What is Cervical Incompetence?

McDonald Cervical Cerclage

[vc_row][vc_column][vc_column_text]A few weeks ago, a friend rang me up and told me that her doctor had just called her cervix incompetent. Here is how our conversation went.

Friend: Hello?

Me: Long time I have missed you.

Friend: (Sounding bored) Well, yeah, been busy

Me: Are you okay?

Friend: Actually, the doctor I am seeing just called my cervix incompetent

Me: Oooh, I um…..

Friend: I will sue him. How can he talk like that? Is that even professional?

Me: Haha haa haaaa

Friend: ( Hangs up).

An incompetent cervix is one that opens prematurely under the pressure of the growing fetus and results in early second trimester miscarriages.

Causes of cervical incompetence include:

1. Genetic weakness of the cervix

2. Severe laceration during previous pregnancies

3. Multiple gestation (twin, triplet, etc)

People with cervical incompetence normally experience multiple pregnancy losses all which occur in the second trimester of pregnancy.

The treatment usually involves placement of a cervical stitch (MC Donald’s stitch) that closes the cervix and prevents it from opening usually from the 12th to the 16th weeks of pregnancy

Your doctor will need you to abstain from sex if you have a MC Donald’s stitch in place till delivery.

People with MC stitch can still deliver vaginally except, the stitch will need to be removed before delivery or any time after the 37th week of pregnancy.[/vc_column_text][/vc_column][/vc_row]

Pre-Conception Care

Pre-Conception Care

Well before each baby is conceived, the two parents involved should actually decide to conceive the baby (as opposed to find yourself pregnant), carry the pregnancy to term and give birth to a healthy baby, while ensuring the mother is healthy throughout the pregnancy and during the post delivery period. During the preparation phase of conception, the two parents to be should undergo pre- conception care.

Pre- conception care is the care given to both men and women who are planning to conceive, with the aim of increasing chances of conception, and reducing the risk of death during pregnancy, with an aim of giving birth to a healthy baby.

It offers patients an opportunity to discuss risk factors that can be minimized before and during pregnancy to ensure a healthy outcome for the mother, father and the baby. The issues to be discussed and addressed include;

Contraception
Couples on contraception who wish to get pregnant should discuss it with their obstetrician and gynecologists. Those on implants and intra-uterine devices should have them removed. Those on three monthly injections should be counselled on the possibility of a delay in the return to fertility for about three or so months.


Maternal chronic diseases

Before pregnancy, women who suffer from chronic diseases like diabetes, hypertension, epilepsy, HIV should be seen by their gynecologists. They should be treated to a level where their diseases or the drugs they take won’t affect the well being of the baby.

    Diabetic women

should have their sugars well controlled before they become pregnant. They should also have their medicines changed from oral tablets which have teratogenic potential to insulin injections.

Pre-Conception Care
Pre-Conception Care

    Hypertensive women

should have their pressures well controlled before pregnancy. They should also discuss the potential to have their drugs changed to drugs that have no teratogenic potential.

    Epilepsy

– women with epilepsy and who are on medications should not ideally get pregnant without discussing it with their doctors. Most of the anti-epileptic drugs they use may cause birth defects such as spina bifida. They are therefore supposed to be started on a course of folic acid supplementation several months before they become pregnant. They should also have their drugs changed to drugs that don’t cause fetal defects.

    HIV positive women

should be put on anti-retrovirals till their viral load is undetectable so as to reduce the possibility of mother to child transmission.

    Hyperthyroidism

– women using anti-thyroid drugs should be seen by their doctors and advised if at all getting pregnant is safe at all. They should also have their drugs changed to drugs that don’t cross the blood placental barrier hence causing fetal defects.

Mental illnesses
Such as depression and anxiety disorders should be screened and treated before pregnancy. Women who are on continuous treatment for mental illnesses should be put on medications that are safe for the child who is about to be conceived.

Nutrition
All women desiring pregnancy should have their nutrition assessed. They should start feeding on folic acid rich foods and taking folic acid supplements if need be. Folic acid prevents against neural tube defects.

Obesity
Women with a body mass index (BMI) of 30 and above should be advised to lose some weight. Obesity is a risk factor for infertility among women. It is also a risk factor for other pregnancy complications like deep venous thrombi i.e clots.

Sexually transmitted diseases
Both parents should be screened and treated for sexually transmitted illnesses such as syphilis so as to eliminate the risk of transmitting it to the unborn baby.

Family and Genetic history
Assess pregnancy risks on the basis of maternal age, maternal and paternal health, obstetric history and family history. Possibility of passing genetic defects like sickle cell to the unborn baby should be discussed.

Advanced maternal age and the risk of getting babies with Down syndrome should also be discussed.

Images courtesy of Citizen Kenya & Lune Magazine

Preventing Birth Defects

As she walked out of the new born unit, my mind drifted back to the phone call I had heard her make…”it is just a small swelling on her back. Something that will definitely close on its own ….” her words kept going round and round in a circle in my mind; just small swelling on her back, something that will definitely close on its own, just a small swelling on her back, something that will close on its own, just a…. I had spent at least one hour explaining to her that her baby girl had spina bifida, a neural tube defect that would need surgery. I had told her that even after surgery, her child would still have problems with movement, and bladder and bowel continence. I had thought she had understood but when I heard her making that phone call, I kept wondering; if she was she still in shock or she had chosen to be overly optimistic, or if she was just trying to re-assure another person, or if she was just being a mother and thinking best thoughts for her child.

No woman carries a pregnancy to term expecting to give birth to a less than perfect child. The shock that normally comes with realizing that your child is ‘not perfect’, that your child has a birth defect is therefore understandable. Being that January is “the National Birth Defects Prevention month”, I would be happy if you took some time off to read a little about preventable birth defects.

Here are some of the causes of preventable birth defects:
 ALCOHOL-
No amount of alcohol is safe to drink while pregnant.
Drinking alcohol while pregnant may result in; FETAL ALCOHOL SPECTRUM, a disorder characterized by; 1. Facial anomalies; small head circumference, small eye opening, flat upper lip
2. Intra-uterine growth restriction and poor weight and height gain after birth and
3. Learning or behavioral abnormalities.
People who are planning to conceive should therefore refrain from drinking and stay alcohol free throughout the pregnancy.

 FOLIC ACID DEFICIENCY
Pregnant women are usually given folic acid supplements throughout pregnancy.
Folic acid deficiency may lead to neural tube defects such as spina bifida and anencephaly
Ideally, women who are planning to conceive should prepare for conception by starting to take their folic acid tablets at least three months prior to conception.
The problem about our society is that, people ‘find’ themselves pregnant, most pregnancies are never really planned. In this case then, you should start taking your folic acid tablets as soon as you find yourself pregnant and not wait till the pregnancy is advanced like the way most people do.

 PRESCRIPTION DRUGS
Drugs that cause birth defects are known as teratogenic drugs in the medical world.
Women who have chronic illnesses and are on drugs should first discuss with their doctors and have their drugs changed to safer ones before they get pregnant.
Pregnant women should also avoid buying drugs over the counter because they may not know if a particular drug is safe for their unborn children.

Some of the commonest teratogenic drugs include;
1. Drugs used in the treatment of epilepsy- carbamazepine{tegretol}, phenobarbitone and phenytoin[epilim].
2. Some drugs used to treat hypertension- eg enalarpril, lisinopril etc
3. Some antibiotics like amikacin, gentamycin, may cause deafness
4. Drugs used in the treatment of cancer, like thalidomide may result in phocomelia, a disorder where someone is born without limbs
5. Some ARVS like Dolutegravir-has a potential risk for spina bifida

 MATERNAL OBESITY
Having a body mass index (BMI) of more than thirty percent is associated with a risk of heart defects in your child.
Women intending to become pregnant should therefore try and lose weight before becoming pregnant to reduce the chances of getting a child with heart defects

 INFECTIONS
Pregnant women should be screened and treated for the following infections; toxoplasmosis, rubella, cytomegalovirus, herpes simplex,
All pregnant women should routinely be screened and if found to be infected, they should be treated.
If untreated, cytomegalovirus may cause anomalies such as hearing loss, vision loss or mental disability.
Toxoplasmosis may result hearing loss, or even visual impairment in a newborn.

APRIL; AUTISM MONTH #LIGHTITUPBLUE#

I bet we all remember Susan Boyle; a Scottish singer who first came to international attention in 2009 after appearing as a contestant on Britain’s Got Talent. She stood before an audience in “Clyde Auditorium” and said that she was trying to become a professional singer (at forty) and that she hoped to be as successful as Elaine Paige (The audience smirked at her on hearing this). She performed the song “I dreamt a dream” so beautifully and so powerfully, everyone including the judges was surprised. They hadn’t expected much from her. She finished second in the contest, losing to the dance troop ‘Diversity’. Every time I am in need of inspiration, I go to you tube and watch her performing “I dreamt a dream”, while ignoring all the people in the congregation who were waiting for her to falter so they can burst out laughing. Susan Boyle was diagnosed with Asperger’s syndrome (now autism spectrum disorder) in 2012. She made her diagnosis public in 2013. Now, autism is a developmental disorder that is characterized by; difficulty in social interaction, challenges in communication and restricted repetitive behavior. World Autism Awareness Day is marked every second day of April as a way to raise the awareness of autism. April is autism awareness month. Autistic children and adults live in our world, amongst us; hence, we cannot afford to be ignorant about autism!

Parents and guardians will first notice symptoms in their children during the second and third years of life. Symptoms vary depending on the age of the patient and severity of the disease. Here are the “defining” symptoms of autism:
speech
1. Delay or lack of development of spoken language. This is often the reason why parents will seek for help.
2. Those who are able to speak are unable to start or sustain a conversation with others
Many children exhibit echolalia i.e repeat phrases and words they hear.
Impaired social interaction-

1. They lack emotional reciprocity
2. John Elder Robinson, said; ‘and I know it is perfectly natural for me not to look at someone when I talk. Those of us with Asperger’s are not comfortable doing it. In fact, I don’t know why it is considered normal to stare at someone’s eyeballs”
Autistics lack non-verbal cues; they are unable to maintain eye contact, unable to understand and use gestures, lack facial expressions and other forms of non-verbal communication.
3. They are unable to adjust behavior to suit social contexts. Hence they are unable to develop, maintain and understand relationships!

Restricted, repetitive patterns of behavior, interests, or activities,
1. They insist on sameness and adhere to routine in an inflexible way.
They may have to sit in a particular chair, dress in a particular way, or eat particular foods every single day.
They become quite distressed if a routine is disrupted.

2.Insensitive to pain or temperature, light or noise.
They are prone to injury since they can withstand extreme pain and temperature.

3.Stereotyped or repetitive motor movements, use of objects, or speech –

simple motor stereotypes, lining up of toys, flipping of objects, echolalia, idiosyncratic phrases
4 they have highly restricted and fixated interests.
They become fascinated with parts of an object for example the wheels of a car.
5.though some will have intellectual disability, others have normal intelligence. Some have very specific talents or abilities especially in music and mathematics. Susan Boyle?

Parents whose children have been diagnosed with autism live in constant fear. They worry their children will hurt themselves, they worry they will grow too fast and the world will hurt them, they worry they will have to face the world someday alone, and the world will not know how to handle them! These are all genuine worries. The good news is that there are others who have done it! I know that most of us have heard about Susan Boyle, but maybe we haven’t heard of other autists like John Elder Robinson, who grew up knowing he was different and was only diagnosed with autism(Asperger’s) at the age of forty by his therapist friend. He taught himself about electric circuits and sound waves and used the self- taught knowledge to design guitars and toys. Then there is Temple Grandin a professor of animal science, consultant to the livestock industry on animal behavior and autism spokesperson and there is Kerry Magro who was diagnosed with autism at four but went on to beat all the odds and became a professional speaker and a best-selling author. These are just but a few of autists who have gone on to become great despite having autism. And who tells you that your child cannot become as great if not greater?

There was a time Temple Grandin wouldn’t talk! “I can remember the frustration of not being able to talk. I knew what I wanted to say, but I could not get the words out, so I would just scream.

PRE-MATURITY

When you get pregnant, the world congratulates you. Mothers share their labor stories with you. They will mostly tell you about the pain which is always so much, words cannot describe it. They will tell you about the not so wonderful regular vaginal examinations that you will be expected to endure. They will advise you about where to go for your antenatal clinic, what to eat and what to avoid, where to buy your maternity and baby clothes, how much pain you should anticipate et cetera. Nobody will ever talk to you about going into labor pre-maturely. Nobody will talk to you about giving birth to a one kilogram child. Because it is never expected. Everybody assumes you will get pregnant, have an uneventful pregnancy, deliver at term to a bouncing baby boy or girl and everything will just be normal.

But sometimes, you will give birth pre-maturely for one reason or another. While a normal pregnancy is assumed to last for forty weeks, some women may deliver at late second trimester or early third trimester. A child born before term is usually under-weight, has immature lungs, is unable to regulate their body temperature, has fewer stores of essential vitamins and minerals and has reduced or no native reflexes. These are children whose suckling reflex is either absent or not well developed hence cannot attach on the breast. They need to be fed via a naso-gastric tube, need to nursed in a warm environment. They may need to be put on oxygen, especially during the first days of life.

Some of the reasons why a pregnant woman may go into labor prematurely include;
– Multiple pregnancy– most twin or triplet pregnancies will rarely get to term.
Mothers carrying multiples should be psychologically prepared to deliver before term
– Hypertensive disease in pregnancy– severe cases are normally induced at thirty four weeks
– Preterm rupture of membranes– followed by drainage of liquor “water”
This is mostly caused by infections
– Third trimester bleeding– may be due to placental separation or abnormal placentation. If the bleeding is massive, then delivery may be done before term.

Going into labor before term is actually a nightmare, the child comes when you are just not ready for them, both emotionally and psychologically. One minute you are pregnant and the next minute you are holding a tiny little thing on your hands who is then quickly snatched from you and rushed to a nursery. Then you literally become a prisoner, living in the hospital waiting for your child to grow to at least two kilograms. Every three hours of the day or night, you are seated before your child, who happens to be sharing an incubator meant for one with four other pre-terms who look extremely like your own.

So you live in the hospital waiting. Your child adds three grams in three weeks and loses five grams in a day. Sometimes you leave them well only to come back and find cardiac monitors sticking from an impossibly small chest, and nasal prongs inserted into the tiny nostrils, with oxygen being literally driven into those tiny lungs. But they live through such days and so do you.
When you have your child too early, the temptation to leave and quit the whole motherhood thing is strong. But then you draw strength from your pre-term child every time you see them work their muscles so hard in a bit to breath. Every time you see their eyes open and they gaze at you, you learn that the gaze is just as genuine, just as penetrating as any other and that alone is enough to push you through the rainy days!

Children born before term, if they receive good care, grow. They grow up normally, attain normal milestones and become as normal as those born at term. No, prematurity doesn’t cause intellectual disability or short stature. I have seen big men and women whose birth weights were as little as one kilogram. I know a doctor who was born pre-maturely, a university student pursuing engineering and as teacher. With pre-maturity, once you grow past the neonatal age, then you can grow on and conquer the world with your smallness!

RAPE

Three year olds are supposed to be innocent. But the one I met two weeks ago wasn’t. She was lying in the hospital bed fast asleep, one hand tightly clutching that of her sixteen years old auntie and her legs tightly pressed together. I remember standing by the bed and staring at the tiny little thing for a while. The moment my hand touched her face, her eyes shot open and she immediately sat on the bed and buried her face into the bosom of her auntie. All children hate men and women in white coats, but this one was a little too afraid.

I remember sitting at the edge of her bed and taking her hand as gently as possible into mine. It took lots of coaxing, tickling and exchange of sweet little edibles before she finally warmed up to me. I took her to the examining room immediately without giving her time to change her mind. But she wouldn’t let us remove her trousers that easily! She kicked and held on to it. We were able to remove it just because there were three of us against her. Soon as it was out she pressed her legs together so tight that a sigh escaped my mouth. She slapped her auntie when she tried to pry open her legs (yeah you read it right, slapped!). It was apparent we couldn’t see anything. We had to take her to theatre and examine her under anesthesia.

With her under the anesthetic slumber, and totally relaxed, we saw it all. Saw the multiple lacerations along the wall of her small vagina. The ragged torn hymen, the reddening around the anus. I struggled with my tears as various scenes flashed through my mind. I saw this little girl walk willingly into the hands of her cousin. Saw her hand holding tightly onto the bigger hand of the cousin as they walked towards the shop so he could buy her a lollipop. saw as he scooped her up and rushed her to his room instead. Saw him collapse on top of him and drive a monster of a penis into the vagina of a three years old, saw as he flipped her over so he could have anal. All this long, the tiny girl kicking and pushing and screaming.

Any grown woman can willingly tell you that first time sex is not a mixture of pain and pleasure in equal measure. First time sex is majorly pain with a tinge of pleasure. It must have been excruciatingly painful for a three years old of course, because, try and imagine a grown ass man on top of a tiny girl, moving his pelvis back and forth like a possessed antelope, with the child struggling to breathe and cry from all that pain at the same time!
You know I started talking about the unfairness of it all but one of the nurses told me that this particular three years old was hurt physically, but not like a three months old they had seen one year ago. It was claimed that she was raped by the father so violently that she developed a recto-vagina fistula (a communication between the rectum and the vagina). That baby had to undergo corrective surgeries and even though she got well, she was physically so hurt that you wouldn’t want to imagine how hard she had cried as his father closed his eyes to savour the moment (yuck)
Most of us teach our children to never trust strangers but most people are being raped by people they have no reason not to trust. It is fathers who are raping their sons and daughters, cousins raping their cousins, favorite uncles raping their nieces, house helps asking the little boys and girls they take care of to lick them down there.

What do we do then? We cannot afford to not talk about sex to our young ones. We need to teach them to run if they can. We need to check them, create time, undress them, bathe them. We need to know them, know how to read their body language. We need to be close enough to them so that they can trust us and tell us if it ever happens to them. We need to install CCTVs in our houses. We need to stop protecting relatives who rape our children. Let us stop this madness of ‘talking’ where rape has happened.

Before you open your mouth to protect a rapist, think about the three- year- old who has to walk with legs far apart to avoid irritating the soreness left between her legs by a rapist. Think about the three -month-old baby forced to live with a colostomy so her rectum can heal or else leak shit for life. Think about that little boy holding his breath as a fat woman makes him lick her. Think about all those living with sexually transmitted illnesses that they got out of rape.

Rape can never be justified no matter what. Even animals know when the mating season is over!

HAPPY BREASTFEEDING WEEK! (Pt 3)

While breastfeeding may not seem the right choice for every parent, it is the best choice for every baby- Amy Spangler

All these benefits and still a mother choose not to breast feed. Why?

  • Breasts are seen as sex objects and for these reason, some women will choose not to breastfeed so as to prevent their breasts from sagging.

I wonder if this is what Anne Quindlen implies in this quote.”When an actress takes off her clothes on screen but a nursing mother is told to leave, what message do we send about the roles of women? In some ways we are as committed to the old Madonna-whore dichotomy as ever. And the Madonna stays at home, feeding the baby behind the blinds, a vestige of those days when for a lady to venture out was a flagrant act of public exposure”

  • Breast feeding is exhausting. Imagine having to be alert all the time, twenty four hours a day and seven day a week? Breast feeding is a tough job that cannot be performed by anyone else except the mother, and mothers happen to be humans who get tired, sleepy like all of us.
  • Partner

Some fathers seem to disagree with the fact that boobs are for breast feeding. They will do nothing to support the mother. Some will even make it worse by telling their wives not to breastfeed

  • Unfriendly working environment

Children need to be breast fed exclusively for 6 months. Very few employers will give their employees maternity leaves in excess of a day.

They don’t make matters better by allowing these women to have their babies around so they can breastfeed them on demand

Mothers are therefore left with one option, to wean their babies when they are barely two months old, and to limit the breast feeding sessions to before and after they leave for work. Sad

MY BABY IS ADEQUATELY BREASTFED IF;

Baby fed at least eight times/ day

Baby is calm and satisfied after feeds

Baby sleeps for 2-4 hours after a feed

Normal motion, no constipation-semi formed stools, with fermentive order. One motion after every feed to one motion in 2—3 days

Normal amount of urine about five to six times per day

Weight gain of 150-210 grams per week

YOUR BABY IS UNDERFEEDING IF,

Slow weight gain, weight loss or no gain at all

Decreased amount of urine

Cries after emptying both breasts

Suckling of fists between feeds

Sleeplessness or short sleep

Constipation or hunger stools-frequent, small, green in color

While some people underfeed their infants, some overfeed or should I say over breast feed theirs. Here are the signs of overfeeding:

Frequent regurgitation, vomiting

Large bulky stools

Abdominal distension

Polyuria- (excessive urination)

Baby overweight

Overfeeding should be managed by feeding the baby four hourly.

BREAST FEEDING MYTHS

Myth: “You can’t breast feed if you have small breasts”.

Reality: Breasts of all shapes and sizes can satisfy the hungry baby.

Myth: “Breast feeding is a lot of trouble”.

Reality: Breasts, as opposed to bottles, are ready when the baby is ready.

Myth: “Breast feeding ties you down”.

Reality: Breast milk can be stored if mother decides she wants to go out. When the mother goes out she always has the food supply for the baby no matter how long she plans to stay out.

Myth: “Breast feeding ruins your breasts”.

Reality: Breast-feeding does not change the shape or size of the breasts. There are other factors (i.e. – age, not wearing a bra, or excess weight) that can change the shape & size of breasts.

Myth: “The father is excluded during breast feeding”.

Reality: An involved father will take advantage of opportunity such as bathing, diapering, holding, & playing with the baby.

HOW TO EXPRESS BREAST MILK

Why learn how to express milk?

To relieve painful breast engorgement between feeds

To help nutrition when suckling is reduced for example in premature children or those with cleft lip

To help feed the baby when the mother is away working for example

To keep milk production going when necessary to rest the nipples e.g. when sore

The best way to learn is from a midwife, and by watching a mother who is already successfully expressing milk. Pumps are available from any chemist. If not, wash hands, and dry on a clean towel, then, try to start flow by:

  • Briefly rolling the nipple: this may induce a let-down reflex, especially if the baby is nearby.
  • Stroke the breast gently towards the nipple.
  • With circular movements, massage the breast gently with the 3 middle fingers.
  • Then start expressing or milking into a clean wide-mouthed container

Expressed milk can be stored in a fridge for up to 24 hours.

Babies should be breast fed on demand i.e. whenever the baby or mother wants with no restrictions on length or frequency. Breast feeding on demand is important because;

  • It keeps the baby happy, and enhances milk production.
  • Fewer breast problems like breast engorgement arise
  • Less incidence of jaundice
  • Breast milk flow is established sooner
  • Earlier passage of meconium ( meconium is the greenish sticky stools that a baby first passes, before their stools become normal)

WHEN NOT TO BREASTFEED

  • If you have active tuberculosis and are on anti-tuberculosis medication {some of the drugs are secreted in breast milk
  • If a mother has cancer and is on anti-cancer medication
  • A mother on anti-biotics- like tetracycline that are secreted in breast milk
  • HIV is not an absolute contra-indication to breastfeeding.
  • Pregnancy- is also not a contra-indication to breastfeeding

It is however prudent to stop breastfeeding at the fifth month- so as to maintain nutrients for the growing fetus

BREASTFEEDING PROBLEMS

  1. Breast Engorgement

Treat by frequent breastfeeding, or manual expression

  1. Breast Abscess

Treated by antibiotics

  • Sore Nipple

This is corrected by ensuring that the baby is correctly attached on the breast

DO YOU HAVE A QUESTION ON BREAST FEEDING? DON’T HESITATE TO ASK! SEND AN EMAIL TO oyunged@gmail.com with your question and I will send you a reply!

IT IS THE WORLD BREAST FEEDING WEEK! (Pt 2)

There are three reasons for breast feeding; the milk is always at the right temperature, it comes in attractive containers; and the cat can’t get it- Irena Chaimers.

Exclusive breastfeeding is defined as “an infant’s consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications.

Infants should be fed exclusively for the first six months of their lives.

The benefits of breast milk to the child and the mother are numerous;

  • Breastfeeding helps mother and child to bond

You already love your child when they are born, when you breast feed them, you love them more and they love you back.

“Mother and child mutually gazing into each other’s eyes, telling each other secrets with just their eyes”

It is often said that a child knows the smell of its mother, and that a mother’s breast will produce milk on its own when the child cries, no matter how far apart mother and child are.

  • Breast fed children have a higher IQ than their counterparts who were never breast fed

See, breast feeding your child makes them wiser and brighter.

Breast milk contains galactose for brain development

  • Breast milk is cheap, clean and gives babies an attractive smell

I do not need to overemphasize the fact that breast milk is cheap, and readily available. Any mother who has tried formula feeds will tell you how much pocket damaging they can be.

Then apart from the issue of cost, there is the other problem of water, your feeds are as clean and safe as the water you use for mixing them and the containers you use

  • Breast milk protects against allergies

Compared to their bottle-fed counter- parts, breast fed infants have a low incidence of allergies such as atopic dermatitis.

  • Colostrum has endorphins good for birth associated stress

Colostrums is the first milk that is normally yellowish in color because it contains a high fat content

  • It reduces the risk of juvenile onset diabetes mellitus , rheumatoid arthritis and inflammatory bowel disease

These diseases are commoner in children who were not breast fed for some reason or another

  • It reduces infant mortality- otitis media, pneumonia and diarrhea are less in breast fed infants

This is because breast milk contains anti-bodies which protect the baby from infections

  • Breastfeeding helps mothers lose weight

Pregnancy is a weight gaining experience (he he) some mothers also gain a lot of weight during the period after giving birth. (What with everyone musing about the way they should eat so that they can breast feed their younglings?)

Breast feeding helps lose some of that undesirable weight

  • Suckling promotes uterine involution and this prevents post- partum hemorrhage

After the baby is born, the uterus contracts and this helps to prevent bleeding

Breast feeding helps in further contraction of the uterus hence reducing the chances of post partum bleeding

  • It is a contraceptive although it is not 100 percent effective

Some women will not start getting their periods until six months after giving birth. This phenomenon is known as lactational amenorrhea.

It is more pronounced in women who breast feed their children exclusively.

During this period, such women will not get pregnant

Note; this is not very effective and it is therefore important to use a contraceptive. If you do not want to be that woman who finds themselves pregnant when her baby is barely five months old

  • Breast feeding helps reduce breast and ovarian cancers

HAPPY WORLD BREASTFEEDING WEEK!

( BABIES, INDULGE………)

The world breast feeding week officially starts today. It is August first, a time to celebrate, encourage and teach all mothers (and fathers)how, why and when to breast feed their babies!

It is popular belief that breastfeeding is a skill that is inherent in all women. Attaching a baby on the breast is however not an ability with which a mother is born. Breast feeding is a skill that must be learned by observation and experience. Learning to breastfeed is as hard as learning to drive and as anxiety provoking. Mothers must therefore be apprenticed ante-natally, and even after their babies are born.

New mothers should start breastfeeding their babies as soon as they are born. A midwife should be present to help guide the mother through. Note that, she will find it tough at first. The first feeds will be problematic. But re-assure them that it doesn’t mean that they can’t do it, and most importantly, their babies will not starve. Therefore, there is no reason to be fast in giving those formula feeds.

How to breast feed

Successful breast feeding starts with the belief that you can do it. Don’t be uncertain or anxious.

-Mother and child should breastfeed in a relaxed environment.

-The mother should be helped into a comfortable position- lying by her side or seated in a comfortable chair.

-The infant should be cradled next to the breast with their head propped up by the mother’s hand.

-The infant should be placed with the their stomach flat against the mother’s upper abdomen (stomach to stomach).

-When the mouth is open the nipple and lower part of the areola is pushed well back into the infant’s mouth against the palate. This way, the hard palate compresses and massages the milk sinuses that lie beneath the areola

Your baby is well attached to the breast if;

  • The mouth is wide open
  • Baby’s chin touches the breast
  • Baby’s lower lip is curled outward
  • Usually the lower portion of the areola is not visible( areola is the black of the breast that normally surrounds the nipple)
  • Their nose is not buried into the breast as this might interfere with nasal breathing

Once the baby is properly attached to the breast, then you should;

Continue feeding until the baby releases the breast

Then hold the baby vertically and gently (note to fathers) tap their back two to three times to drive out swallowed air (burping the baby).

Place the baby in bed either lying on their side or prone (lying on their back).

TIM IS SPECIAL

The sun is already up by the time I wake up, its rays are penetrating through my curtains, it isn’t very hot outside otherwise, and the gleam of light penetrating through my curtains into the room would be hurting to my eyes. It rained last night and the smell of wet soil makes me sick. It isn’t like the past; I used to love the smell of wet soil, but not anymore. Things have really changed. I have grown a great deal, I have laughed and loved, I have wept and rejoiced, and, and I no longer eat soil.

Timo is fast asleep, he snores, his mouth is open, and a dried white line runs across his cheek (saliva). He is not about to wake up. I want to read my Bible, a verse from yesterday’s sermon, I remember the word, and how it touched me, I remember the pastor and his great sense of humor. I also remember the woman who had sat beside me during the service. I remember her long, locked, dyed hair, her soft chocolate face, a mole on her upper lip, her almost flat chest and her oversized hips. I even remember the body hugging pink dress that she was wearing, and her black boots, and her white purse (pink, black, and white in a brown body, is that what the fashionistas call color blocking these days?).I don’t know why she offered to hold Timo, maybe it is because she loves children, or maybe she wanted an excuse to remain seated while other faithfuls stood to praise, or maybe, she wanted to just help so I could rest for a while. I could have asked her why she wanted to hold my baby. She didn’t look like the type that loves babies. I could have asked why, I could have asked, I didn’t ask. I handed her the baby and looked at her perhaps to decipher her reasons for wanting to hold my baby. She made herself more comfortable in her chair, and proceeded to expose the baby’s face. All this while my eyes were fixed on her, she was startled I could tell from the way she heaved herself forward suddenly, from the way her upper lip, the one with the mole quivered, from the way tiny droplets of a liquid gathered on her face. She must have had sweat dripping down her spine. She must have felt a sudden strong urge to itch her armpits, she must have, and she must have. She handed me my baby after three minutes, only three minutes and I could tell they had been the three longest minutes in her life. She was going to pee. She left, with her purse. The service went on. The people sang, the preacher preached, prayers were said and the service ended. She; the woman with oversize hips, whose hair was locked, the woman who had asked to hold Tim for a while, she didn’t come back, I hope she didn’t pee on herself, I hope she reached the toilets before her sphincters gave way. I hope she is fine because, some things are traumatizing, things like Tim’s face.

Tim is different. He is turning nine in three months. He is not in class two like most of his age mates. He does not play, he does not know how to sit down yet, he doesn’t even know how to talk. He doesn’t know me, he doesn’t know that I am his mama, he doesn’t know himself, he doesn’t know his name, and he doesn’t know that he is a boy. Tim is a special child you know, he doesn’t talk, he doesn’t hear, he doesn’t walk, he only sees. I know he sees because he follows me with his eyes. He opens his eyes when he hears a sound, and he closes his eyes when there is too much light. Tim can’t turn away from too much light, his neck can’t turn. Even when he sleeps, he has to be turned or he will get decubitus ulcers for sleeping on one side for too long.

I am the mother of Tim. It’s been nine years, I cannot complain. I do not know why He gave me this child, this child that cost me my husband, his father. I do not know how He decided that I should be the one to carry him in my womb, and to take care of him forever. As long as he lives, he is going to need me by his side. He has cerebral palsy. I used to take him for therapy, physiotherapy but I no longer take him. I haven’t given up yet, but I somehow know nothing will change his state, not even physiotherapy. I can’t keep house girls; I work, in a school, as a matron. I always lock him in the house, carry my bag and leave. He cries, when I am away. He becomes hungry. But I can’t do anything against it. If I stay at home, we will both starve to death. So I choose to leave him. If he would talk, I know he would love to ask why I leave, he would never ask though.

Being a mother of a special child is special. If the special child is the first, you will get paranoid. You will not want to have other children for fear of having a similar child. Your husband might leave you. Your relatives might stop associating with you. You might fear traveling with your baby because people stare, others get amazed and awed, and in this era, others take photographs of their faces, their shriveled hands and upload them with hash tag…thanking God I am normal…. Having a special child is not easy. If you are a little weak, you might abandon your child. I have heard of a couple who strangled a neonate with cleft lip and palate because they couldn’t live with the “shame”. That is despicable, shameful, inhuman, ugly, evil, and satanic. Children with cerebral palsy, autism, Down syndrome, cleft lip and cleft palate, congenital talipes, hydrocephalus among other conditions should be left to live. They should be helped to live as comfortable as is possible…………

STRENGHT TO MOTHERS RAISING THESE CHILDREN………