Tuesday, 17 October 2017

Healthy eating while breastfeeding

Good nutrition is important for everyone. It is particularly important for breastfeeding mothers to eat healthy, varied and well-balanced meals. During pregnancy, body stores of certain nutrients such as iron, calcium and vitamin D, can become depleted.  Eating healthy, balanced meals could help replenish these stores. If a poor diet is consumed during pregnancy and while breastfeeding, the mother's nutrient stores will be reduced which could in turn affect the nutrients supply to the baby. It is therefore very important that a healthy diet plan is followed by pregnant and nursing mothers so as to fulfill both their nutritional needs as well as that of their babies. 
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Making breast milk is hard work for the body. Energy requirements increase during lactation (it has been estimated that the energy cost of breastfeeding is around 650 kcal/day). Mothers who exclusively breastfeed are said to require an extra 500 kcal/day on average. Some of this energy is obtained from fat stored during pregnancy. There are additional requirements for other nutrients,  most of which can be met by eating healthy balanced meals.

Some nutrient-dense foods a breastfeeding mum could eat include fish and other sea foods, meat, fruits and vegetables, nuts such as groundnuts and walnuts, as well as diary products such as milk, cheese, yogurt etc. 

Nutrients in Breast Milk:
With the exception of vitamin D, breast milk contains everything a baby requires for proper development during the first six months of  its life. The composition of breast milk is highly regulated, and a mother's diet can have significant effects on the concentrations of some nutrients. If a mother's diet does not provide sufficient amounts of nutrients, it can affect both the quality of her breast milk as well as her own health. 

Generally, an ounce (28 ml) of breast milk is said to contain about 1923 calories, with 3.64.8% being from protein, 28.832.4% from fat and 26.831.2% from carbs, mostly lactose. Unlike baby formula, the calorie content and composition of breast milk varies. Breast milk changes during each feeding and throughout a mother's lactation period in order to meet her baby's nutrient needs. At the beginning of a feeding session, the milk is more watery and usually quenches the baby's thirst. The milk that comes later is thicker, higher in fat content and more nutritious; and  may contain 23 times as much fat as milk from the beginning of a feeding, and 711 more calories per ounce. Therefore, to get to the most nutritious milk, it's important that a baby "empties" one breast before switching to the other.

A new mum might be tempted to lose weight quickly after delivery. It is completely normal to not lose any weight, or even gain some during the first 3 months of breastfeeding. Due to hormonal changes in her body, a new mum may have a bigger appetite and be more prone to holding on to body fat. Restricting calories too much, especially during the first few months of breastfeeding, may decrease both a mother's milk supply and her much-needed energy level.

However, she will likely experience a spontaneous increase in fat burning after 36 months of breastfeeding and start losing more weight than mothers who don't breastfeed. By then, losing about 0.5 kg body weight per week through a combination of diet and exercise should not affect her milk supply or milk composition, assuming that she is not undernourished . All in all, a breastfeeding mum should remember that it took her body several months to put on the weight, and it may take months to lose it.

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Friday, 13 October 2017

Thai-inspired Shrimp Spaghetti

It is very easy for food and feeding to become monotonous and therefore boring. At times just adding a little twist to the foods you eat regularly can make a lot of difference especially when you have picky eaters in the home. Children, just like adults are attracted to colorful things and when a dish is not just colorful but contains strings that children can pick and eat, then chances are high that the dish will be loved by children. This dish has a melt-in-the-mouth savory taste that will appeal to both adults and children. 
Prepare  this easy-to-cook, pleasant-looking food for your family and watch everyone relish the meal.   

To prepare this food you will need
  •  Spaghetti
  • Fresh Parsley leaves
  • And sauce. 

To prepare the sauce you need the following
  • Shrimps
  • Onions
  • Ginger
  • 2 cloves of garlic
  • Red, Green and Yellow bell peppers
  • A cube of Knorr seasoning (optional)
  • Salt
  • Pepper
  • About 20g of butter (or any oil of your choice)
  • Curry and  thyme

Pour the spaghetti into boiling water, add some salt and let it cook slightly for about 3 to 5 minutes then drain off the water. It should not be completely cooked as it would be cooked further in a sauce.
Then prepare the sauce by first blending together the onions, ginger, bell peppers and garlic.
Green, Red and Yellow Bell peppers
Fresh Parsley leaves
Melt the butter in a pot and pour in the shrimp to saute. Then add the curry, thyme, seasoning cube and whatever spice or seasoning you want to add.
Then you pour in the blended mixture and bring to boil

Pour the slightly cooked Spaghetti into the boiling sauce and cook. The sauce should be just enough to cook the spaghetti until al dente; that is firm to the bite  and not soggy
Once the spaghetti is completely cooked,  dish into a plate and sprinkle some chopped, fresh parsley on your food.
The parsley not only enhances the taste and nutritional value of the food, it makes the food quite colorful and attractive to picky eaters and everyone alike
Beauty in a plate

Saturday, 7 October 2017

Non-essential baby care items that can make baby care easier.

When it comes to newborn and child care, there are things you cannot do without; the essentials such as baby wears and diapers. There are also those that may not be  essential but can  make the daunting tasks of child care a tad easier; those that can be described as non-essential but very helpful. They include 

1. A pacifier. While not exactly essential a pacifier can be  helpful especially during those moments when the baby just keeps looking for something to nibble on even after being fed, or those moments when you are trying to round off a task and need the baby distracted. It could also help replace the comfort of a mum's nipple when the baby wants to sleep for babies who like sleeping while latched on to their mums breasts. Pacifiers also serve as better alternatives for babies who want to suck their thumbs as the habit can easily be broken unlike thumb sucking. Finally, research seems to suggest a relationship between pacifier usage and reduction in cases of Sudden Infant Death Syndrome (SIDS). 

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A Pacifier. Source ; Wikipedia

2. Diaper bucket/pail. In baby care, diaper disposal can be a major source of headache to mothers especially when the baby's poop begins to smell very bad and necessitates throwing away the thrash each time one such poop-filled diaper shows up. This cannot always be realistic no matter the part of the world you live in, more so a place like Nigeria that lacks an effective refuse disposal system. A diaper bucket/pail can take away the stress of daily diaper disposal.
 The diaper bucket is used to discard soiled diapers.  Having one means you do not need to dispose of used diapers daily without bothering about the smell of baby poo or urine as they are usually airtight and have odor suppressing mechanisms that does not allow smell sift out. A diaper bucket allows you the convenience of discarding soiled diapers at your convenience while keeping your house diaper-stink free.
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Diaper buckets/pails

3. Diaper bag. While a mum can do without a diaper bag, having one makes going out with a baby much more convenient as compared to using a handbag. Most diaper bags come with different compartments that can contain different baby items as well as what a mum would want to put in her handbag, with everything in its compartment you don't need to search  to find an item as each item has a location meant for it. Besides, a mum can decide to always leave certain baby supplies like diapers, wipes or baby cloths in the bag to reduce the risk of forgetting to take one item or the other her baby may need outside the home. Few handbags are as big as diaper bags that can contain all a mother and her baby may need outside the house. 

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An open diaper bag showing how different baby items can be fitted into different compartments for easy accessibility
4. Breast Pump. Every mother knows that there are times when she needs her "me time" and would be willing to pay so much to be relieved of her mummy duties no matter how short the duration. There are also those moments at night when a mother needs her much-deserved sleep but cannot afford to because she has to nurse.The breast pump can come be of help in such situations provided the mum has someone who can take care of your baby at such moments. The breast pump helps extract breast milk faster than using the hands. All the mum needs to do is pump out the much milk you believe your baby will need, store in the refrigerator and go rejuvenate. A breast pump can help you work towards keeping your baby fed when you aren't available. Some baby pumps can be manually operated while others are electrically operated. The electric ones can be quite pricey but they make pumping a lot easier than when you use the manual ones. This baby care equipment can be of immense value for mums who after their maternity leave need to resume work but want to sustain exclusive breastfeeding.
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A manual breast pump
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An electrically operated breast pump

5. Baby carrier/wrap. Our mothers used to carry their babies on their backs with a wrapper tied at the front and sometimes a shawl to hold the baby's leg in place. The baby carrier brings a modern twist to that and what's more, you can carry your baby in front and have a complete view of your baby unlike when the baby is tied to the back. Reminds one of an Igbo proverb that talks about not vouching for anyone, not even the baby tied to your back. Perhaps the carrier can make a mum vouch for the baby in her front since she has it in her complete view. 
Ensure you know the strength of the carrier/wrap before you buy, the carrier or wrap should come with weight specifications stating the maximum weight of a child it can support so you don't carry a baby heavier than it can support and risk throwing your baby to the ground from a height as high as it's mum's chest
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A baby carrier

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A mum carrying her baby in a  baby wrap

Monday, 2 October 2017

Red flags every pregnant woman should take note of.

The maternal mortality rate in Nigeria is unacceptably high and necessitates a critical review of our healthcare system with the aim of improving not just  maternal outcomes but every other health indicator. While we wait and clamour for an improvement, we need to look out for ourselves and for those around us.
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Just like in every aspect of health, there are certain things that could signal problems when they happen to a pregnant woman. Since our emergency healthcare system leaves so much to be desired, every pregnant woman should be aware of these and take necessary steps to get medical attention as fast as possible for her sake and that of her unborn baby. It it usually better that one gets to the hospital and it turns out there was no need to have panicked than one failing to get there and things turn awry. Most times, early medical attention  makes the difference between life and death.
 Any of these occurrences should make a pregnant woman get medical attention as fast as possible as they could signal that something is wrong.
(1)Spotting or bleeding at whatever stage of the pregnancy.

(2) A throbbing headache that paracetamol does little or nothing to relieve.

(3) Excessive dizziness. Dizziness often comes with pregnancy but if it becomes excessive that you can't stand please get medical attention fast.

(4) Severe cramping anytime during the pregnancy.

(5) Greenish or black vaginal discharge

(6) Sickness. We have perfected the art of self-medication in Nigeria; often to our peril. Pregnancy is not a time to engage in self medication. Whenever you feel sick. let a medical practitioner do the diagnosis and prescribe the appropriate drug . Not all drugs are safe in pregnancy. Some drugs could expose you and/or your unborn baby to harm. 

(7) Painful and rhythmic contractions when your pregnancy is not yet full term.

(8) A fall face-down on your belly or any other hard, strong painful contact with your bump.

(9) Any instinctive feeling that something is wrong with you or your pregnancy

(10) Not feeling your baby's kick for 12 to 24 hours after 27 weeks of your pregnancy.

While any of these occurrences does not necessarily mean that something is wrong with you or your unborn baby, they mean you need medical attention ASAP, in fact FAST to rule out something wrong. And it's important for you to insist on getting medical attention.  If your registered hospital is being slow or cannot attend to you, it is not a time to wait it out, go to an equally good medical center with skilled and licensed health workers in attendance and get attention. No mother wants to loose her life in the process of bringing forth another human, no mother should. Most times, early medical attention can make the difference.

Friday, 29 September 2017

Infant gas distress; how to handle it.

Having a new baby comes with  both exciting and distressing challenges. Some challenges can make even an experienced  mum loose sleep. Top among the distressing challenges is infant gas which can cause distress for both the new mum and baby. Some babies do not show very obvious signs of infant gas distress and that can make a mum whose older children fell into that category as babies panic when she births one who is disturbed greatly by gas.

In our part of the world, there are so many traditional remedies many mums employ to relieve gas distress like massaging the baby's tummy with a towel dipped in warm water, giving the baby bitter cola water or some other herbal mixtures; methods which aren't backed by scientific research but by tales handed down from one mum to another. Some other mums go the orthodox way of giving their babies gripe water or similar products.

Infant gas is a natural occurrence in newborns as a result of their young and still-maturing intestines and digestive systems. While it may not obviously disturb some newborns, it can cause seemingly great distress in others which could drive some mothers into seeking and applying unorthodox and most times futile solutions to ease their babies' distress.
As a new mum, so long as your baby is thriving well, gaining weight and seems fine during periods when it isn't having gas distress then all you need do is take the following steps to reduce your baby's gas distress episodes.

(1)Ensure your baby  burps after each meal. Simply position your baby in a manner that helps to quickly expel the stomach gas contents. There are several methods But the most common is by lifting your baby to your chest, and placing its chin on your shoulder then you gently but firmly pat or rub your baby's back. This method quickens the gas expulsion process as it makes the gas float to the top of the stomach and get expelled fast. 

(2) Do not let your baby cry so much out of hunger before your feed him/her. Crying out of hunger makes a baby feed frantically when the food comes and could gulp so much air in the process. This may not be very realistic for busy mums to practice but you can try your best.

(3)Find and suspend consumption of the offending food(s). Certain foods a baby's mum consumes could cause increased gas troubles for her baby. The most commonly  reported culprits are foods containing cow's milk and diary products like yoghurt and cheese. The myth that milk, tea and yoghurt increases breast milk supply does little or nothing to help this issue at all. As one pediatrician would say in cases of infant gas pain, "search for coincidences". Whenever your baby appears to have a lot of gas pain, evaluate the foods you consumed within the past 24 to 48 hours and check if they are same with those consumed before previous episodes of increased gas distress. You could decide to go a day or two without the suspect foods and check for any improvement. Whenever you are convinced a particular food is the culprit then suspend it from your diet and gradually introduce it back  around when your baby is 3 months old; when its digestive system should have significantly matured to handle such foods. The commonly reported suspects in gas pain include milk and other diary products, beans and cabbage. Someone may question how milk consumed by the mother could cause gas in her baby while the baby's food is basically milk alone.  The proteins and sugars in breast milk are easily digestible by the baby's system unlike those in cow's milk and other diary products. 

While you try your best to relieve your baby of its gas distress bear in mind that it is a natural occurrence which studies suggest babies get relief from at around 3 months of age, but if you ever get exceedingly worried and concerned, you can never go wrong by taking your child to a pediatrician. 

Wednesday, 27 September 2017

The rantings of a Nigerian mum

The human mind is complex.  Everyone's ability to grasp seemingly simple issues also differ. The poor health indices in many parts of Africa stems not only from the poor health systems but also from the inability of  a large number of its inhabitants to adhere to evidence -based health recommendations.What else would explain that the Nigerian government banned female genital mutilation and no licensed health practitioner will perform it but some parents still go to quacks to perform it? What explains why parents will be told what to use on a baby's umbilical cord stump and they go ahead and use things that could expose the baby to harm? Or what could explain that a cereal manufacturer clearly writes on his product's package that it is not an infant cereal yet some parents argue and ignore the instructions; ignoring the fact that the manufacturer knows what his product contains and why it is not suitable for certain persons. In all such cases the excuses are same as or similar to  " I've been doing this for years and everything is fine", "my child has been eating this and is very healthy ".
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Medical and health research use a lot of statistics and percentages; and before the continued use of a practice or product or product is recommended, the involved health bodies must have studied the problem and known the adverse reactions involved and the statistics of occurrence. So if they say use product a, the safety margin is high or if they discourage a practice or product, the consequence is relatively high. That does not always mean that everyone who fails to heed to the recommendation will be affected,  it means that there is a good chance they will  be affected.

Now if a manufacturer said his product isn't for a certain age group, it doesn't mean anyone within the said age group that uses it will have an adverse effect, it simply means that the chances are high and that you do so at your own risk.

Effects of a product could range from nothing at all to acute or chronic effects. the product may not have an effect on someone, it may also have an effect but not clearly visible at the time and may elicit a chain of reactions with long term effects, it could also have an immediate effect.While most cases like these are arguably a direct or indirect effect of the failure of our health system and regulatory agencies, we as sensible humans need to learn to obey instructions especially when it comes from the sources who know better. Like the manufacturer of a product who knows what his product contains, or health agencies like the World Health Organization (WHO) who give recommendations based on evidence-based research, or your licensed health practitioner who possibly knows better. .

Saturday, 16 September 2017

Caring for a newborn's umbilical cord stump

It is not unusual in Nigeria to learn of different unorthodox and potentially risky ways of caring for the umbilical cord stump in newborns. One often hears of, and sees cases where toothpaste, powder, cow dung, peppery soup and so on are used (some newborn babies really suffer) all in a bid to get the stump to fall off fast. Using these items has a the potential of exposing your newborn to infection. And infection of the umbilical stump can be fatal. Why give that chance if it can be avoided?

Caring for your newborn's umbilical stump need not be a hectic process, in fact when handled well, it is a simple and straight forward process. Written below are the only things you need to do to care for the stump and watch it fall without any problems to your newborn and stress on your part.

  1. The World Health Organization  (WHO) recommends dry cord care; as in applying absolutely nothing on the stump but ensuring the area is kept dry at all times.  In regions of the world with high neonatal mortality rates (which Nigeria may be included), the WHO recommends  the use of chlorhexidine on the areas around the cord stump. Chlorhexidine can be bought over-the-counter in drug stores. Most times, just ensuring the site is kept clean and dry is care enough. Some pediatricians recommend the use of methylated spirit on the stump while others believe it makes the cord stay longer before falling off. Either chlorhexidne or methylated spirit can used to clean the areas of the skin surrounding the stump to kill any microbes that could be in close proximity. Getting your doctor or midwife's opinion could be the safest option. Keep your baby's diaper away from the umbilical stump, it is advisable you place the diaper below the belly button and ensure you change dirty diapers promptly to prevent leakage of urine or stool towards the stump which could infect it. 
  2. Do not be in a hurry to make the stump fall. Some babies have theirs on well past 10 days. Avoid quick fix procedures. No adult walks around with an umbilical cord  which means your newborn's own must eventually fall off. Some of those quick fix procedures can expose your baby to Omphalitis which can be fatal.
  3. When the cord falls off, care is still needed to prevent infection. There is a common practice in some parts of Nigeria to dab hot water on the navel at this stage, propagating a  myth that dabbing the navel with hot water reduces infant gas. This is a very risky and completely unnecessary procedure. It has been known to expose some newborns to life-threatening infections. Simply bath your baby as normal and ensure the area is kept clean. At this stage of your baby's life, it's immune system is fragile so you should not allow everyone  handle your baby especially when naked. It's advised you ensure people wash their hands before handling your baby. No matter how they may perceive it, it's your baby and your duty is to protect him/her.
  4. If at any point the stump starts to smell bad, bleed , or the area looks reddish and your newborn is in pain, waste no time in taking your newborn to the hospital as that could be an infection of the cord stump which can be fatal.