Archive for August, 2012

Myths and Truths on Caring for Babies

Having a baby brings a lot of joy to the family.  However, taking care of a newborn is quite challenging. During the first days, weeks and months of the baby, mothers, especially first timers, seek support and help from their husbands, parents and in-laws on how to take care of their newborn.   In the Philippine setting, there are a lot of myths or “haka-haka” when it comes to taking care of infants that do not offer any benefit  and often times cause harm to the baby.

The Perinatal Association of the Philippines (PAP) came out with a pamphlet with the objective of giving truths to myths or misconceptions that have been passed down thru generations in our country on the proper way of taking care of newborn infants.  It is written in our vernacular, Filipino or Tagalog, for everyone to understand and relate to.  It is entitled ” Tamang Kaalaman na Dapat Malaman Sa Pangangalaga kay Baby”. Here are the 14 common myths (haka) and truths (dapat) that parents should know.

Haka:  “Sabi ni Lola bigkisan ko si baby para lumiit ang tiyan at huwag lumuwa ang pusod”

Dapat:  Ating dapat malaman na ang isang sanggol ay ginagamit ang tiyan sa paghinga.  Subalit, kung may bigkis, ito ay maaaring makapagpahirap sa paghinga at makasanhi ng pagsusuka ng sanggol.  Hindi liliit ang tiyan ng isang sanggol kapag ito ay binigkisan sa dahilan na ang kanilang tiyan ay sadyang malaki hanggang 3 taong gulang.

Haka:  “Sabi ni Lola, kailangan bigkisan para hindi maimpeksyon ang pusod”

Dapat:  Ang pusod ng sanggol ay kailangan nahahanginan upang ito ay mabilis matuyo.  Kapag ito ay nakulob, mamamasa it at maaring magkaimpeksyon na may kasamang mabahong amoy.

Haka:  “Naku madalas may kabag si baby, sabi ng matatanda lagyan ng acete de mansanilla ang tiyan”

Dapat:  Ang paggamit ng acete de mansanilla o alcamporado ay hindi makaaalis ng kabag.  Ang madalas na paggamit nito ay maaaring magdulot ng bahagyang pagkasunog ng balat.  Ang wastong pagitan ng pagpapadede at tamang pagpapadighay ang makapagpapabawas ng kabag.

Haka:  “Naku nagmumuta ang mata ni baby, lagyan ko  nga ng gatas ko para mawala”

Dapat:  Ang paglagay ng iyong gatas ay maaaring makasama sa mata ng iyong sanggol gawa ng mga protina na nasa gatas ng ina.  Maaaring sa umpisa ay linisin lamang ang mga mata ng bulak na may tubig.  Kundi man mawala ay mas magandang isangguni mo sa doctor upang mabigyan ng wastong lunas.

Haka:  “Madalas sinukin ang sanggol ko.  Ma sakit kaya siya sa puso o di kaya ay lumaki ang bituka?”

Dapat:  Ang pagsinok ng isang sanggol ay kalimitan nangyayari.  Hindi ito sa kadahilanang may sakit sa puso si baby.  Kundi, ito ay nangyayari kapag nabibigla ang pag-ubos ng kanyang dinedede.  Kaya ugaliin na ingatan ang pagpapadede.

Haka:  “Hay, Martes na naman bawal maligo si baby ngayon at gawa ng may pusod pa”

Dapat:  Ang pagpapaligo sa sanggol ay dapat araw-araw upang mapanatili ang kalinisan nito.  Bagkos kung ang pusod ay nakikita pa, ito ay maaaring mabasa huwag lang maibabad sa pagligo.  Makatutulong ang mahanginan ang pusod upang mapabilis ang pagtuyo nito.

Haka:  “Tatlong linggong gulang pa lang si baby, nilagnat siya, bibigyan ko na siya ng gamot”

Dapat:  Ang sanggol na wala pang isang buwan na gulang ay di maaaring agad-agad bigyan ng kahit na anong gamot sa lagnat.  Kadalasan ang sanhi ng lagnat ay ang masyadong pagbalot sa baby.  Kapag tuloy-tuloy o mataas ang lagnat (38°C pataas), dapat dalhin sa doctor upang masuring mabuti ang baby at Makita ang dahilan ng lagnat.

Haka:  “Si baby ay may sipon at ubo ngayon pababakunahan ko na siya kaso baka di kayanin”

Dapat:  Maaring bakunahan ang mga batang may sipon o ubo.  Ang karaniwang hindi maaaring bigyan ay ang mga sanggol na may mataas na lagnat o di kaya nagkaroon ng reaksyon gaya ng pag-convulsion pagkatapos maturukan.  Itanong sa inyong Health Care provider ang mga iba’t-ibang maaaring reaksyon ng bawat bakuna sa iyong sanggol.

Haka:  “Lalong nagkakasakit ang anak pagbinakunahan, kaya di ko na siya pababakunahan”

Dapat:  Ating isipin na ang mga bakuna ay makatutulong sa pag-iwas ng mga sakit na maaaring ikamatay ng isang sanggol o bata.  Kaya dapat hikayatin ang lahat ng magulang na ipagpatuloy ang pagbigay ng bakuna sa kanilang mga anak.

Haka:  “Naku! Limang beses na nagtatae ang anak ko, malambot at madalas nangangamba ako baka anong mangyari”

Dapat:  Ang pagtatae ng tatlo o higit pa ay karaniwan nangyayari sa isang sanggo lalo na kung ito ay gumagatas sa ina.  Dapat kang mangamba kung ito ay higit sa pitong beses ng pagdumi, matubig, may kahalong bahid ng dugo, sipon, o di kaya may mabahong amoy.  ito ay ikonsulta mo sa pinakamalapit na center o ospital.

Haka:  “Iyak ng iyak si baby, nilalagnat at nagtatae. Nag-ngingipin yata”

Dapat:  Ang isang sanggol ay maaaring magkaroon ng ngipin simula anim na buwan pataas.  Walang katotohanan na ang pagtatae at pagkakaroon ng lagnat ay sanhi ng paglabas ng ngipin.  Upang hindi mabahala, kailangan mong isangguni sa doctor ang dahilan ng kanilang pagtatae at pagkakaroon ng lagnat.  Maaari ring magbigay ng malamig na “teether” upang maibsan ang kirot at pamamaga ng gilagid ng baby.

Haka:  “Naku, ano ba ito! Puro rashes ang baby ko di kaya sa kinain ko kanina”

Dapat:  May katotohanan na maaaring sa pagkain ang sanhi ng paglabas ng rashes ng baby mo.  Subalit, maaari ito kung may lahi ng allergy ang isa o parehong magulang.

Haka:  “Wow! Sarap naman kumain ng karne at taba makakatulong ito sa paglaki ng aking anak”

Dapat:  Napakahalaga sa isang bagong panganak ang wastong pagkain ng carbohydrate, protein at fat upang sa ganun ay makuha ng isang sanggol ang tamang nutrisyon na makatutulong sa paghubog ng katawan at isipan.

Haka:  “Naku, tatlong buwan na si baby pakakainin ko na, bibigyan ko siya ng mga lugaw lang.”

Dapat:  Ang unang pagkain ng sanggol ay sinisimulan sa  6 na buwan.  Mga simpleng nilagang gulay lamang ang maaaring ibigay sa umpisa ng pagpapakain.  Isang bagong pagkain bawat lingo ang dapat ibigay sa unang buwan ng papapakain.  Ang paglaki ng bata ay mabilis sa unang taon nito.  Tatlong beses ng birth weight (3x the birthweight) sa pagbigat at limampung porsyento (50%) ng birth length naman sa paghaba.  Kailangan ng pagkain para sa enerhiya at mabilis na paglaki ng kanyang katawan.

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August 24, 2012 at 2:30 pm 13 comments

What is Dengue?

Dengue Fever (DF) or Dengue Hemorrhagic fever (DHF), its more severe form, is an illnesses not new in our country. It is a disease that continues to scare us every time one develops fever especially during the rainy months. Although it has been known to be more common during the rainy season, it has become an all-year round disease because of the unpredictable rains we experience even during the non-rainy months. This dreaded febrile illness affects infants, young children and adults of all walks of life. Presently, there is still no specific treatment for dengue.

Epidemiology

Dengue is a mosquito-borne disease common in countries with tropical and sub-tropical climates worldwide (Southeast Asia, South Pacific, American Tropics). It occurs mostly in urban and semi-urban areas where population density is high, the water supply is inadequate (resulting to water storage hence, a good breeding place for the vector), and the solid waste collection and storage are also inadequate. All these conditions make Philippines a good candidate for dengue prevalence.

Transmission

Dengue is caused by the dengue virus (DEN) belonging to the genus Flavivirus, family Flaviviridae. There are four distinct serotypes, named DEN-1, DEN-2, DEN-3 and DEN-4. The dengue virus is transmitted to humans by the bite of a female Aedes mosquito principally Aedes aegypti, infected with any one of the four dengue viruses. Mosquitoes bite people and animals because they need the protein found in blood to help develop their eggs. The symptoms of dengue appear 3-14 days after the infective bite.

The Aedes mosquito can be identified by the black and white stripes in their body. They are known to be day-biting mosquitoes peaking at dawn and dusk. They breed in clean, stagnant water accumulated in containers which is usually found in households.

Clinical Presentation

According to WHO and expert consensus groups in Latin America and Southeast Asia, “dengue is one disease entity with different clinical presentations and often with unpredictable clinical evolution and outcome”.

Dengue has a wide spectrum of clinical manifestations from non severe to severe symptoms. Initially, patients develop sudden onset of high-grade fever for 2-7 days, often accompanied by flushing of skin (reddening), generalized body ache or weakness, muscle pain, joint pain, and headache, loss of appetite and vomiting. Some may present with sore throat, reddening of throat and eyes. These symptoms in the early stage usually make it difficult to distinguish from other non-dengue causes of fever. But since it is endemic in our country, dengue is almost always not ruled out. Hence, close monitoring of warning signs and other clinical parameters are advised.

The warning signs of dengue include abdominal pain, persistent vomiting, weakness or restlessness, signs of bleeding like rash, red or black stools and vomitus, red or tea-colored urine, and profuse vaginal bleeding in females with menses. These warning signs may progress to severe dengue after fever wanes, usually at 3-7 days of illness. This may manifest with severe bleeding, respiratory distress due to fluid accumulation in the lungs, hypotension, and other signs of organ involvement like impaired consciousness, and heart abnormalities. However, some patients recover before the critical phase sets in. As of present time, there are still no known predictive factors of who will develop severe or non-severe dengue.

Treatment

As mentioned, there is still no specific treatment against dengue virus.  Early recognition and early intervention plays a vital role in the recovery from the disease.  The keys in the treatment of dengue are fluids, both oral and intravenous, depending on the phase and severity of illness; and close monitoring of clinical symptoms and parameters such as vital signs (blood pressure, heart rate, respiratory rate, pulses) and urine output, as well as laboratory work-ups like the complete blood count (CBC).

We can protect ourselves and our families from dengue by preventive measures to avoid mosquito bites such as applying insect repellants,wearing protective clothing (long sleeves and pants), using insecticides cautiously, screening doors and windows, and using mosquito nets (kulambo).  Control measures to eradicate breeding of the Aedes mosquitoes include covering and regular emptying and cleaning of water storage containers and other sites that usually collect water after the rains (unused tires, roof gutters, flower pots etc.)  Defogging is recommended only during an epidemic and larviciding is effective under certain conditions.

There is still no vaccine available for protection against dengue.  However, a dengue vaccine is now on its way and is at the third phase of clinical trials.  It is expected to be available  two years from now.  Let us hope for its success and its availability to everyone to remove the burden of dengue on every Filipino’s shoulders.

©pinoykidsMD

August 14, 2012 at 4:59 am Leave a comment

Breastfeeding Awareness Month

August is the National Breastfeeding Awareness Month in the Department of Health (DOH) Annual Calendar. The World Health Organization (WHO) also celebrates World Breastfeeding Week every first week of August. Breastfeeding is being promoted all over the world because of the many benefits it gives to both the baby and the mother. Many studies have been done through the years that proves breastmilk as the best milk a mother can give to her child because it contains the exact nutrients a baby needs to grow.

“A mother who breastfeeds helps in her baby’s development and enriches the relationship between them.” This is the Philippine Society of Gastroenterology and Nutrition’s (PSPGN) stand in promoting breastfeeding in our country. The society enumerated the benefits of breast milk and breastfeeding for mothers and infants as follows:

Benefits of Breastmilk

  • Safe, sterile, and always available
  • With perfect nutrients to fully sustain the growth and development of the baby from birth up to six months; after 6 months, still a good source of nutrients when given with adequate complementary foods
  • Easily digested and absorbed; efficiently used by the baby’s immature system
  • Contains antibodies and substances which protect the babies against infection
  • Contains fats (DHA) which enhance brain development and intelligence of the baby

Advantages of Breastfeeding

  • Promotes emotional bonding between the baby and mother
  • Protects the mother’s health against cancer (breast, uterus, ovaries), obesity, and post-partum hemorrhage
  • Promotes early return to pre-pregnancy weight
  • Gives the family big financial savings
  • Furthermore, here are some helpful tips for the breastfeeding mothers regarding correct positioning and attachment for breasfeeding, breastmilk expression and storage and proper diet for lactating mothers.

Correct Breastfeeding Techniques

  • Support the baby’s head and entire body throughout the feeding; the head, back and hips should be facing the breast and aligned in a straight manner.
  • Maintain the position of the baby in such a way he is “face to face”, “chest to chest”, “tummy to tummy” with the mother.
  • Support the breast with the hand of the opposite arm in a C-hold position: thumb above, 4 fingers under the breast.
  • Stimulate the infant to open the mouth wide by stroking the corner of the baby’s lips; check that the chin touches the breast and the lower lip is turned outward.
  • Ensure that the baby grasps the entire nipple plus one inch of the surrounding areola.
  • Allow the baby to suck 15 to 30 minutes per breast to extract both foremilk and hindmilk.
  • Empty the breast around 8-10 times or more a day to ensure adequate milk supply.

Breast Milk Expression and Storage

A small amount of breast milk may be expressed before starting breastfeeding to soften the nipple area. This can be done to relieve painful, engorged breasts. It is importantant for mothers to wash their hands thoroughly before expressing breast milk.

  • Express breastmilk by hand or by using a breast pump when breastmilk supply is abundant and when the mother is planning to go back to work.
  • Store in sterile polypropylene (cloudy hard plastic) containers, properly labeled with the date and time of breastmilk collection.

Recommended Breast Milk Storage Period

  • Room temperature (25 degree Celsius): 1 hour
  • Refrigerator (4 degree Celsius): 5 days
  • Freezer compartment of a 1-door refrigerator: 2 weeks
  • Freezer compartment of a 2-door refrigerator: 3 months
  • Deep freezer with constant temperature (-20 degree Celsius)

Diet of a Lactating Mother

  • Rice – 6 cups
  • Fruits (vitamin C rich; different varieties) – 4 pieces
  • Vegetables (green leafy and yellow) – 1 1/2 cups
  • Meat, fish, poultry, seafoods – 5 pieces (matchbox size for meat), or 2 cups cut into small pieces
  • Egg – 4 pieces a week
  • Mongo, beans, taho – 1 1/2 cups 3x a week *
  • Milk – 2 glasses
  • Fats (olive oil, corn oil, butter) – 7 teaspoons
  • Fluids – 7 glasses water, 1 glass fresh fruit juice

* except in babies with G6PD (glucose-6-phosphate enzyme deficiency) detected by newborn screening

Frequency of Breastfeeding

  • Breastfeeding should be done on demand, i.e., day and night, as long as your baby want. Babies need to feed eight or more times within 24 hours from birth.
  • If your baby is getting enough milk, she should look satisfied after the feed.
  • Her/His weight loss should be less than 10% in the first week of life. The gain in weight should be at least 160 grams in the following weeks or a minimum of 300 grams in the first month.
  • Your baby should wet as frequently as she feeds.
  • Her/His stool should change from dark to light brown or yellow by her third day.
  • Babies should be breast-fed exclusively during the first six months of life. This should be continued until she is at least two years old, even when solid food is started up.

August 1, 2012 at 3:55 pm Leave a comment


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