Psychologists recommend art therapy and play, as both are sensory-based, and don’t rely on verbal cues. These exercises encourage your child to be creative and express themselves in an organic manner. It also helps with developing fine motor skills, teaches languages through visual aids (shapes and colours) and inspires creativity and inventiveness.

7. Pop into the library 

One of the best ways to keep your child busy, engaged and entertained is through books. Books help to:

  • keep the brain active.
  • develop a deeper parent/child bond if you actively read and discuss books with your children.
  • nurture the imagination.
  • expand language and vocabulary skills.

Visit your local library, have storytelling sessions or enrol them in summer programmes.

8. Let them be boss for a day

Choose a day where your child gets to set the schedule. Give them the chance to create and set rules. Use this as a learning opportunity to act as a guide. You may not always agree, and their decisions may not be all that healthy, but relax your rules for a bit. This exercise should be about showing your child that their individual choices and decisions matter.

9. Host play dates with other children

Encourage social interaction and interpersonal skills with play dates or sleepovers. Whether it’s with friends or family, a big part of your child’s learning focuses on communication and social interaction. A study by the National Centre for Biotechnology confirms that a social child is a happy and well-adjusted child, and that play dates mitigate issues like loneliness and depression.

10. Encourage business skills

Plan entrepreneurship projects. Get the whole family involved and let your child use the opportunity to bake, build, craft and then sell their goods. The opportunity to learn and develop these skills will boost your child’s confidence while at the same time, nurture economic management skills.

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Can I fall pregnant if I have diabetes?

Diabetes is a chronic condition and once you’ve been diagnosed with it, you need to take care of your health by monitoring and keeping your sugar levels in check.

These checks become more important and necessary when you’re pregnant, as your body goes through a lot of changes.

Yes, you can fall pregnant if you have diabetes, but managing your condition becomes important for your own health and the health of your baby.

How will diabetes affect your pregnancy?

Poorly controlled diabetes increases the chances of having a big baby, weighing of more than four kilograms (a larger-than-average newborn). This is caused by the high blood glucose (sugar) that leads to more glucose crossing the placenta, to the baby. All this excess sugar means your baby produces more of the hormone insulin, which changes to fat. This fat will mostly be found around the baby’s shoulders and trunk. This is bad news as it might up your chances of having a difficult labour and birth.

The most common complications of diabetes affect the eyes, kidneys and nervous system. After you’ve delivered your baby, these symptoms usually disappear but you or your baby might need treatment.

Let your doctor know about any changes in your body as these could be symptoms of an underlying condition. Common conditions with pregnant women are:

  • Urinary tract infection that leads to fever.
  • Swelling in limbs and face.
  • Carpal tunnel syndrome that leads to numbness and tingling in hands.
  • High blood pressure that leads to fluid build-up.
  • Protein in urine.
  • Risk of premature delivery.

Most of your baby’s organs start forming during the first trimester of your pregnancy. It’s very important to start controlling your diabetes not just when you are pregnant, but before you even plan to have a child.

A healthy mom means a healthy baby:

  • Do a pre-pregnancy test to assess your blood sugar levels. This will help you plan diet and lifestyle changes.
  • Check with your doctor if you can continue your current diabetic medications while trying to get pregnant. You’ll most likely be advised to switch to insulin injections.
  • Monitor your blood sugar levels regularly. Get a home kit for convenience.
  • Exercise regularly and control your diet.
  • Since you’re likely to have a high-risk pregnancy, speak to a It’s better to talk with someone who has experience in treating pregnant women with diabetes. This will make for an easier pregnancy journey for you and your baby

Good to know:

Exercise can do a pregnant mom a world of good! It can help to keep your diabetes in check while at the same time contributes to your overall health.

Women who exercise throughout their pregnancy may also experience:

  • Increased energy levels.
  • A more positive outlook and lower anxiety levels.
  • An easier, uncomplicated labour.
  • Faster recovery time after giving birth.
  • Ability to maintain a steady, reasonable weight gain.
  • Less chance of needing a caesarean.
  • Faster postpartum weight loss.
  • Better sleep quality.  

References:

I’m pregnant! Now, what do I do?

Lately, your breasts feel tender, you can’t seem to keep your favourite foods down. When last did you get your period? Oh…

With a few home pregnancy tests done and dusted, you guessed it, you’re pregnant! But what should you do now?

Confirm your pregnancy

Before shouting about your baby bump, confirm your pregnancy. Dr Philip Zinn, a Cape Town obstetrician and gynaecologist recommends a urine test. A positive urine test should be enough to confirm that you’re pregnant. If you’re still not convinced, talk to your doctor about a blood test.

Let the countdown begin!

Once your pregnancy is confirmed, it’s time to calculate when your little bundle will be arriving. The gestation period (the time it takes for a baby to develop) is about 38 weeks. This means you can start counting 40 weeks from the first day you missed your period. Conception usually takes place about two weeks after a woman’s last period begins. Once you have a date, add 266 days to that. This should give you your most likely due date.

Decide when to make the announcement

A good time to tell people about your pregnancy is after the first trimester (three months after you fall pregnant). Next, decide on who you’re planning to tell first. Your family first makes sense and you can tell your co-workers when you feel comfortable. Keep your maternity leave in mind. Lastly, consider how you’re going to tell everyone. This could be in person, via a phone call, in writing or digitally (online posts or a text message).

Choose a doctor

You’ll be spending a lot of time with the doctor or midwife, so pick a good match. Once you find someone who’s well-qualified and you’re comfortable with, make your first prenatal appointment. This should ideally happen when you’re eight weeks pregnant.

Make some changes

Once you’re pregnant, you’re not driving solo anymore, you have a little one along for the ride. Follow a protein-rich, high-fibre diet, drink plenty of water and get lots of rest. If you’re under-or overweight, start a healthy eating plan. Say no to alcohol and limit yourself to two cups of coffee a day. Smoking is a definite no, so if you’re considering quitting, now is the time! Ask your doctor about how much exercise you should be doing. Walking is a safe option for all stages of pregnancy. Avoid strenuous exercises and competing in sports events.

Take stock

Talk to your doctor about important health screenings, like those for German measles, hepatitis, HIV, syphilis and iron levels. These tests ensure that you’re protected from certain diseases. Don’t take any medication without first talking to your doctor. This includes over-the-counter medication. When it comes to supplements, folic acid is very important to help your baby develop. Take at least 400 micrograms of folic acid every day to reduce the risk of spine disorders in your baby. Ask your doctor about other important prenatal vitamins.

Schedule your scans

Scans are there to make sure your baby is developing normally. During the first trimester, you may have a scan at about six to seven weeks. There’s also a dating scan done between 10 and 14 weeks to confirm your due date. A different scan is also done at this time to check your baby for Down’s syndrome. If your baby measures between 45mm and 84mm, then a blood test may be done as well. In your second trimester, you may have a scan between 18 and 21 weeks to check your baby’s development. If your placenta is laying low, you may need a scan at week 32. A growth scan between week 28 and 40 is also recommended.

Make your booking

It’s important to know where the birth will take place. This will depend on your financial circumstances and medical aid plan. It also depends on where your doctor or midwife is located, or what government services (clinics) are available. If you plan to have your birth at a private hospital, make sure you book a bed for the birth.  If you’re planning on having it at home, make backup plans like a booking at a medical facility, in case things don’t work out. Public and government maternity services work on a risk level basis. This means you don’t book an actual room unless you have a condition which puts you at risk, like high blood pressure, diabetes or asthma. When you go into labour and you’re using a government hospital, take your ID and clinic card with you. You’ll be assigned a bed in an antenatal ward, give birth in a labour ward and then moved to a postnatal ward.

Figure out your finances

Your pregnancy will cost a pretty penny and once your baby comes, so you’ll have to budget even more. Include basics like blankets, nappies, baby clothes, baby wipes, a pram and a car seat in your budget. Stocking up early should help in the long run. Also include your medical expenses (scans, doctor visits, stay at the hospital) and long-term needs of the baby like education costs.

References:

Can you treat your child’s epilepsy with a ketogenic diet?

Children with epilepsy have repeated seizures. These are caused by abnormal electrical activity in the brain. This condition is usually treated with medicines. But if medicines can’t control the seizures, a special diet like a ketogenic programme might help.

A ketogenic (or keto) diet is high-fat and low-carbohydrate. There is evidence to suggest that a diet like this may help to reduce seizures.

The science

The diet is very high in fat, and very low in carbohydrates, yet does still include sufficient protein to support normal growth and development in your child. According to the University of Rochester Medical Centre, a ketogenic diet causes the body to make ketones, which are chemicals made from the breakdown of body fat.

In a healthy person, the body generally doesn’t make or need to make ketones. Ketones are an energy source that the body would use only during fasting. This means that for someone who has epilepsy, a ketogenic diet would enable the brain to use ketones for energy rather than glucose – as much as possible.

This is important because ketones are largely water-soluble, so they move easily into the brain, and while the can’t use fatty acids for energy, it can easily use ketones for a large portion of its energy needs.

Ketogenic diet and epilepsy

A keto diet is gaining popularity as a backup plan for children whose epilepsy symptoms are difficult to control using medication alone, or as a treatment for children with seizures when medicine isn’t working properly. Research into how effective the diet may be is still ongoing, but there is evidence to show positive changes in neurotransmitters, gene expression, and influences on neuron receptors.

The diet may not work for every child, but some children become seizure-free when they start eating this way. Some may stay on it for many years. Your child’s doctor can help determine if the diet is right.

Diet menu

A dietician can help you figure out exactly what your child needs to eat, and how much of it. The ketogenic diet is relatively low in important nutrients, so your child may need supplements like Vitamin D, folic acid, iron, and calcium.

There are three food groups for this diet:

Fats: cream, butter, margarine, oils, mayonnaise, salad dressings, nuts, nut butter and avocado.
Protein: chicken, red meat, fish, cheese, milk, eggs and nuts.
Carbohydrates: bread, pasta, rice, potato, fruit and vegetables.

Breakfast

Scrambled eggs made with:

  • 2 tbsps heavy cream
  • 1 large egg
  • 2 tbsps butter
  • 1 medium strawberry

Lunch

Quesadilla with a creamy avocado dip made with:

  • 1 tbsp heavy cream
  • 2 tsp mayonnaise
  • 1 tsp olive oil
  • One-sixth of an avocado
  • 1 tbsp butter
  • 1 large egg white
  • 2 tsp almond flour
  • 12g grated cheddar cheese

Dinner

Chicken salad served on an iceberg lettuce leaf made with:

  • 3 tbsps heavy cream
  • 20g cooked chicken breast
  • 2 tbsps mayonnaise
  • 34g cucumbers and tomatoes

Snack

  • 26g macadamia nuts
  • An orange

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Common breastfeeding questions, answered

How soon should your baby start feeding? Is it normal for latching to be so painful? How often should you breastfeed?

Breastfeeding doesn’t come naturally to all new mothers.

Here’s what you need to know to breastfeed with confidence.

1. How soon should you start breastfeeding your baby?

Having your baby latch onto your breast within the first hour of giving birth is strongly recommended. This is because your baby is most alert in those first few hours and the latching reflex is also at its strongest.

Breastfeeding soon after birth has several other benefits:

  • The skin-on-skin contact helps create a bond. Studies suggest that skin contact helps your baby to naturally gravitate and push towards your breast.
  • The first liquid your baby gets is called colostrum, which is the first fluid before your milk arrives. It’s an immune-booster which will help your baby fight off illnesses.
  • It provides you with an early opportunity to help your baby latch properly. It’s recommended that you breastfeed your baby for at least six months before introducing solids, although you can continue providing breastmilk until your child has reached the age of two.

2. Is it normal for breastfeeding to be painful?

There will be a period where you experience some sensitivity, particularly in the early days, but this usually subsides within a month. If you’re experiencing any pain after that, it may mean that your baby isn’t latching correctly, or there’s an underlying medical condition. An adjustment in your feeding position can help. It’s important to remember to gently break your baby’s latching at the end of a feed, as suction can damage sensitive breast tissue. If your child stops feeding naturally, your breast will automatically be released.

If you still have pain for longer than a month, talk to your doctor.

3. How do you know if your baby is getting enough milk?

It’s hard to measure how much milk your baby is getting, but these are the signs of a well-fed baby:

  • Your baby nurses between eight to 12 times a day.
  • Your breasts feel comfortable, often softer after feeds.
  • After feeding, your baby releases your nipple on his own.
  • You can see visible swallowing while your baby is nursing.
  • There’s an increase in the amount of urine and stools your baby passes. Note that bowel movement colour also starts changing when your baby is four to five days old.
  • Visible signs of weight gain.

4. How should you express and store your breastmilk? 

If your breasts feel engorged, or you have other reasons for needing to store your breast milk (going back to work, for example), remember that just like cows milk, your breast milk needs to stay fresh. You can store it in the fridge, freezer or even at room temperature. Make sure you use bottles or containers that have been completely sterilised before storing breastmilk in them. Keep records of the date you express your milk to keep track of its freshness.

Don’t store milk:

  • At room temperature: for more than six hours.
  • In the fridge for longer than eight days (it’s recommended that you stop at six).
  • In the freezer for more than four months.

Good to know

  • Your breast pump should be sterilised after each use.
  • Since breastmilk contains antioxidants that can easily be damaged by extreme temperatures, it is preferable to keep breastmilk in the fridge rather than the freezer.
  • When defrosting frozen breastmilk, avoid using a microwave. Instead, boil a pot of water and place the frozen breastmilk container inside of it to thaw naturally.

References:

How to produce more breast milk

Being a new mother can be scary! Even more so, if you a low milk supply. There are different reasons for this condition, including waiting too long to start breastfeeding, not breastfeeding enough, breast surgery and certain medications. Other factors may include premature birth, pregnancy-induced high blood pressure and maternal obesity.

If you’re struggling with producing enough milk for your baby, here are some things you can try:

Latch on

If your baby has a poor latch, he’ll struggle to remove the milk from your breast. To check that your little one is latched on properly, make sure his mouth is open wide enough before he attaches to your breast. Check that his tongue, bottom lip and chin touches your breast first. Once attached, see that his chin is touching your breast and his nose is free so he can breathe easily. Once your baby latches properly, your body will easily produce more milk.

Breastfeed, breastfeed, breastfeed

Think of breastfeeding as supply and demand. The more milk your baby wants, the more milk your body will make. In the first few weeks after your baby is born, you should be breastfeeding at least every two to three hours. If more than three hours have passed since the start of your last feed, wake your little one up to feed.  The number and length of feeds will naturally increase your milk supply.

Power pump

Another way to increase your supply is with the help of a breast pump. A breast pump is a manual or electrical device that helps you extract milk from your breasts. The more you empty milk from your breasts, the more milk you will make. Aim to pump after every second breastfeeding session for about 15 minutes. The additional suction will send a message to your body to make more milk.

Revitalise yourself

A healthy mom means a healthy milk supply. Stress, tiredness, smoking and a bad diet can all affect how much milk you’re producing. Identify your bad health habits with the help of your doctor and make some changes! Looking after your own health will help increase your milk supply, naturally. Also, remember to drink lots of water to stay hydrated while breastfeeding.

Change it up

To build a strong supply of breast milk, feed your baby with both breasts. If you feed with just one breast more than the other, one breast may become larger. Remember to take turns feeding with both your breasts for your comfort and to ensure that you have more than enough milk in both of them.

Ditch the formula

Offering your baby milk formula instead of your breast all the time may seem like you’re helping yourself, but it may decrease your milk supply. Not only will you produce less milk, but your baby may stop early and refuse your breast. Avoid using formula as far as possible to keep a regular breast milk supply.

References

Protect your baby from cot death

Imagining your baby in any kind of danger is your worst nightmare. So, it’s important to know the risks of something as common as cot death, and how to prevent it.

Sudden infant death syndrome (SIDS), or cot death, happens for many reasons. It’s when a baby who’s 12 months old, or younger, suddenly dies during sleep with no warning signs. Infants between two and four months are most at risk.

Protect your little one

There isn’t a foolproof method to prevent SIDS, but there are ways to lower the risk.

Baby on his back

You may be tempted to place your baby on his side to sleep, but this puts him at risk of SIDS. This is because he can roll over onto his stomach. This position puts your baby’s face in the mattress, which can smother or suffocate him. Whether your baby is going to nap or sleep for the night, always place him flat on his back. Avoid leaving him to sleep in a pram or carseat for long periods. Tell anyone who takes care of your baby (babysitters, grandparents, friends, siblings etc.) how important it is to place your baby to sleep on his back.

No soft toys and bedding

You might think that soft bedding would be best for your baby’s comfort, but this increases the risk of suffocation and smothering. Only use a firm mattress for your baby’s cot and don’t stuff it with blankets, pillows, stuffed toys or cot bumpers. A fitted sheet is enough to keep your baby comfortable and lower the risk of SIDS.

Keep your baby cool

Overheating can increase the risk of SIDS. Dress your little one in light, comfortable clothes for sleeping and keep the temperature in the room comfortable. If the room temperature is lower than usual due to cooler weather, a onesie is the perfect clothing option if your baby is sleeping. It covers the arms, legs and feet. Avoid using blankets to keep your baby warm as he may get tangled in it while sleeping.

Don’t smoke around your baby

Babies born to women who smoke during their pregnancies are three times more likely to die than babies born to non-smokers. Smoking when you’re pregnant or smoking near your baby (secondhand smoke) increases the risk of SIDS. Try to quit smoking and don’t allow anyone to smoke around your baby.

Don’t co-sleep with your baby

Snuggling with your baby or breastfeeding is easier to do in your bed, but don’t share a bed with your baby while sleeping. It’s important to keep your baby close, but it’s dangerous for your little one to sleep with anyone in the same space. If your baby falls asleep in your arms, place him into his cot once he’s settled. You’ll lower the risk of your baby being suffocated or smothered by you or your partner while you sleep.

Immunize your baby

According to the American Academy of Paediatrics; the risk of SIDS is 50% lower in babies who are immunized. Take your baby for all his necessary injections. Talk to your doctor about which ones your baby needs and any tips to keep your baby safe.

Breastfeed for as long as possible

Breastmilk helps protect your baby as the milk contains antibodies to keep away viruses and bacteria. It lowers the risk of SIDS by up to 50%, so breastfeed for as long as you can. Remember, you shouldn’t drink alcohol if you breastfeed as alcohol increases the risk of SIDS.

References