COMPOSITION OF BREASTMILK

The composition of breastmilk is not constant. It is constantly changing, even throughout a single feed. Breast milk varies to meet the infant’s individual nutrition and fluid requirement per time, age and condition (Prentice, A. 1995). Can you beat that!
Breastmilk is a complex fluid, rich in nutrients and non-nutritional components e.g. hormones, antimicrobial factors, growth factors, digestive enzymes, DNA, RNA (Jenness R. 1979). It contains all the nutrients needed by the baby from birth to about 6 months of life. Water is not needed!!!

Factors that affects the compostion of breastmilk (Prentice A. 1995)

• Stage of lactation
• Maternal diet

Stage of Lactation
This can be divided in four which differ in composition and volume of milk produced. Colostrum, transitional, mature and involutional. The composition does not change suddenly; it is a gradual process and may not even be noticed except you express breastmilk in a cup or bottle.
COLOSTRUM; can you see it is in capital letters, yes. Please my people do not throw this milk away. Why? This is the thick, yellowish milk that is produced in the first 3-7days after delivery. It is very rich in lactoferrin, leucocytes (soldiers of the body), Vitamin A (good for eyesight), secretory IgA (antimicrobial factors), immunizing factors, high in protein and sodium and has less fat (Mepham. T B.1987) I am sure you don’t want your baby to miss out on all these goodies that you don’t have to pay for.

Transitional milk is produced around 8-20days. The milk gets lighter in color not as yellowish as the colostrum

Mature milk; this is the milk produced during full lactation that is when the mother and child has established a feeding pattern and this usually occurs any time after 20 days. It is very high in fat, lactose, Vitamin B1. It contains all the other nutrients listed above too but just very high in these. This is where the foremilk and the hind milk can be observed. The foremilk is the milk produced immediately the baby starts nursing; it has a HIGH WATER CONTENT. The hind milk flows after few mimutes of nursing by the baby and contains that high fatty content. Can you see that the breastmilk is just over complete and well-designed #grinning

Involutional milk is the milk produced when the baby is ready for solids, from 6months old. It is low in zinc, low in fat also. This shows us clearly that by 6months of the child’s life, breastmilk alone won’t do the job of maintaining those chubby cheeks every mother desire. Begin the introduction to solids and this does not mean the cessation of breastfeeding

Maternal diet
This can also affect the breastmilk’s fatty acids, vitamins, zinc, selenium, iodine and fluorine (Bates CJ, Prentice A. 1994). As said in an earlier post, the diet of the mother causes variation in the composition of the breastmilk. Spicy foods can add flavor to the breastmilk, alcohol will give the breastmilk a sedative effect on the infant. Maternal diet also plays a role in allergies, once you are aware of an allergy in your child and you are still breastfeeding, my advice is to avoid such food till you stop breastfeeding as the allergen’s active component can pass from your bloodstream to the breastmilk.

Nutrients in Mature Breastmilk
Water
Proteins; Casein 40% and Whey 60%. I had to write this because it is only breastmilk that can boast of having this ratio, which is superb.
Fats; essential fatty acids, long-chain poly unsaturated fatty acids. These are the easily digestible fats
Carbohydrates; lactose
Minerals, Vitamins & Trace elements; Vitamin A, C, D, E, K, Iron, Phosphorus, Calcium, Sodium, Potassium, Magnesium, Chloride
Antimicrobial factors, Digestive enzymes, hormones, growth factors

My mother, who sat and watched my infant head while nursing calmly at her breast #hopeyouknowthatisnothowthesongwassang. I couldn’t resist singing it like that. With what the breastmilk contains, it is a balanced diet indeed. Let me shock you further
For each 100ml of breastmilk, this is approximately what is given; compare these values to some of our adult foods

• Energy 60-75kcal or 280kj. Do you want your baby to be active and energized, give breastmilk
• Protein 1.3g
• Carbohydrate; lactose. In colostrum- 2.5g/100ml, mature milk 1g/100ml.
• Fat about 4.2g
• Iron 76mcg
• Calcium 25-35mg
• Phosphorus 13-16mg
• Sodium 15mg
• Vitamin A 60mcg
• Vitamin C 3.8mg
• Vitamin D 0.01mcg (www.infantnutritioncouncil.com)If there is no contraindication or uncorrectable problems associated with breastfeeding, mothers please, exclusively breastfeed your babies for 6 months while families, workplace and the society at large support a breastfeeding woman.

Thank you
Yours sincerely
Simply Matty
R. Paed. N

Breastmilk; a mother’s meal Breastfeeding; a team work.

Breastfeeding or the decision to breastfeed your baby is a personal matter or your choice therefore never feel guilty over your choice. However, I would prefer you make an informed choice or decision, hence the reason for this post.This post is also about celebrating the world breastfeeding week; August 1-7th.

WHAT IS OPTIMAL BREASTFEEDING?

I am sure you’re wondering why optimal and not exclusive. I heard this word ‘optimal’ when I went for a scientific meeting from Dr Chris Isokpunwu, Head of Nutrition, Federal Ministry of Health and I fell in love with it, it is so encompassing.

Optimal breastfeeding is the early initiation of breastfeeding within the first hour of life, exclusive breastfeeding without the addition of water or infant formula in the first 6 months of life, giving of timely adequate complimentary feeds and continued breastfeeding till 1-2years of life.

You know experience and observation has shown me that most Nigerian women breastfeed their babies, I can see the wheels spinning in your head thinking, so what is then the problem. The issue is EXCLUSIVE BREASTFEEDING FOR 6MONTHS. This is what we are not doing and this is what is more  beneficial for us and our babies.

Breastmilk contains all that your baby needs especially in the first 6 months of life. It is so complete. I need you to do an experiment for me if you are breastfeeding or have someone breastfeeding around you. Express or have the mother express about 30mls of breastmilk into a cup, leave it to rest for about 2-3 hours,  put it where no one can shake it, tell me what you observe in the comment box below.

I am so sure we know or have an idea of the benefits of breastmilk and breastfeeding, please let me remind you once again, thank you.

BENEFITS: they are numerous but I’ll list few so I don’t bore you with a very long post.

FOR YOUR BABY

1. Perfect blend of nutrients needed to grow
2. Easily digested
3. Breastmilk has varying composition that keeps up with the infant’s growth, state of health and nutritional needs (AAP, 2011) It means that your breastmilk changes to suit your baby’s need. If your baby is sick, your breastmilk changes in composition to that state, that is more white blood cells (soldiers of the body) are produce.
4. Exclusive breastfeeding, note the emphasis, reduces childhood obesity and diabetes (AAP, 2011)

FOR THE MOTHER

1. Reduced risk of ovarian, breast,  cervical and endometrial cancers associated with 2years duration of breastfeeding  (AAP, 2011)
2. Exclusive breastfeeding helps the mother to return to her pre-pregnancy state faster. It promotes weightloss, 1/2 of calories needed to manufacture milk is gotten from fat stores and about 500-1500 calories is needed per day to produce sufficient milk for your baby (Mothering from the heart; AAP 2011) WOW!!! The only time you can loose weight without dieting or exercise. #runningawaybeforethefitnessguruscatchme. Can you see that pap alone won’t do the magic.
3. Breastfeeding gives you an excuse to sit down and relax #winking

FOR THE FAMILY

1. Closer bond especially in homes where fathers support the woman. Please, men support our nursing mothers. We take permission to borrow for 1 year #youshaunderstandwinking
2. Breastfeeding is not expensive, just feed the nursing mother with adequate meals. Not pap and amala alone #raised eyebrows
3. Breastmilk tastes great. To babies sha, as for me, Yuck!!!!

TO THE ENVIRONMENT,  SOCIETY AND NATION

1. Less pollution from the tins of milk
2. More jobs are provided especially in the agricultural sector
3. A healthier nation is ensured
4. A brilliant generation is being nurtured
5. Reduced cost of healthcare and economic savings for the country

Psalm 22:9 NKJV But You are He who took me out of the womb; You made me trust while on my mother’s breasts.

I hope with these few words of mine, I have been able to convince you to make an informed decision #whewsooutofbreath

Another time!

Thank you

 

Developmental Milestones

Hello,

How have you been since my last write up? We continue today. For a recap, check my previous posts, thank you.

Remember, every child is unique and will achieve his/her milestones at their own pace

The milestones will still be discussed under these headings;

• Physical
• Movement/Gross
• Fine motor/Adaptive
• Social/Emotional
• Language/communication
• Cognitive (learning, thinking, problem-solving)
• How to help your baby’s development.
• When to seek help

Your Baby at 5months (Age range 4-6months)

Physical

• Birth weight doubles
• Drooling
• You’ll see signs of tooth/teeth
• Chewing and biting of anything in sight begins

Movement/Gross

• Lies on the chest with head up and extended arms, like a push up posture
• Can roll from back to side, later can roll from abdomen to back and back to abdomen
• Can sit with support, later sit without support
• No head lag when in sitting position
• When baby is lying flat on the back, can put feet to mouth
• When held in standing position, supports weight on legs and might bounce
• Brings hand to mouth
• Rocks back and forth, sometimes crawling backward before moving forward

Fine motor/Adaptive

• Inspects and plays with fingers and hands
• Carries objects to mouth
• Grasp objects with hands
• Can transfer object from one hand to the other
• Plays with his toes
• Brings feet to mouth
• Drops one object when given another one or when another one excites them
• Can grasp small objects
• Can hold bottle

Social/Emotional

• Smiles spontaneously, especially at people
• Likes to play with people and might cry when the playing stops
• Copies some movements and facial expressions, like smiling and frowning
• Demands attention
• Expects feeding when mother or feeding utensils are seen
• Shows excitement with the whole body, kicking of legs, squealing
• Knows familiar faces and begins to know if someone is a stranger
• Likes to look at self in the mirror or love their pictures to be captured
• Pats breasts with both hands
• Discovers other part of the body apart from mouth and toes
• Laughs when head is hidden in a towel or you cover your face with your hand (peek-a-boo)

Language/Communication

• Makes consonant sounds n, k, g, p, m and b.
• Laughs aloud
• Turns to voice
• Begins to babble sounds like “ah”, “eh”, “oh”, “da”, “ma”, “mu”, “hi”, “di”
• Copies sounds heard
• Makes sounds to show joy and displeasure
• Cries in different ways to express hunger, tiredness, pain or displeasure.
• Responds to own name
• Takes pleasure in hearing own sounds

Cognitive

• Holds arms out to be picked
• Has likes and dislikes
• Has mood swings- from crying to laughing with little or no cause
• Follows moving things with eyes from side to side
• Shows curiosity about things and tries to get things that are out of reach
• Begins to play.

Play is an integral part of a child’s development. It is very necessary

How to help your baby’s development

• Hold and talk to your baby
• Pay close attention to your baby’s cries, likes and dislikes
• Copy your baby’s sound
• Act excited and smile when your baby makes sounds, do not shush your baby
• Give age-appropriate toys to play with
• Allow your baby to explore his surroundings
• Hold your baby in a standing position once in awhile
• Read, sing and laugh with your baby
• When he drops something on the floor, pick it up and give it back. It is a sort of game to them but it teaches them cause and effect
• Show your baby books with colourful pictures
• Put your baby on his tummy or back and put toys just out of reach. Encourage him to roll over to reach the toys
• Do not carry your baby all the time. Put him on a mat surrounded with toys and let him learn independence

When to seek help

• Does not smile at people
• Cannot hold head steady
• Doesn’t coo or make sounds
• Doesn’t bring things to mouth
• Doesn’t follow objects with eyes
• Doesn’t try to stand when held upright
• Shows no affection to even you the parents
• Does not roll over in any direction
• Does not laugh or babble
• Seems very stiff, with tight muscles
• Seems very flat or lax like wax
• Does not respond to sounds around

There is a mobile app for monitoring your baby’s developmental milestones by CDC.

This is the bit I carry today. Till I come your way again,

I Remain

Yours Truly

AskMatty.

You can follow me on Facebook- AskMatty, Instagram@simplyaskmatty

References

1. Developmentalmilestones. http://www.dpeds.org/milestone
2. David. W & Marylin J. Hockenberry. Wong’s Clinical manual of Pediatric Nursing
3. Learn the signs, Act Early. http://www.cdc.gov/milestones

Developmental Milestones

How your child acts, moves, plays, learn, speaks or do anything is an important pointer about his or her development. Everyone hears growth and development especially in relation to children, these two indices are vital and says a whole lot about your child.

Growth is increase in size while development is the process of change in the physical, behavioural, cognitive, social, emotional e.t.c. Hope you got the drift.

Developmental milestones are things most children can do by a certain age. Growth measurements are needed to evaluate your child.

Let’s go on to the business of the day. This topic will run for a while. I would like you to check on it again and again. This is a guide and not a rigid rule that is why you will see the ages are in a range. Not all children will show the behaviours on this list, however you should consult with your child’s doctor or nurse if you observe any of these;

• Your child does not achieve majority of the milestones within a reasonable period of time after the end of a stage. For example, your child should be able to support the head without it falling behind (head lag) by 2-4months. You can wait for a month, if he or she has still not achieved this, seek professional help. Do not delay and;
• Your child suddenly stops making consistent progress.

Babies born too soon (preterms) tend to achieve milestones a little later as the calculation of their real age clinically starts from when they reach 40weeks of pregnancy age even outside the womb. #ohyes #topicforanotherday

“It is important to intervene early to improve the outcomes of the children who have developmental delay“

There is a mobile app that can help you track your baby’s milestone, it is CDC’s Milestone Tracker

The milestones will be discussed under these headings

• Physical
• Movement/Gross
• Fine motor/Adaptive
• Social/Emotional
• Language/communication
• Cognitive (learning, thinking, problem-solving)
• How to help your baby’s development.
• When to seek help

YOUR BABY AT 2 MONTHS: Age Range 0 to 3months

Physical

• Posterior fontanelle closes

Movement

• Can turn head from side to side when lying on tummy.
• Can hold head up more erect.
• When held in standing position can bear slight weight on legs
• Begin to push up when lying on tummy.
• Makes smoother movements with arms and legs .
• Head is steady at the shoulder.
• Raises up arms and legs when a loud sound is heard and may even cry.

Fine motor

• Unfist fisted hands.
• Hits at objects.
• Holds an object if it is placed in the hand but will not reach for it by self.

Social/Emotional

• Smiles at you.
• Begins to smile at people.
• Can calm self down for a short while.
• Tries to look at parent.

Language

• Coos, chuckles, makes gurgling sounds.
• Turns head towards sounds.
• Babbles a lot
• “Talks” to a familiar voice

Cognitive

• Pays attention to faces.
• Begins to follow things with eyes.
• Stops crying when parent enters the room
• Gets bored and cries if activities does not change.
• Begins to recognize people and familiar objects like feeding cups, spoon and bottles

How to help your baby’s development

• Talk, smile, sing and play with your baby anytime you attend to him/her.
• Help them get into a routine e.g. sleep more at night than during the day.
• Know your baby’s cues.
• When they make sounds, encourage them. Do not shush them.
• Know and pay attention to your baby’s different cries. Know what each cry means. Not all your baby’s cry indicates feeding time.
• Read to your baby and show him/her pictures.
• Leave your baby once in awhile to learn to play by self.
• Hold their toys high up to encourage them reach for it.
• Lay your baby on the tummy when awake and put toys nearby.

When to seek help

If your child does not;

• Respond to loud sound;
• Watch things as they move;
• Smile;
• Bring hands to mouth and;
• hold head up when lying on tummy.

Thank you

Follow me on

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Yours truly,

Askmatty

References

Developmentalmilestones. http://www.dpeds.org/milestones

Learn the signs, Act Early. http://www.cdc.gov/milestones

David. W & Marylin J. Hockenberry. Wong’s Clinical manual of Pediatric Nursing

Words of encouragement to Parents of Premature Babies

I came across a write up with the heading, “10 Notes from NICU Nurses to Parents of Premature Babies”. I was like Wow! this is what I tell my babies’ parents or will say to these parents.

I’ll post the 10 notes to encourage you too. Bravo!!!

1. “Don’t ever be afraid to ask questions. There is no such thing as a stupid question. You know your baby the best.”

Cheryl Cavallaro, NICU Nurse

2. “It’s important to include the extended family members for the health of your baby and extended family”.

Joyce Abrames, NICU Nurse

3. “Don’t try to compare your experience (or your baby’s) to anyone else’s. Take each new milestone or victory and celebrate it with all you have. Those little victories will get you through. Spend all the time you can with your baby – bond, learn and love. Finally, be kind to yourself, and practice self-care whenever you can. You can do this.”

Morgana Jokiel, NICU Nurse

4. “There are good days and bad days. It will feel like a roller coaster, and you’ll have to be patient. Ask a lot of questions. If you don’t understand something, ask.”

Mary Jane Stover, NICU Nurse

5. “Once you have a premature baby, you enter a world you never knew existed. The surprising result is that you will meet a group of people you will never forget for the rest of your life. We will always be there to get you through. You are not alone.”

Rebecca LaClair, NICU Nurse

6. “Remember that your love for your baby (or babies!) is the most important things you can bring 100% of the time, and don’t forget its incredible power. Your infant can feel that, even in the smallest touch.”

Alissa Ray, Clinical Nurse

7. “You will never be alone on this journey. Your family is surrounded by caring and dedicated professionals who will listen to your concerns, cry with you during difficult times, hold your hand, and make you understand that whatever it takes, we are in this journey together to make sure that your precious one will get the best care ever.”

Liberty Abelido, Nurse Manager

8. “Parents need to take time to care for themselves so that they are better able to provide care for their baby. Talk to your baby. Touch them. They relax and are better able to cope with the environment because they will hear a familiar voice and that provides a sense of security.”

Tarisai Zivira, NICU Nurse

9. “Every day may be so different from the next. Keep your eye on the goal–your baby’s safety, health, and happiness. Babies are so much smarter, stronger and braver than we can imagine. They let us know when they are ready to go home with you. ”

Clara Song, Faculty Neonatologist

10. “Never underestimate the strength and resiliency of babies. Preterm, ill, congenital anomalies or whatever condition brings them into the NICU, they are still sweet babies that ENDURE and give something to their parents and families, no matter how small…HOPE! Take that hope and bring good energy to your my every time you visit.”

Donna Dichirico, Nurse

Everything i say when I am in the NICU is captured in each of the notes. #feelingemotional #proudtobeanicunurse

The notes I love most are 1,3,6 and 10.

In closing, when you see or come across a family who has had a preterm birth or a preterm baby or babies, show them some extra love. They sincerely need it.

Note; NICU- Neonatal Intensive Care Unit

Yours Truly

Simply Matty

Reference
The Pulse, General Electric Healthcare. http://www.newsroom.gehealthcare.com Nov 14, 2017

Photo credits: Pls bear with me, I cannot remember that. Howbeit, I give honor to whom it is due and acknowledge their work. Thank you

World Prematurity Day

Hello,

I am so excited today. Why? Today is a day set aside to raise awareness about everything related to prematurity. Starting from preterm birth, its causes to the care of preterm, the list is endless. We will be dwelling on terminologies today.

You will hear these terms used in the hospital setting when a preterm birth has occurred. This is a list, though not exhaustive, but it will serve as a guide.

1. Preterm- a baby born alive before 37 weeks of pregnancy are completed

2. Extreme preterm- babies born before 28weeks

3. Very preterm- babies born between 28weeks and 32weeks

4. Moderate to late preterm- babies born between 32 to 37weeks

5. Low birth weight (LBW)- babies with birth weight less than 2.5kg

( Behrman RE, Butler AS. Preterm Birth: Causes, Consequences, and Prevention. Washington (DC): National Academics Press (US); 2007. B, Prematurity at Birth: Determinants, Consequences, and Geographic Variation)

6. Very Low birth weight (VLBW)- babies with birth weight less than 1.5kg or 1.5kg.

Subramanian, KN Silva, Suna C. S. et al 2014. Extremely Low Birth Weight Infant. http://www.emedicine.medscape.com

7. Extreme Low Birth- birth weight less than 1kg or 1kg

8. Small for gestational age-babies who are smaller than the expected weight for the weeks of pregnancy

9. Apnea-cessation of respiratory activity (breathing).

10. Apnea of Prematurity- cessation of respiratory activity of more than 20 seconds with or without low heart rate or bluish extremities or body

11. Cyanosis- bluish coloration of the body or extremities. An important sign of impending danger.

12. Hypoglycemia-low glucose level

13. Hypothermia- temperature 35°c and less than 35°c

14. Kangaroo care- this is a method of keeping the preterm baby warm, increasing their survival rate and also for transport to another health facility in case there is no transport incubator. It involves putting the baby in between the breasts; skin to skin. A cap and diaper are the item of clothing the baby puts on. The mother or carer also wears nothing on the upper torso. A long armed wrapper is tied around the baby and the mother or carer.

photo credit: twindocotorstv

photo credit newtimes

15. Expressed breastmilk: this is breastmilk that is expressed into a cup or bottle either by hand or breast pump. Babies born at less than 32-34weeks don’t have good or strong sucking reflex, hence they are fed via a feeding tube.

16. Intravenous fluid- the lay man’s term is “drip”.

17. Hand washing- very important. It is the process of washing your hands before and after attending to each baby

18. Incubator- a glass like container where preterms are nursed for warmth and close observation

19. Oxygen administration- this is giving of oxygen gas to babies who have difficulty in breathing via a nasal catheter or face mask or nasal prongs.

20. Oxygen saturation- this is the measurement of the circulating oxgen in the baby’s blood. It is measured with a pulse oximeter. Its probe maybe attached to the baby’s fingers, wrist or toes or earlobe.

21. Full Blood Count- an investigation to know the analysis of the baby’s blood

22. Electrolyte and Urea level- a blood sample that reveals the balance or imbalance of electrolytes in the baby

23. Respiratory distress syndrome- this is evident by difficulty in breathing and or rapid respiration, grunting, and bluish coloration of the extremities

24. Hyperbilirubinemia- also known as neonatal jaundice. Develops as a result of rapid turnover and destruction of the red blood cells and an immature liver. The bilirubin levels are measured by doing a serum bilirubin(SB) test daily and treated with phototherapy or exchange blood transfusion if the SB levels are too high

25. Infection- the invasion and multiplication of micro organisms

I think I can stop here.

Preterms are a special group of babies who need specialized, skilled and delicate care.

If you come in contact with any, ensure they are taken to a hospital that has a NICU.

#letsgivethemabettertomorrow

I remain yours truly,

Matty Fakay, R. Paed.N.

Thank you.

Fever in Children and Babies

Greetings! It has been awhile. Yes, I have been so busy trying to update myself and I am not through. In respect to this, I will like to seek your permission to post on my blog only once in two weeks, please.

You can follow me on Instagram @simplyaskmatty, and like my facebook page; Askmatty. I will be dropping health tips now and then before any post on the blog. You can also follow me on the blog so that it is delivered directly to your inbox. Just click on follow below the post. Thank you.

What is fever?

Fever is not a disease, it is a normal response of the body to a variety of conditions, the most common of which is infection. It is also a sign that the body’s defenses are trying to fight an infection.

A child is said to have fever or hyperthermia when his temperature measures 37.8°c and above. The challenge for parents is to know when to be concerned and whether the child can be observed and treated at home or taken to the hospital. #iamheretoguideyou#

Measuring the body’s temperature

Whenever you think your child has a fever, take his or her temperature with a thermometer. Feeling the skin with your hand does not give an accurate reading of temperature. When you use your hand, not only will you feel the child’s warmth but also yours. This is called tactile temperature.

There are different points at which to take your child’s temperature- mouth (orally), armpit (axillary), ear, forehead, and anus (rectally). The most accurate way to take a child’s temperature is to use a digital thermometer rectally or orally. All of these points are acceptable and the commonest in Nigeria is via the armpit.

Hold the thermometer in place; ensuring the shiny end is well covered either under the tongue in the mouth or under a dry armpit or in the anus. For use in the anus, ensure you put vaseline around the shiny end before inserting in the anus. The thermometer is not removed until a beeping sound is heard.

Causes of fever

• Infection.
• Swaddling a baby in too many clothes or blankets. #hmmm# #YesIseeyou#
• Some childhood immunizations, for example, Diphtheria, Tetanus, Pertussis vaccine (DPT) and Pneumococcal vaccine (PCV) though the timing of the fever varies.

Did you observe that teething did not reflect among the causes? Your child may be irritable and uncomfortable while teething but not feverish. Fever while teething is not general to all children.

Treating your child’s fever

The height of a child’s fever is not always the best indicator of whether the child needs to be treated and/or evaluated. What is of upmost importance/note is how the child behaves, the appetite, and how well he or she appears (ill-looking, flushed or not active).

A child with fever can be observed and/or treated at home. It is however important for parents to know when a child with fever needs to be evaluated by a health care provider (doctor or nurse; preferably with a specialty in paediatrics).

A health care provider should be consulted when:

• Babies who are less than three months of age have a temperature of 37.8°c and above regardless of how the infant appears. NOTE: these babies should not be given any fever-reducing medication until they have been evaluated as it can mask the severity of whatever is ailing them;

• Children who are three months – three years who have a temperature of 37.8°c and above for more than three days and/or who appear ill (fussy, refusal of feeds and fluids);

• Children of any age who have a febrile seizure (convulsions that occur when a child between 6 months and 6years of age has a temperature greater than 38°c). Babies less than 3 months in age DO NOT HAVE FEBRILE CONVULSION. If you notice your baby having seizures, please seek medical help.

• Children of any age who have recurrent fevers for more than seven days, even if the fever lasts only few hours;

• Children of any age who have a fever and have a chronic medical problem such as heart disease, cancer or sickle cell anaemia (SS);

• Children who have a fever as well as a skin rash or other symptoms such as stiff neck, severe headache, severe sore throat, ear pain, repeated vomiting and diarrhoea.

Treatment At Home

1. Increase the child’s fluid intake

Having fever can increase a child’s risk of becoming dehydrated. Do not force him/her to eat, but encourage the child to take adequate amount of fluids e.g. water, milk, tea, soup etc. If a child is unwilling or unable to drink fluids for more than a few hours, please take to the hospital.

2. Rest

Most children feel tired and achy when having a fever. It is not necessary to force the child to sleep, rather allow him or her to rest as much as possible.

3. Sponging and Exposure

DO NOT GIVE A COLD BATH TO ANY CHILD HAVING FEVER AND NEVER GIVE ANY TYPE OF BATH TO A BABY LESS THAN A MONTH OLD HAVING FEVER. For new-borns and babies less than a month, expose them to fresh air and remove thick clothing and blankets. For children who are 3months and above, a bath with lukewarm water (water directly from the tap or water left under the sunlight) can be given. The use of cold water is wrong, it causes shivering. Shivering tells the body “I am cold therefore pump up the heat” and this is not what we want.

4. Medication

Use acetaminophen (paracetamol) or ibuprofen. This will reduce the child’s discomfort and the child’s temperature. Remember not to give babies less than three months old any fever medication when they have a temperature of 37.8°c and above. Rather expose them and take them to the hospital.

CAUTION: Never give aspirin to children under the age of 18 years due to the fact that it can cause a rare but serious condition called Reye Syndrome (a condition that causes swelling in the liver and the brain). Some teething powders contain aspirin also known as acetylsalicylic acid, so beware.

Paracetamol may be given every 4-6 hours as needed but should not be given more than five times in a 24hour period. Paracetamol should not be used in children younger than 3months of age without consultation with a health care provider. #hmmm# #paracetamolabuse#

Ibuprofen may be given every 6 hours. It should not be used in children less than 3months-6months of age.

CAUTION: The doses of acetaminophen and ibuprofen should be calculated based on the CHILD’S WEIGHT AND NOT AGE. Fever-reducing medications should only be given as needed and discontinued once symptoms have resolved. Do not turn them to routine drugs.

Yours truly

Simply Matty R. Paed.N

“Wisdom is profitable to direct”

References

American Association of Pediatrics. (2015) Caring for your Baby and Young Child: Birth to Age 5. 6th Edition. www.healthychildren.org

Ward M.A, Edwars M.S & Torchia M.M. (September, 2017) Patient Education: Fever in Children (Beyond the Basics) www.uptodate.com

Photo credits: Pinterest, daMata, shuttersock

Fever in Children and Babies

Greetings! It has been awhile. Yes, I have been so busy trying to update myself and I am not through. In respect to this, I will like to seek your permission to post on my blog only once in two weeks, please.

You can follow me on Instagram @simplyaskmatty, and like my facebook page; Askmatty. I will be dropping health tips now and then before any post on the blog. You can also follow me on the blog so that it is delivered directly to your inbox. Just click on follow below the post. Thank you.

What is fever?

Fever is not a disease, it is a normal response of the body to a variety of conditions, the most common of which is infection. It is also a sign that the body’s defenses are trying to fight an infection.

A child is said to have fever or hyperthermia when his temperature measures 37.8°c and above. The challenge for parents is to know when to be concerned and whether the child can be observed and treated at home or taken to the hospital. #iamheretoguideyou#

Measuring the body’s temperature

Whenever you think your child has a fever, take his or her temperature with a thermometer. Feeling the skin with your hand does not give an accurate reading of temperature. When you use your hand, not only will you feel the child’s warmth but also yours. This is called tactile temperature.

There are different points at which to take your child’s temperature- mouth (orally), armpit (axillary), ear, forehead, and anus (rectally). The most accurate way to take a child’s temperature is to use a digital thermometer rectally or orally. All of these points are acceptable and the commonest in Nigeria is via the armpit.

Hold the thermometer in place; ensuring the shiny end is well covered either under the tongue in the mouth or under a dry armpit or in the anus. For use in the anus, ensure you put vaseline around the shiny end before inserting in the anus. The thermometer is not removed until a beeping sound is heard.

Causes of fever

• Infection.
• Swaddling a baby in too many clothes or blankets. #hmmm# #YesIseeyou#
• Some childhood immunizations, for example, Diphtheria, Tetanus, Pertussis vaccine (DPT) and Pneumococcal vaccine (PCV) though the timing of the fever varies.

Did you observe that teething did not reflect among the causes? Your child may be irritable and uncomfortable while teething but not feverish. Fever while teething is not general to all children.

Treating your child’s fever

The height of a child’s fever is not always the best indicator of whether the child needs to be treated and/or evaluated. What is of upmost importance/note is how the child behaves, the appetite, and how well he or she appears (ill-looking, flushed or not active).

A child with fever can be observed and/or treated at home. It is however important for parents to know when a child with fever needs to be evaluated by a health care provider (doctor or nurse; preferably with a specialty in paediatrics).

A health care provider should be consulted when:

• Babies who are less than three months of age have a temperature of 37.8°c and above regardless of how the infant appears. NOTE: these babies should not be given any fever-reducing medication until they have been evaluated as it can mask the severity of whatever is ailing them;

• Children who are three months – three years who have a temperature of 37.8°c and above for more than three days and/or who appear ill (fussy, refusal of feeds and fluids);

• Children of any age who have a febrile seizure (convulsions that occur when a child between 6 months and 6years of age has a temperature greater than 38°c). Babies less than 3 months in age DO NOT HAVE FEBRILE CONVULSION. If you notice your baby having seizures, please seek medical help.

• Children of any age who have recurrent fevers for more than seven days, even if the fever lasts only few hours;

• Children of any age who have a fever and have a chronic medical problem such as heart disease, cancer or sickle cell anaemia (SS);

• Children who have a fever as well as a skin rash or other symptoms such as stiff neck, severe headache, severe sore throat, ear pain, repeated vomiting and diarrhoea.

Treatment At Home

1. Increase the child’s fluid intake

Having fever can increase a child’s risk of becoming dehydrated. Do not force him/her to eat, but encourage the child to take adequate amount of fluids e.g. water, milk, tea, soup etc. If a child is unwilling or unable to drink fluids for more than a few hours, please take to the hospital.

2. Rest

Most children feel tired and achy when having a fever. It is not necessary to force the child to sleep, rather allow him or her to rest as much as possible.

3. Sponging and Exposure

DO NOT GIVE A COLD BATH TO ANY CHILD HAVING FEVER AND NEVER GIVE ANY TYPE OF BATH TO A BABY LESS THAN A MONTH OLD HAVING FEVER. For new-borns and babies less than a month, expose them to fresh air and remove thick clothing and blankets. For children who are 3months and above, a bath with lukewarm water (water directly from the tap or water left under the sunlight) can be given. The use of cold water is wrong, it causes shivering. Shivering tells the body “I am cold therefore pump up the heat” and this is not what we want.

4. Medication

Use acetaminophen (paracetamol) or ibuprofen. This will reduce the child’s discomfort and the child’s temperature. Remember not to give babies less than three months old any fever medication when they have a temperature of 37.8°c and above. Rather expose them and take them to the hospital.

 

CAUTION: Never give aspirin to children under the age of 18 years due to the fact that it can cause a rare but serious condition called Reye Syndrome (a condition that causes swelling in the liver and the brain). Some teething powders contain aspirin also known as acetylsalicylic acid, so beware.

Paracetamol may be given every 4-6 hours as needed but should not be given more than five times in a 24hour period. Paracetamol should not be used in children younger than 3months of age without consultation with a health care provider. #hmmm# #paracetamolabuse#

Ibupropen may be given every 6 hours. It should not be used in children less than 3months-6months of age.

CAUTION: The doses of acetaminophen and ibupropen should be calculated based on the CHILD’S WEIGHT AND NOT AGE. Fever-reducing medications should only be given as needed and discontinued once symptoms have resolved. Do not turn them to routine drugs.

Yours truly

Simply Matty R. Paed.N

“Wisdom is profitable to direct”

References

American Association of Pediatrics. (2015) Caring for your Baby and Young Child: Birth to Age 5. 6th Edition. www.healthychildren.org

Ward M.A, Edwars M.S & Torchia M.M. (September, 2017) Patient Education: Fever in Children (Beyond the Basics) www.uptodate.com

Photo credits: Pinterest, daMata, shuttersock

The Rhesus Blood Group System

It seems ‘developmental milestones’ does not want to be treated o. #smiling#

My heartfelt prayers goes to all worldwide going through one pain or the other caused by natural disasters, violence, terrorism etc. Don’t lose hope. I envelop you with God’s love wherever you are.

Today’s topic was a question I was asked. I think this blog is already responding to its name, Askmatty. So keep the questions rolling in. #ALERTLONGPOSTBUTWORTHITw#

Every one’s blood is one of four major types; A, B, AB or O. The blood types are determined by the type of antigens (proteins on the surface of the blood cells that can cause a response from the immune system) on the blood cells.

copyright honestly, i cannot remember.

 

Rhesus (Rh) factor is protein found on the red blood cells of most people. It is an inherited gene passed down through parents to their children. When a person has this factor, they are called Rhesus positive (Rh+ve) and when a person does not have it, they are called Rhesus negative (Rh-ve).  This shows that your blood group will either be A⁺/ A^–/B⁺/B^–/AB⁺/AB^–/O⁺/O^–

A simple illustration;

No	MOTHER If she is;	FATHER If he is;	CHILDREN They will be;
1.	Rhesus Negative	Rhesus positive	Either Rh-ve or Rh+ve
2.	Rhesus positive	Rhesus negative	Either Rh-ve or Rh+ve
3.	Rhesus negative	Rhesus negative	All Rh-ve
4.	Rhesus positive	Rhesus positive	All  Rh+ve

 

I hope you understand. Your blood group (which is different from your Rhesus factor) can carry either Rh+ve or Rh-ve. When the Rh-ve individual is exposed to Rh+ve blood, the individual produce antibodies (proteins in the blood produced in response to foreign substances) in their blood and this is called sensitization, the individual is said to be Rh sensitized. This situation could arise in different instances;

• During pregnancy;
• During labor;
• During blood transfusion;
• During abortion (spontaneous or otherwise – a miscarriage is also a type of abortion);
• In an ectopic pregnancy (a pregnancy in which the fertilized egg grows in a place other than the womb/uterus);
• Bleeding during pregnancy and;
• Any trauma or procedure that could cause some of the fetal blood cells to mix with the mother’s e.g.

1. Amniocentesis -a procedure in which a needle is used to withdraw and test a small amount of amniotic fluid and cells from the sac surrounding your baby.
2. Chorionic villus sampling- a procedure in which a small sample of cells is taken from the placenta (tissue that provides nourishment to and takes waste away from the developing baby in your womb) and tested.
3. Manual rotation of a baby in a breech presentation( a position in which the feet, shoulder or the buttocks of the baby would be born first) before labor
4. Blunt trauma to the abdomen during pregnancy

The above reveals that more problems lie with the Rh-ve woman with the Rh+ve baby putting both of them in danger. These antibodies could cross to the fetus/baby across the placenta and form complexes with the fetal red blood cell. These affected red blood cells get destroyed by the RES of the fetus/baby because it was seen as a harmful substance or antigen. It was this recurring process that gave rise to “ABIKU” in the Yoruba culture – a condition where a woman repeatedly loses a baby or pregnancy. (Please note that been Rh-ve is not the only cause but it is one of them)

During the Rh-ve mother’s first pregnancy, nothing usually happens (this is so if she has not been sensitized before) because the initial response to the antigen is slow; sometimes taking as long as 6months to develop and often the baby is born before the woman’s body develops many antibodies. If preventive treatment is not given during the first pregnancy, there are threats in  subsequent pregnancies to her and especially to her fetus/baby.

Prevention of Rhesus sensitization

Rhesus (D) immune globulin (Rhogam) is an immunoglobulin injection used to prevent antibodies from forming during pregnancy when a mother has Rh-ve blood and baby is Rh+ve and after a person with Rh-ve blood receives a transfusion with Rh+ve blood.

copyright@ medmovie.com

This is usually administered to the mother to prevent;

• Hemolytic anaemia or disease of the newborn (a condition where the baby’s red blood cells are destroyed faster than the body can replace them) in the fetus/baby. This hemolytic anaemia is also a major cause of neonatal jaundice #storyforanotherday#.  Red blood cells are the ones who carry oxygen to all parts of the body. Therefore less RBCs equals less Oxygen. #letmeleavetheoutcometoyourimagination#;
• Abortion or Miscarriage etc.

How is Rhogam used?

WOMEN WHO ARE ALREADY SENSITIZED SHOULD NOT BE GIVEN RHOGAM

For non-sensitized Rh-ve pregnant women, Rhogam is given;

• during pregnancy at 28-30weeeks of gestation (pregnancy); and
• after delivery, within 72hours. If both doses are given, it reduces the risk to 0.1% and;
• If the woman is unable to have both doses, she must be given the injection after delivery. It is most effective 72hours after delivery but can be given within 10-28days.

Each pregnancy, delivery of a baby with Rh+ve blood, blood transfusion and other instances I mentioned above require repeated doses of Rhesus immune globulin.

Rhogam can be given intramuscularly (in to the muscles of the buttocks or arm, preferably arm for fast action) or intravenously (in to the veins). The type you buy will determine where it will be given though the commonest is the intramuscular type.

CAUTION: AVOID LIVE VACCINES FOR 3 MONTHS AFTER TAKING RHOGAM. Don’t worry your Tetanus toxoid (T.T) can be given, it is not a live vaccine.

Please don’t forget that all these are required for a woman with Rh-ve blood carrying a baby with Rh+ve blood. If the husband is Rh-ve or she is Rh+ve, no need for the above.

For a sensitized woman, Rhogam is not helpful. Your doctors know what to do as you’ve been sensitized. How would you know if you are sensitized? First of all, you’ll be told to do a blood test to determine your blood group and antibody levels. If the result is positive your doctors know what to do but expect that you’ll be closely monitored more than other women, therefore do not compare. Your antibody levels will be checked at 28, 32 and 36weeks of gestation. Your baby may also be delivered early if he/she shows signs of severe anaemia.

I cannot exhaust this topic without going into medical jargons so let me put me pen down right here. I hope with this few points of mine I have not confused you but rather enlightened you.

For more on this topic, you can visit my references or chat with me on +2348068441420 or mail me at simplyaskmatty@gmail.com

Thank you

I remain yours truly

Matty Fakay R. Paed. N

designed by daMata.

 

References

1. acog.com. The Rhesus factor, 27 September, 2013.
2. medscape.com. Rho (D) Immune globulins. Accessed on the 13^th September 2017
3. Amarasinghe W. I., Gunawardana K., Panadare A., Rannalu P. and Rathnayaka C. Management of Rhesus Negative Mother. SLCOG National Guidelines. slcog.com

 

 

 

 

 

Is it Just Sore Throat?

This is not what I actually had in mind to talk about this week but I believe we could all learn from this.

Therefore, a quick digression from the topic of this week which is Developmental Milestones.

Over the weekend, a friend’s child, aged 1year and 4months, refused feeds, had fever and was not actively playing as she used to. She was commenced on antimalarial but the mother didn’t want to self -medicate, hence I was called, I told her to continue with the antimalarial as that treatment regimen is never wrong in Nigeria. Malaria is endemic and epidemic to Nigeria. The mother was advised to see a paediatrician (a doctor trained to care for children), which she did and a diagnosis of pharyngitis/tonsillitis was made, in layman’s words ‘sore throat’

Acute pharyngitis is redness, pain and swelling of the throat while tonsillitis is inflammation of the tonsils (a pair of tissue on either side of the back of the throat). A child may have one of either or both of the above.

Sore throat occurs as a result of the inflammation or infection of the tonsils, uvula (what we call belubelu)), soft palate (this is behind your uvula) and the pharynx.

For this discussion, allow me to use APT to depict acute pharyngitis/tonsillitis. #ThankyouDaluNagodeEse# I am trying so hard not to use too may medical terminologies or jargons #cheeky#

APT can occur in children younger than 2years of age, though not so common and more likely in older children. It is common during the rainy and harmattan season when most respiratory viruses and bacteria are circulating. The common microorganisms found to be the culprits are either viruses or bacteria. Most of these infections are spread through close contact with the sick; kids can pick them from school or daycare.

Does that mean children shouldn’t go to school or daycare? No, just ensure that your child’s school/ daycare center has a health policy where sick children are either allowed home or taken to the hospital/sick bay/ school clinic.

The signs and symptoms differ from child to child but the common ones you’ll see include,

• Sore throat #amlaughing# because sore throat is actually a symptom and is seen in other illnesses;
• Fever or chills;
• Trouble or painful swallowing;
• Hoarseness or change in voice;
• Headache;
• Ear pain #amsureyouarewondering wetinconcernearwiththroat# there is a close relationship with the ear, nose and throat. Injury or pain in one may affect the other;
• Nausea and vomiting;
• Belly pain;
• Foul breath;
• Aches and feeling tired;
• Red or swollen throat;
• Red or enlarged tonsils;
• Throat and tonsils may have whitish discharge; and
• Trouble breathing or snoring.

Did you observe that the symptoms listed above can be likened to any other illness e.g. malaria, hence why you should not self-medicate when you or any of your family members are not feeling too well. Ensure you see the appropriate health care provider for your care. #youwouldnotvisitacarpentertomakeyourhair#

For your doctor to make an accurate diagnosis for your child you’ll be asked some questions, the child’s ear, nose, throat and tonsils will be examined. Based on what is seen, you may be asked to do a throat swab or blood tests. It is important this is done to give the right drug and prevent complications such as acute rheumatic fever or valvular damage of the heart.

Treatment will depend on your child’s symptoms, age and general health. PLEASE, on no account should you use another child’s prescription (you know this practice of my child/ the older sibling also showed those same signs and these drugs were prescribed) or use a previous prescription for a recurring pharyngitis or tonsillitis.

As most APT are viral in origin, they should resolve after few days without the use of antibiotics but if it doesn’t resolve after 3days, there is increase in severity, difficulty in swallowing or breathing, drooling, stiff neck or neck swelling, please take your child to the hospital. Per chance your child has recurring episodes of three or more treated tonsillitis, surgical removal of the tonsils (tonsillectomy) may be suggested by your doctor. Do not fear.

Care of a child with acute pharyngitis and or tonsillitis

1. Fever: Expose child to fresh air or cool air, wear light clothes for the child, and apply cool cloth to the skin (tepid sponge). Please never use cold water to tepid sponge a child. Cold water will cause chills and shivering. The shivering will cause an increase in temperature which can lead to febrile convulsion. If a child is shivering, cover with more clothes or blankets even if the temperature is high. #rememberwhatIsaidaboutshivering# Do not give your child aspirin to relieve high temperature (fever).
2. Pain: Oral paracetamol or ibuprofen can be given for the pain. Do not give ibuprofen to children younger than 6 months of age or to children who are dehydrated or vomiting all the time. A cool or warm compress to the throat can relieve pain also. If the child is old enough, a warm salt water gargle can be done (tell your child not to swallow the water, he or she should swirl it around in his/her mouth, then spit it out).
3. Food and fluids should be given as tolerated as there is painful swallowing. Preferably cool and bland (not spicy) fluid or foods should be given as they are less painful to swallow than hot and solid foods.
4. Washing of your hands before and after attending to your child, this is to prevent spread of infection.
5. Ensure you complete the regimen of the antibiotics prescribed (that is if your doctor prescribes antibiotics) even when you see improvement.

Resources http://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/pharngitisandtonsillitisinchiildren. Accessed on 25/09/17

http://www.pinnaclehealth.org. Accessed on /27/09/17

For images- http://www.wikipedia.com

Ward, S. L & Hisley, S. M. (2009) Maternal-Child Health Nursing Care; optimizing outcomes for mothers, children and families. Ist Edition. Davisplus, Philadelphia.

Proverbs 4:5 Get wisdom; get insight; do not forget, and do not turn away from the words of wisdom.

Yours sincerely,

Simply Matty R. Paed. Nurse

Finally……

We have tarried long on breastfeeding and of a truth, we cannot exhaust this topic. If you need more information, you ask your questions in the comment box below or whatsapp me on 08068441420. I’ll gladly listen to you.

A lot is going on in our country, Naija, but we will truimph.

We will be moving on to other topics as from next week. If there is any topic that is you will like me to treat please, send a mail or message to simplyaskmatty@gmail.com, 08068441420.

Before i leave you to a wonderful weekend. I’ll share two things with you.

Over the course of the week, one of my preterm baby’s picture was sent to me and to say i was excited and glad will be an understatement, he was admitted with a birth weight of 800g, discharged home with a weight of 1.5kg. He is weighing much more than that now. #Hooray#

Second thing

I LOVE MY READERS. #hugsandkisses#

The Lord inhabits the praises of his people.

Yours sincerely

Simply Matty

Photo credits

Ankara nappy, i cant remember

Preemie, @peekabo

My humble self, my phone camera #Lolll#

Overweight Exclusively Breastmilk fed Babies

Happy new month peeps, it has been awhile. I went to visit my president at Aso Rock #laughingoutloud#. Yours truly was in Ibadan o, working and researching to give you accurate and right health information.

Thank you for your comments and questions, keep them coming, together we can give our children a solid foundation.

Why this topic? All thanks to one of the mothers who asked a question; ‘Can an exclusively breastfed baby be overweight (a baby fed on demand)? Thank you, Mrs. Esan for this beautiful question, you made me delve in to research. I hope this write up will answer yours and several others.

The AVERAGE weight gain in an exclusively breastfed baby for the first three to four months is about 170grams per week #notetheaverageincapitalletter# That is to say some babies may exceed this. There is no evidence that a baby who gains rapidly on breastmilk will have weight problems as an older child (Mohrbacher and Stock 2003). Research has shown that exclusively breastfed babies who gain very fast in the first 6 months become leaner than formula-fed babies after the first 6 months #Jasperisagoodexampleofthis# (Dewey et al 1993). But remember o, genetics, social, cultural and family food practices play a major role in determining obesity later in life.

Now, can a baby who is BREASTfed exclusively be overweight? NO. Did you notice that the breast is in capital letter? Yes, there is a reason for that.

What is Overweight sef? Overweight is a weight that is at or above the 95th percentile of weight for recumbent-length on the growth chart in the W.H.O growth curve. Plenty grammar abi! Check that chart you were given at the immunization centre, you’ll understand all this grammar

Let us take a case scenario. Baby Audu and Baby Collins, both male, birth weight 3kg, 4months old, been fed exclusively with breastmilk, were brought to the infant welfare clinic by their mothers, and there the similarities ended. Baby Audu is weighing 5kg now while Baby Collins is weighing 7kg, everyone at the clinic exclaimed that baby Collins was overweight and obese but the mother insisted that he is been fed with only breastmilk. Wherein lies the problem? Apparently, Collins mother works in the bank, has to drop her baby in a crèche and she expresses her milk into a bottle and the baby is bottle-fed while at the crèche but she breastfeeds when she is with her baby #eureka#

A baby feeding at the breast will suckle and is better able to regulate their food intake compared to their counterparts who are bottle-fed. Bottle feeding does not allow a baby to control how much he/she eats rather it is the giver who controls or determines when the baby has had enough, thus they never learn satiated feelings. A baby who nurses on the breast will spend some of that time actively feeding and at other times they just use sucking on the breast to calm down, play, rub on their gum etc., they self-regulate or control the amount of calories they take in, thus helping them develop healthy eating pattern (Dr Lori Feldman-Winter, AAP). I should say this will apply to babies exclusively breastfed for 6 months.

Does this mean you should not bottle feed your baby? I wouldn’t say so. We have to be realistic. More women are entering the labor market these days, I would say please only introduce bottle when it is absolutely necessary e.g. when you have to resume work and workplace has no arrangement for a nursing mother, flat or inverted nipples that refuses to come out even with nipple shields. Moreover, this kind of obesity disappears later inasmuch as it is breastmilk that is inside the bottle #grinning#

Few tips from La Leche League International, if you have to bottle feed

• Pace the feeding so the baby eats slowly and has control over the flow of milk
• Take frequent breaks, allowing the baby to take a breath
• Resist the temptation to coax or force your baby to finish the whole bottle at once
• Feed baby when not too hungry, this achieves small frequent feeding and avoids overeating
• Monitor your baby’s growth by plotting routine weights and length on the growth charts for exclusively breastfed babies by W.H.O. (Osayande et al 2009). A mistake is usually made even by some health care professionals when they use the same growth chart for all babies. No, it shouldn’t be. Exclusively breast fed babies have a separate growth chart by W.H.O; one for baby boys and one for baby girls at different ages #VIOLA! Link for chart http://www.who.int/childgrowth/standards/en/ so baby Collins may not have been overweight after all.
• Once bottle feeding with breastmilk has been introduced, encourage activity and avoid juice or sugary beverage intake. Babies are individuals with their own individual growth patterns; they regulate their intake of milk to meet their unique needs.

Thank you,

Yours Truly

Simply Matty R.Paed.N

Photo credits

Twin girls: Brandoswifeey mixed babies, Big baby: New Jersey family,  Matty’s infused coconut oil: Damata