Friday 27 November 2015

NIGERIA'S TREND IN MATERNAL MORTALITY

The World Health Organisation recently released a document titled "Trends in maternal mortality: 1990 to 2015". That document left my heart bleeding. Despite recording a 44% reduction in global maternal mortality rates from 1990 to 2015, Sub-Saharan Africa accounted for 66% of the maternal deaths, with Nigeria accounting for 16%. The average annual change in maternal mortality rate in Nigeria since 1990 to date was placed at 2%.



Forget the statistics and the figures, we are talking about human beings; women like me (and maybe you), our mothers, sisters, friends, colleagues and neighbours.   We are taking about 867 maternal deaths per 100,000 live births in this age and time. If you are a Nigerian reading this, you'd know this figure could probably be less than the true figure as countless deaths go unreported. Hardly are the deaths in rural areas recorded. We need to really do something about this ridiculously high figure. We need to help save mothers from avoidable deaths. How? Get informed. Get enlightened. Throw away those behaviours, cultural and religious beliefs that put our lives at risk. Some of which are addressed as follows.

Get medical attention once pregnancy is confirmed. You don't necessarily have to wait for the traditional 16 weeks post-conception to seek medical attention. Given the very high maternal mortality rate, we in our part of the globe should seek medical attention ASAP. This ensures that whatever that could go wrong is noticed early and if possible nipped in the bud. No matter how experienced you are, as per how many kids you've had, get early attention. Maternal death knows no experience.

Eat healthy.We have countless myths surrounding what to eat and what not to eat in pregnancy. It seems the very foods which are necessary are forbidden in pregnancy. Foods like plantain, snails, meat, eggs, etc carry laughable myths that make the uninformed mum keep away from them. If in doubt, ask the TRAINED midwife or doctor nearest to you. 

Take your prenatal  vitamins. With the nausea that often accompanies pregnancy this aspect is often difficult, but try in whatever possible way to achieve it as your well-being and that of your unborn baby depends considerably on it.

Rush to hospital once you aren't sure what is happening to you.  I was well known in the two places I registered for birth as I kept appearing off and on schedule for even the slightest disturbance. I had a myriad of questions to ask and when one doctor or midwife didn't have a convincing answer, I asked another. I knew almost everything that could go wrong at whatever stage and their signs. I believe one should rather be paranoid and safe than careless and dead.

Pray. We are a religious people so I wouldn't forget to emphasise the need for prayers. At whatever stage, seek the grace of God to accompany you. But do not replace medical attention with prayers, each has its own role to play. 

Push myths aside. We have so many myths surrounding pregnancy with some bothering on the diabolical. Stick pins to your cloth, never cross your legs, never scratch your tummy, never spit on the wall, bla Bla bla. Some of which are from the pit of hell. Please put them aside. Don't even give heed to all the visions and dreams people tell you about.

As much as possible, give birth at a registered health facility with at least a midwife in attendance . 

Heed your doctor's or midwife's advice. Many maternal deaths have occurred as a result of the mum's refusal of assisted birth. If your doctor suggests a cesarean section, if you aren't convinced, seek a second or maybe third opinion from a medical practitioner and not your pastor or man of God.

The issues to address are countless. When in doubt, ask your midwife or doctor. Even though we have a medical system which leaves so much to be desired, the ridiculous death rate can be drastically reduced when we do what is up to us. We should do those up to us while those in charge of policies and laws guiding right and wrong in maternal care do theirs. 

May we lose neither our lives nor that of our loved ones in the process of bringing forth. 



Wednesday 18 November 2015

CHOOSING A DAYCARE CENTRE

Image result for choosing a daycare
Source:https://www.klayschools.com

Whether white, blue or whatever-coloured collar job a mum has, it gets to that time when the working mum has to leave her precious little one in the care of another. This "another" could be a relation, a nanny or a caregiver at a daycare centre. Handing over our little ones to someone else should never be shabbily done. It should take a lot of research and other considerations. Even relations should be chosen with care especially with increasing reports of paedophilia.


Several factors should be considered when settling for a daycare centre to assist you in childcare.

Is the centre registered and government approved? These days of child-kidnapping, you certainly don't want to risk keeping your child with people who cannot be traced. The local authority should also be aware there is a daycare centre there and also know who the caregivers are. We certainly do not want stories that touch. Child-stealing cases seem to be on the increase, so also is paedophilia.

How do other parents using the centre feel? Are they confident or helpless? Make sure you get to interview not just one or two users of the centre. Do they feel confident that their kids are well taken care of? Or is it an I-don't-have-a-better-option feeling/attitude? Would the parents be happy to recommend another parent to the centre? Would they readily leave the centre if another seemingly better one springs up in the neighbourhood? You really need to know.

How do the kids themselves feel? This has to do with the kids old enough to show readable emotions. If you are nice to a kid, he/she naturally gets to love you in return and would be very willing to be left with you. It may take a little while, but it certainly will happen. Watch the countenance of kids being dropped off. Are they happy and willing to part with their parents? Granted some kids could be clingy, but if it seems to be the norm with almost all the kids at the centre then that's a red alert, something is certainly not right. Those kids are certainly not handled well. Stranger anxiety doesn't apply in this case. A caregiver overtime ceases to be a stranger to a kid.

 What are their health policies? I would always root for caregivers who run comprehensive medical tests on prospective employees. I would also root for those who have a strong health policy. Sick children should be kept at home till they recover, especially those with communicable diseases. Caregivers with communicable diseases should NEVER be allowed near the kids.
What other policies do they have? Only parents or people confirmed to be assigned by them should be allowed to visit or pick up kids left in their care. How do they handle emergencies? How prepared are they for emergencies. Can parents show up at random to visit or pick-up their kids? If the answer is 'no' then something is amiss. Make sure you read all the terms and conditions before handing over your kids to them.


How much? This shouldn't be the most important but it does matter. It should be an affordable place for you the parent. Contrary to what many people believe, cost doesn't always equal quality. Some low-priced caregivers give quality care while some expensive ones treat kids shabbily.

Convenience. How convenient is it for you the parent to drop off and pick-up your child on your way to and from work? It has to be somewhere close to your home or your workplace so that you either drop them just on your way to work and pick them when almost home, or you drop them when almost at the office. In the latter's case, you get to always enjoy the ride to and from work with your kids, thereby spending more quality time.

What do your instincts say? Always trust your instincts when it comes to your child. if your instincts say 'no', then no it is. It's better you are paranoid and your child is safe and happy.

What is the child/caregiver ratio? How many children is one caregiver responsible for? 3:1 should be the worst obtainable especially if the kids in question are babies. 5:1 can go for toddlers. Sadly, that is hardly the case in our part of the globe as one may even find as much as 10:1. Personalised child care should be strongly advocated.


After you have done your checks and balances, you can then settle for a particular daycare centre. Daycare homes (where the child is taken care of at the childgiver's home) seem better as one can also negotiate for weekends and beyond-office hours.

May we never fall prey to wolves in caregivers garbs.

Monday 9 November 2015

DRUG ABUSE AMONG MUMS

Most mums mean well, but sometimes our meaning-well has the potential to expose our loved ones to peril. There is a very dangerous habit many of us Nigerians have imbibed ; drug abuse. When I found out some mums also engage in that I was moved to tears. The other day, I saw a mum giving her 3+ years old daughter 2 tablets of our 500mg paracetamol, I screamed and asked her why, she said the recommended half or one tablet has no effect on her, another mum came for her 3 months old daughter's vaccination and the little girl's cloths were stained with a yellowish substance, she said it was the colour of the malaria drugs she gave her daughter which she threw up. I asked her the name of the drug she named an adult malaria drug and added for good measure how she split it into two to give her daughter. I was gobsmacked. After vaccinations you'd hear some mums advising others to give the baby half a paracetamol tablet.
For heaven's sake there are specific drugs meant for kids, designed for their tender organs and tissues. It's bad enough that we have fake and substandard drugs to deal with, adding drug abuse especially for our babies worsens the whole thing. Some health workers also play a significant role in this. A woman who just gave birth in a very good hospital was discharged without giving her drugs for her baby only for an experienced midwife to complain about the "oversabi" and half-bred doctors and went ahead to prescribe ampiclox (a brand of antibiotics) , Abidec (a brand of multivitamins) among other drugs saying the baby needs them.

Please Informed mum (and dad too) if you must give your child any drug, let it be the one meant for children his/her age and at the dosage recommended by a qualified doctor, preferably a paediatrician. It took years of different phases of clinical research to arrive at a recommended dose. People tend to say "but the one I've given hasn't killed the child", it doesn't have to kill the child, at least not immediately . You could be exposing the child to chronic poisoning, could be weakening the child's kidney, liver and other organs. We have so many tropical diseases to contend with, adding poisoning and organ failure to the list is horrible especially as we do not have the best of healthcare systems. The very people who produce and research into those drugs advocate as drug-free a life as possible. Drugs should only be taken when it's advantages trump the attendant disadvantages. That's why many people tend to embrace alternatives to medicine.

I would also classify those who give their kids herbal concoctions as drug abusers as well. Traditional medicine now booms in Nigeria, some mums will tell you "oyibo no dey treat this one" and go ahead to reel out traditional drugs for the particular ailment being discussed. The side effects of most of those drugs are unknown. Much as I appreciate traditional medicine, I feel we've not done in depth clinical research on those plants parts we believe are medicinal. Before a drug is approved for use, it goes through different phases of clinical research. Hardly has any of our magic plant parts gone through that.
Please let's be wary of what we expose our little ones to. I advocate all drugs for kids be prescribed by doctors and dispensed by pharmacists, including the over-the-counter ones. Let's join hands and say no to drug abuse, especially in kids.

May we never expose our little ones to peril.

Sunday 8 November 2015

WHEN THEIR TANTRUMS GET OVERWHELMING

Every mum seems to have gotten a bit of the scathing looks and comments that reek strongly of "you are a bad mum" from passersby and people around those moments our kids decided to throw their little tantrums. It amazes me as fellow mums seem to be the worst offenders ( if they can be thus described) in this, instead of the "keep calm, I've been there and I understand " look, they criticise the most.
Being a mum is one occupation everyone around you feels they can do better than you are doing. It annoys me most when the look or advice reeks of disdain. You go shopping with your kid who seems to demand everything he/she sees, you refuse some and oblige some. Lil master or mistress decides to throw a tantrum and you passerby feel my baby is disturbing ; please take a hike, or better still, go sit in a thrash can for all I care. Or my baby decides to babble, squeal or even cry in church, in as much as I'm trying to keep him calm, please do not shout at me nor even at my baby as you wouldn't like my burning look or the way I'd completely ignore you if you happen to be someone I'm friendly with.
Dear Informed mum, please do not overwork yourself just to please people around you. Sometimes when you can't handle the childish fits, ignore them and those around too. And if you are around a mum who is having that experience at that point in time, if you must react, give her a "I've been there look" or better still help her calm the child.
Our kids can really be overwhelming sometimes.

Monday 2 November 2015

Exclusive breastfeeding

So much misinformation (maybe under-information is a better word) exists about exclusive breastfeeding. I took a survey recently of nursing mums' opinion on exclusive breastfeeding and it was horrid to say the least. One mum replied in Igbo " Tufiakwa! I choro si nwa'm gbakpo?" literally translated to mean " God forbid! do you want my child to dry of thirst?". Another asked me why I'd not give a baby water as if I can survive without water. In her opinion it was sheer wickedness. More mums were of the opinion that the breastmilk isn't enough to satisfy a baby's hunger, many from the upper social and economic class felt it is made for mums who may not be able to afford quality formula or whose babies' will be fighting off lots of infections cos of the environment they live in. Some plainly replied they just couldn't carry on as it was so stressful for them and they abandoned it almost as soon as the started.

Every mum wants the best for her child, even when she isn't sure what the best is. Breastmilk is the best food for the baby; research has proven that time and again. The World Health Organisation and many informed doctors and nurses recommend giving a baby breast milk alone for the first six months of life. It has numerous benefit both nutritional and non-nutritional. It provides all the baby needs for the first six months of life. Breastfeeding gives a child a high level of protection against infections through different passive immunity mechanisms, it helps prepare the child's body systems for the introduction of more heavier types of meals. Your baby will not dry out nor die of thirst if exclusively breastfed cos the breast contains about 90%water. Some research works also suggest exclusive breastfeeding reduces the mum's risk of breast cancer. Infant formulas are actually made to 'be like' breast milk. Why get the prototype when you have the original at your disposal?. Breastmilk has a kind of demand -supply mechanism ; the more a baby demands, the more Breastmilk is supplied. So the question of Breastmilk not being enough doesn't even apply.

The advantages of breastfeeding alone can never be overemphasized. This piece isn't meant to judge mums who do not exclusively breastfeed but to enlighten them the more about its advantages. Ofcourse one doesn't have to undertake a course one can't undergo but we know if mums know what the best is, then they will do their best to give their babies the best.

IMMUNIZATIONS, TO DO OR NOT TO DO

IMMUNIZATIONS, TO DO OR NOT TO DO
The importance of immunizations can never be overemphasised in our part of the world with the various types of infectious diseases our tender ones are susceptible to. The Federal Government of Nigeria with the support of the World Health Organization has a National Programme on Immunization that performs weekly immunizations in primary health care centers and certain private health facilities, this is to ensure improved access to and coverage of routine immunization services. It was with excitement that Nigeria's delisting from Polio-endemic list was greeted. Nigeria can now be said to be polio-free. I wish same could be said of other childhood killer diseases like measles, diphtheria, tuberculosis, tetanus and pertussis.

Once a child is born, it is recommended that the vaccines BCG (Bacillus Calmette–GuĂ©rin) and HBV (Hepatitis B Vaccine) that protects them from tuberculosis and Hepatitis B respectively be administered before discharge from the hospital. BCG is administered intradermally (below the skin, on the shoulder) while HBV is intramuscular (the muscles of the laps)The babies also should receive their first oral dose of Polio vaccine then. At 6 weeks of age, the baby should be ready to receive the first dose of the conjugated vaccine (often called penta) which protects them from diphtheria, whooping cough, tetanus, pertussis, meningitis and pneumonia. 2 booster doses of the same conjugated vaccine is administered at least 4 weeks apart. From about 16 weeks of age your baby is supposed to receive an injectable Polio vaccine (IPV), at 9 months the first measles vaccine dose and yellow fever vaccines should then be administered . The booster measles dose comes sometime after 12 months of age. These immunizations are for free in government owned health facilities though sometimes paltry service charges are required. The cost of these immunizations in private hospitals is also small, at least can never be compared to the cost of caring for a sick child.

Dear Informed Mums, please never take your child's immunization for granted. A single day of exposure can cause harm. Our babies depend on us for their protection, they can do nothing by themselves. I usually recommend immunizations be done in good health facilities where anaphylactic reactions can be promptly attended to.