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 ".
Image result for motherhood
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 the potential of exposing your newborn to infections. 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 straightforward 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 chlorhexidine or methylated spirit can be  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 primary 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. 

Monday 11 September 2017

Things to do before travelling with a baby aged 6 to 12 months old

Travelling with babies can be stressful, the stress is more when the baby has started to explore its surroundings and has a mind of its own. This post targets babies between  6 months to 1 year old; the age when babies get wriggly, start to crawl, reach out for items and cry when they are not allowed to have their way. Babies within this age range also have nutritional needs  beyond just breast milk and formula.The fact that these babies have started exploring and having minds of their own as well as their more increased nutritional needs make traveling with this age group a bit more complicated than with those belonging to the 0 to 6 months age group.

When planning a long-distance trip that involves air travel with babies this young , you may need to take the following steps.

  1.  Consult your baby's pediatrician or your family doctor. Just like in all such travels, a very important step is to get medical advice and screening for your baby. There may also be need for some vaccinations depending on your destination. Your baby's medical practitioner will determine the baby's medical needs based on your destination and would offer you the needed advice. You need to know what you and your baby could be exposed to by visiting a particular region of the world.
  2.  Inform the airline of your child's age. Most airlines classify every child below 2 years of age into a group allowed to be carried on the lap of an adult during air travel . You may need to inform them of the specific age of your child so they make certain provisions for you. Most babies within the 6 to 12 months age group are too big to fit into most airlines' bassinet. You may need to inquire about the availability of, or possibility of carrying a portable travel cot. Informing them could also make them assign to you seats around unoccupied ones thereby allowing you a little extra room.  You could also make inquiries about car seats suitable for aircrafts if you desire to invest in one. If possible, choose flight times that coincide with your baby's sleeping hours, it would make things a lot easier for you as the child would likely be asleep most of the journey. Inquire about availability of baby strollers in the airport or aircraft. A stroller will make life much easier for you during boarding, transfer times and disembarking. Some airlines offer baby strollers at the airports but collect them back before boarding. Strollers aren't common in Nigeria but if you have one you are usually allowed to check in with it, submit to the air flight attendant upon boarding the aircraft, and collect back just before disembarking. Travelling with a stroller for a child this young can do you a world of good; it saves you the stress of carrying a baby on your arm during checking in, transfer times and when your trip is finally over and you need to leave the airport. 
  3.  Feeding: This can be more challenging when compared to feeding their younger counterparts. Depending on how long your flight and transfer time will be in total, you may need to take your baby's cereals, milk and whatever your child will need to eat within the travel period. You may not need to carry the entire tin of food (for foods that come in tins), you could simply scoop out smaller portions into smaller containers, or better still buy travel-size sachets for cereals that have such sizes. It is not always advisable to give your baby food offered in the aircraft especially if it is something the baby has never eaten; you just never can tell what the baby's reaction would be. You do not want a food-induced medical emergency  tens of thousands of feets above sea level. It is safer to give the baby foods it is used to. Travel times are not the best of times for babies to try out new foods. Remember to carry extra supplies of baby plates and cutlery to reduce the need for washing up after each feed. You need to also plan what water your baby will drink. Parents with babies are allowed certain concessions so you may be able to carry a small water bottle or flask containing your baby's water if you don't trust the one offered by the airline . If you need your baby's food warmed at any point, feel free to request that from the air flight attendants on board.
  4.  Your baby will be entitled to luggage allowance just like adults, use the allowance efficiently; carry extra cloths, diapers and everything your child will need including portable toys. Take a little more than what you estimate you will need. It is safer to have more cloths or diapers than needed than to run out of them while still on transit.
  5. Carry an age-appropriate toy in your hand luggage especially one your baby loves. If your travel involves long transfer times at airports or lengthy flying times, you and your baby will need the distraction toys can afford.
  6.  Very importantly, you will need an extra dose of confidence and thick skin. Babies this age can get fussy and throw tantrums while on board an aircraft for various reasons that could range from boredom, being in close quarters with so many adults or the strange feeling being suspended on air can bring. You may not be lucky enough to seat near an understanding co-traveler so you may need to learn how to ignore snide remarks and be unapologetic about travelling with a baby. You should not apologize for your baby's behavior, the best you can do is reduce whatever can trigger tantrums but sometimes no matter what you do in such situations, your baby will throw a huge tantrum while on board an aircraft.

You may need to read tips from the write-up dedicated to babies between 0-6 months of age  as some of their needs similar.

We hope you and your baby have a pleasant and safe trip.

Tuesday 5 September 2017

Things you need to do before travelling with a newborn baby

Mothers do not always get the luxury of always being at home  with their newborn babies despite the maternity leave laws . Sometimes, it becomes necessary that the new mum embarks on a trip and by this we mean long trips that entails sitting in a car or an airplane for hours. With birth tourism in the USA being fashionable among well-to-do Nigerian parents,  it is not unusual to see a mum returning home with a baby who is barely a month old.

Travelling with  newborn babies is really not encouraged as it increases the newborn's exposure to potentially harmful disease-causing organisms which the baby's fragile immune system may not yet be equipped to fight, but  when the travel is inevitable then certain steps need to be taken to not only protect the baby but to also ensure its's comfort and that of the mother. 

This write-up focuses on babies between the age of 0 to 6 months who are believed to be fed only milk. It also focuses mainly on air travel. Travelling with an exclusively breastfed baby is relatively easier compared to one on mixed feeding or formula. 
Below are steps you should consider taking when planning and embarking on a trip with a newborn baby. 

  1.  Consult a pediatrician or at least your family doctor. This is a highly recommended step to take. The physician would look at your baby and the disease profile of the region you are visiting and then give you recommendations on what to steps to take to protect the health of your newborn. If necessary he/she would recommend particular vaccinations for your child. Certain parts of the world are renowned for certain diseases, it is safer you know what you and your baby are up against before embarking on any journey.
  2.  Inform the airline or whatever means you are using to travel about your baby. When booking air tickets, children below 2 years of age are grouped together; you may need to inform them of the specific age of your baby and  request a bassinet, or inquire if you can carry a bassinet of your own. If you are going to use the airline's bassinet there will be need for you to take along bed sheets of your own. You wouldn't want to expose your newborn's skin to publicly used sheets or bassinet surfaces no matter how clean they look. Also inquire about the requirements needed; some airlines require you to provide some kind of proof of being the parent of the baby and a written consent from the other parent if available.
  3.  Feeding.  as mentioned earlier, if your baby is exclusively breastfed things become a tad easier as you would definitely be taking your breasts along with you to feed the baby. But if your baby is fed on formula or any other food, you will need extra preparation. Airlines give certain concessions to mothers with babies therefore you should be able to take your formula or whatever food your baby takes. Due to the often bad stories one reads about airline water, you may need to carry a water flask; a small flask of about 500ml filled with hot water. But almost all airlines serve their passengers bottled water so you could request the water be boiled or warmed for your baby's meals as you desire. In which case you have to ensure you have packed in your add-on luggage your baby's food, water, plates and spoons. You may need to take at least two plates or spoons to ease off the need to wash up after each feed. But if You can't, the air hosts/hostesses can be of help to you.
A very portable 500ml flask that can keep baby food or water hot for several hours
The flask above usually comes in small bags like this that eases carriage
4.  You need more than enough supplies of cloths and diapers. Good enough, all international airlines give luggage allowance to babies just as they give adult travellers, so you could put your baby's luggage allowance to full use. Use the number of hours you are to be on air as well as the waiting time at transit airports to estimate how many cloths and diapers your baby needs. You should add extras to whatever you have estimated as you never can tell. It is better to take a little more than needed than be stranded midway without cloth or diaper.

5. Buy disposable changing mats. Depending on how many hours your journey will last, you may need to change you baby's diaper and/or cloths at intervals and would at some point need to use a public space for that. I do not recommend the use of the changing tables located in airline toilets for health and hygiene reasons, but you could find yourself left with no other option so you just take a changing mat, place it on the surface, change your baby's cloth or diapers , and discard the used mat. Discarding each mat upon usage and taking a new one for each change is recommended as the used one is already in contact with the public space. Your aim is to protect your baby's delicate health and skin as much as you can. You would be amazed with the kind of germs one can pick up from such changing rooms.
Image result for disposable diaper mats
disposable changing mats

6.  Upon boarding, request the help of a host/hostess in settling down. You should be given a seat belt extension and shown how to fasten both you and your child unto the seat. 

7. Get appropriate clothing for your baby. You need to find detailed information about the prevailing weather condition at your destination to know exactly what cloths to put in your hand luggage in readiness. There could be a sharp contrast between the weather condition of where you are coming from and your destination so you need to get weather-suitable cloths for your baby and you. There is need to carry such cloths in your carry-on luggage as you and your baby may need to wear them before disembarking from the aircraft.

8.  Travel light. This needs to be emphasized upon especially if it is just you and the baby with no other adult on the trip. You don't need the extra stress of waiting to carry  other luggage at either check in or check out. Traveling light will do you a lot of good unless you have people to help you at both ends of your journey, that is someone to check in your luggage before departure and someone to help pick them up upon arrival.

9. Take advantage of every concession allowed parents with children. Airlines usually give priority to parents with children during boarding, if it isn't so obvious, request for it. You are not supposed to queue up alongside others during boarding. Most airlines allow parents with children board alongside their first class and business class passengers.. Determine whatever concession you are allowed and take advantage of it/them.

We do hope you and your little one have a safe and pleasant trip