Medical App & Medical Advice with Hello Doctor

How to wean your baby off breastmilk.

Breastfeeding is a special time shared by you and your little one. That’s why having mixed emotions about stopping or cutting down on nursing your baby is completely natural. But it doesn’t signal the end of the intimate bond; it just means you’re nourishing and nurturing him in different ways.

When should I wean my baby?

The World Health Organisation (WHO) recommends that babies be exclusively breastfed for the first 6 months, thereafter you should slowly introduce them to solids.

How do I know my baby is ready?

Your baby:

  • sits up without support and has good control of his neck muscles
  • opens his mouth when he sees food coming his way
  • chews his fist
  • wants an extra milk feed
  • tries to grab pieces of finger foods and bring them to his mouth.

Before starting

Make the transition easier by taking it slowly. Weaning is easier if it’s gradual. These tips can help:

Try one food at a time

This helps your baby get used to new flavours and textures and makes it easier to spot if he has a reaction to any specific food. Baby cereal made from oats are easily digested unlikely to cause an allergic reaction.

Fruit and vegetables

Avoid focusing on fruits – doing so can encourage their taste for sweet foods and make it more difficult to introduce vegetables and other savoury foods. Pureed fresh fruit like apple, pear or banana and pureed vegetables like carrot, potato, butternut and sweet potato are good choices. If you decide to buy ready-made baby foods, always check the ingredient list carefully. Some of these are laden with ‘free sugars’ which can cause tooth decay. Make fruit purees a small part of your baby’s diet – fresh is best.

Make it a family affair

Try to eat together as much as possible, as your baby will learn from the rest of the family. Build up slowly by getting him into a routine of offering him solid food at the same time each day. The aim is to transition your baby from solely drinking milk to eating your usual family foods, so try offering smaller mashed-up portions of the food that the rest of the family is eating. However, always make sure you haven’t added any salt or sugar, or any other foods that are not suitable for babies.

Start small

Offer one or two teaspoons to get him used to tasting and swallowing more solid textures. It’s all about exploring and learning at this stage – don’t worry about getting him to eat specific amounts. It’s going to be madly messy, but wonderfully comical too. If your baby doesn’t seem interested, leave it and try again another day.

Avoid choking

Never leave your baby unattended when he’s eating, in case he struggles to swallow. Avoid giving rounded foods, like grapes and hard, crunchy and very chewy foods.

Liquids

After breast milk or formula, cooled boiled water is best. Avoid juices as it can lead to dental caries, obesity or even poor weight gain and a runny tummy.

Care for your breasts

Your breasts may become uncomfortable while weaning. Try expressing just enough milk, apply a cold compress or gel pack or consult your pharmacist for and an over-the-counter pain reliever.

If you have gone back to work, consider nursing before work and immediately once you’re home, or express your milk in a bottle from which your caregiver can feed your baby. This will prevent blocked ducts, mastitis (infection that causes breast pain and swelling on your breasts as well as fever and chills). Immediately consult your doctor if you have these symptoms. They will most likely prescribe an antibiotic to clear up the infection. Remember that you can continue breastfeeding if you have mastitis.

References

Why do some people get hangry?

Hanger is when you experience a combination of hunger and anger. In a nutshell, hanger could be compared to the grown-up version of a baby crying for milk. But why do some people become hangry?

Your body’s first instinct is to keep you alive. When you haven’t eaten for a while, the level of sugar (blood glucose) in your blood decreases. When this happens, your blood sugar becomes too low and triggers the stress hormone cortisol and adrenalin (fight-or-flight hormone). These hormones are released to rebalance the blood sugar in your body.

Although these hormones give you some energy, it’s not the good kind. It’s the kind of energy that makes you feel agitated, unfocused and even angry.

If you opt for foods with lots of carbs or sugar to give you energy, you’ll be even worse off. This is because when you eat lots of carbs and sugar, you blood sugar skyrockets, giving you a temporary rush of energy, only to crush soon thereafter.

The crash is caused when insulin tries to use your body’s glucose reserve but it’s too much for your body to handle. This just leaves you with more cravings for food.

Although feeling hangry could affect anyone, people who struggle with controlling their anger could be more likely to experience it.

What to do about your hanger

Sadly, hanger can’t be avoided entirely. The good news is there are ways to lower your chances of experiencing it.

Avoid having too much sugar

Keep sugary treats and carb-heavy foods at a minimum. Besides the usual culprits like pastries, sweets and cake, these include seemingly healthy foods. Watch out for hidden sugar in low-fat yoghurt, sauces, fruit juice, sports drinks, granola, flavoured coffee and cereal.

Eat foods that are digested slowly

Foods that are high in protein and fat digest slowly because they are absorbed by your body in stages. They also slow down the absorption of sugar in your bloodstream.

For snacks with healthy fats choose nuts, avocado slices, cheese sticks, dark chocolate and seeds. For a dose of protein have boiled eggs, peanut butter on celery sticks and grilled chicken breast strips. If you must have carbs, chose vegetables or fruits. The fibre found in fruit slows down the digestion of carbs which means your blood sugar won’t rise drastically.

If you have other carbs like wholegrain crackers for example, pair it with a protein or a healthy fat like avos to slow down digestion.

Catch some Z’s

When you’re exhausted, your stress hormone cortisol overworks itself. This causes your body to crave food. Get at least eight hours of sleep each night and stick to a bedtime. Wind down an hour before bed and switch off all devices.

Good to know

  • Try these if you often become hungry:
  • Eat small meals throughout the day.
  • Avoid junk foods, which can cause a sugar crash. Choose nutritious, high-fibre foods to keep you feeling full.
  • Exercise regularly to help lower your blood sugar. Don’t overdo it – exercise can contribute to insulin sensitivity. Stick to a 30-minute workout three times a week unless your doctor suggests otherwise.
  • Stay hydrated.

If you experience hanger more than once or twice a week, talk to your doctor and dietician.

References

Which symptoms are normal after getting a vaccine?

Your little one has just had his latest vaccines. He seems irritable, is crying and is struggling to sleep. Is this normal?

Vaccines aim to protect your child from serious illnesses like measles, whooping cough and polio. The drugs in vaccines are made from parts of the diseases it protects your child from. They don’t cause the disease, but ‘’tells” your child’s body to make antibodies (blood proteins) which fight diseases.

For example, after a vaccine for measles, if your child’s body comes into contact with measles, their body would fight the disease as they can recognise it.

Unfortunately, like with other medication, vaccines come with side-effects. These side-effects are usually harmless and will clear up. Severe reactions to vaccines are rare because the process to get a vaccine approved is rigorous and involves many safety tests.

To protect your child, it’s important to know which reactions are normal and what’s not. Here are some normal and uncommon reactions to vaccines to get you clued up.

Normal vaccine reactions

A mild reaction after a vaccine means the medicine is working. It’s also a sign that your little one’s body is creating new antibodies to fight infection. Usually, these symptoms go away on their own within a few days.

  • A slight fever.
  • Tenderness and redness where the injection was given.
  • Fussiness.
  • Trouble sleeping.
  • A small, hard lump where the injection was given. This may be there for a few weeks but shouldn’t raise concern.

Vomiting, loss of appetite or drowsiness are also normal reactions, but are less common.

How to manage common side effects

If your child is experiencing any side effects, you can ease his discomfort.

  • Dress him in cool, loose clothes.
  • Give him fluids to drink.
  • Put a cold, wet cloth on the injection site to ease pain or swelling.
  • Ask your doctor and pharmacist for over-the-counter medication for pain and fever. Check the label for dosage instructions or ask your doctor if it isn’t clear.

When is it serious?

In some cases, reactions after a vaccine can be serious. This usually happens if your child has an allergic reaction. Severe reactions are rare, but it’s important to know what they are so you can help your child.

Look out for serious symptoms:

  • Swelling in the throat or face
  • A pounding heartbeat
  • Pale complexion
  • Weakness
  • Hoarseness
  • Dizziness
  • Breathing problems (e.g. wheezing)
  • Seizures
  • Uncontrollable crying for three hours or more

If your child experiences any worrying symptoms, take him to your doctor immediately. If you have any questions before your child gets any vaccination, ask them. Your doctor will be able to put your mind at ease.

References:

How to treat the yellow rash on your baby’s scalp

Are there flaky or scaly patches on your baby’s head? While dandruff may be somewhat rare in babies, cradle cap isn’t. There may be yellowish or brown scales forming on your baby’s head. Your baby may also have oily and thick crusty patches on the scalp.

Cradle cap is a common baby rash that starts at around 3 weeks of age, and affects up to 70% of infants. Bedsides the scalp, it can sometimes also be found behind the baby’s ears, eyebrows, forehead, and even on the upper torso. The good news is that it isn’t harmful to the baby, or a sign of bad hygiene, nor is it contagious.

What causes cradle cap?


When the scalp makes too much oil, it traps the skin flakes and prevents them from naturally shedding, leading to those yellowy scales.

The cause of cradle cap in babies is unknown, but dermatologists believe the mother’s hormones are likely to play a role. This is because hormones can be passed to a baby through the placenta before birth or through breast milk when the baby feeds.

Another possibility is that oil glands are more active in babies because their own hormone levels are high during the first year of life.

The presence of a type of yeast called Malassezia, which is normally found on the skin, is produced by oil glands, and this may also be a factor.

Most mild to moderate cases of cradle cap aren’t itchy or painful. Severe cases can be. In most severe cases, your baby could lose some of their hair with cradle cap. But even in those rare instances, any hair that your baby loses will grow back after the rash has cleared.

Treat the oily skin

Shampoo regularly


Shampooing your baby’s scalp daily can help treat and prevent cradle cap. Use a gentle baby shampoo without fragrances to help prevent skin sensitivities.

Apply oil


Baby, coconut or mineral oil can help soften the scales on your baby’s skin. Apply a very small amount; just a few drops and massage it directly into the scales.

Brush your baby’s scalp


To help remove scale build-up, gently brush or massage your baby’s scalp with a baby brush or comb. Avoid scratching or picking at the scales as it can worsen the condition.

If all else fails, see a doctor


Cradle cap is often mistaken for another dry skin condition, eczema. While eczema can be itchy and irritating, parents may be unaware that their baby has cradle cap. If your baby’s skin becomes red and inflamed or if your child has a fever, you’ll have to take your little one to a doctor.  Cradle cap shouldn’t bleed easily or be extremely itchy, and your baby shouldn’t be unwell from the condition either.

If symptoms persist and there seems to be no improvement with treatment, see a doctor.

References:

Does your baby’s cough sound like a dog’s bark?

If so, it could be croup. Croup is a viral illness that makes your baby’s voice box and windpipe swell. The high-pitched or barking cough develops when air is forced against a narrowed.

The smaller your child is, the more noticeable the sound. Some children with severe croup get a harsh, tight sound while breathing in. This is called stridor.

When does it happen?


The virus that triggers croup can be passed on by breathing in respiratory droplets from a cough from an infected person, or from playing with toys that have the virus on them. Croup normally affects infants and children between the ages of six months and three years. As children grow, so do their airways. Therefore, children older than six don’t often get diagnosed with croup.

What are the symptoms?


You may notice the typical symptoms of a cold, like a runny nose and fever. Usually, the barky cough begins at night and gets worse when your child gets upset and cries. Croup usually lasts for around five days.

How is croup diagnosed?


The doctor will usually listen for a cough and stridor. They may also ask if your child has had any recent illnesses that caused a fever and congestion, and whether the child has a history of croup or other breathing problems.

He may also perform an X-ray if the croup is severe and doesn’t get better after treatment. An X-ray, in this case, will help show the top of the airway narrowing to a point, which doctors call a “steeple sign”. This is a narrowing of the airway below the vocal cords.

Home treatment for croup

If your child wakes up in the middle of the night with croup, try to keep him calm to help ease his breathing. Crying can make croup worse.

For a fever, medicine like paracetamol, or ibuprofen for kids older than 6 months can help make your child more comfortable. Ask your doctor for guidance before giving your child any medication.

Help your child breathe in moist air. This can make him feel better.

  • Use a cool-mist humidifier or run a hot shower to create a steam-filled bathroom where you can sit with your child for 10 minutes. Breathing in the mist will sometimes stop the severe coughing.
  • In cooler weather, take your child outside to help ease symptoms so they can breathe fresh air.
  • Make sure your child is well-hydrated. If needed, give small amounts of liquid more often using a spoon or medicine dropper. Children with croup should also get lots of rest.

When to call the doctor


If you’re concerned that your child’s croup is not improving, contact your child’s doctor, especially if you see the following symptoms:

  • A sound that gets louder with each breath.
  • If your child speaks or makes verbal sounds for lack of breath.
  • Seems to be struggling to catch his breath.
  • Has blue lips or fingernails.
  • Has stridor when resting.
  • Drooling or extreme difficulty swallowing saliva.

References:

Does your child have meningitis? Know the danger signs

Spotting meningitis can be tricky, and it can be easy for your little one to develop it without you knowing. That’s because the early warning signs and symptoms are almost identical to the flu.

Don’t worry though. By getting to know the signs and symptoms, you can ensure your child gets the right treatment before it becomes serious. Meningitis is the inflammation of the meninges; the membranes that cover the brain and spinal cord.

Meningitis is usually caused by bacteria or viruses, and sometimes by illness and certain medication. It spreads like colds and flu, when someone who’s infected touches, kisses, sneezes or coughs on you.

Common signs:

  • Nausea and vomiting.
  • Drowsiness.
  • A small appetite.
  • Confusion and disorientation.
  • Sensitivity to bright light.
  • Fever.
  • Headache.
  • Neck stiffness.

More severe symptoms include coma and seizure.

Watch out for these signs in toddlers: 


A refusal to be fed, irritable when picked up, a fever, and a bulging soft spot on their head, and moaning and crying.

Preventing meningitis is the best way to work against it. Remember, not every child gets the same symptoms and they can appear in any order.

Make sure your little ones wash their hands often with soap and warm water. Encourage this, particularly after using the bathroom; when they’ve been around other kids, and when they’ve been in contact with a sick person. Teach them not to share food, utensils and drinks with anyone who is, or has recently been, sick.

If you suspect your child or anyone else has meningitis, you should:

  • Take them to your doctor immediately.
  • If you can’t get there right away, call a doctor and describe the symptoms.
  • Go to the nearest emergency room if your doctor isn’t available.

Treatment


If a doctor suspects your child has meningitis, he will do tests. A sample from the spinal cord is usually taken. This can show signs of inflammation and infection due to a virus or bacteria. Blood samples may also be taken to check for bacterial infections in the blood. Sometimes, imaging of the head is done to check for swelling and inflammation around the brain.

There are two kinds of meningitis, viral and bacterial. Depending on which kind your child has, he’ll be treated a certain way.

Bacterial


Severe bacterial meningitis is very serious and must be treated immediately with antibiotics. It helps reduce the risk of complications like brain swelling and seizures. The type of antibiotic depends on the type of bacteria that caused the infection. The sinus may be drained if there’s a build-up of mucus and infection.

In some cases, doctors may give an antibiotic to someone who’s been around an ill person with bacterial meningitis to prevent them from developing the disease themselves.

Viral meningitis


Unfortunately, antibiotics can’t be used for viral meningitis, but mild cases usually clear up on their own. It can be treated with bed rest, plenty of fluids and over-the-counter pain medication.

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

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:

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.

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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.

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