Editorial Team Editor: Dr. Biji Thomas George Associate Editor: Dr. Yousef Abdel Mohsin El Qabbany Issue Manager: Shyju Joseph
It has been said that â€œhaving a baby changes the way you view your in-laws. You love it when they come to visit now. They can hold the baby and you can go out!â€? Indeed, having a baby can be a joy and a stress. The joy and stress
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start not just when the baby is born, but during the pregnancy as
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There are a lot of myths and legends surrounding what to do and
what not during a pregnancy. Our consultant Obstetrician Dr. Bernd Wittman gives us an oversight on the care mothers need to take during a pregnancy. After the delivery, a common worry, especially for new mothers, is when the baby keeps crying unstoppably. When is it something serious and when is it something simple like a wet nappy? Dr. Achini De Silva, our Senior Paediatrician tells us of the various causes why babies cry incessantly. We also carry an article on how to avoid muscle strains and injuries during sports and work outs.
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Dr. Biji George Editor
So You Are Dr. Bernd K. Wittmann Sr. Consultant MD, FRCSC You probably missed a period, had a home pregnancy test, and it was positive - what now? The best approach is to see your physician, who will check out your medical history for any problems, and will order an ultrasound examination (US) after 7 weeks, to conﬁrm the dates and make sure that there is a baby with a heartbeat. Of course, you have been taking Folic Acid before you conceived, and your life style is healthy. If all is well, and you have neither bleeding nor cramps, then you have a better than 90% chance of a successful pregnancy. However, every couple at this stage is worried if the baby is normal. With the advent of ultrasound in obstetrics 50 years ago, there has been an ongoing search for ways to identify and document normal features of the baby. Severe anomalies can sometimes already be seen between 10 - 12 weeks, however
the ﬂuid at the neck of the baby (nuchal = neck translucency
most problems are recognized later. In an attempt to try to
- NT) can disappear after 14 weeks.
conﬁrm early on that the baby is normal, scientists have
Should all be normal, then you should see your physician or
recognized that between 11 - 14 weeks, speciﬁc ultrasound
midwife every 4 weeks until 6 months, and then more
features combined with blood tests can provide a very
frequently. At around 20 weeks, an ultrasound examination
accurate assessment of the risk of some major chromosome
will be booked, and the baby will receive a full examination of
anomalies. This test is called First Trimester Screen, and many
all the anatomic features which can be recognized at this
professional organizations have recommended that this test
time. This examination is also used to show you and your
is being made available to all pregnant women. The
husband all the beautiful features of your baby. Four to six
ultrasound examination at this time will already provide a lot
weeks later is the best time to perform a 3D/4D ultrasound
of detailed structural information of the baby, and help
examination, if you are interested in seeing real life features of
conﬁrm that all is well. This test is available at Starcare Hospi-
your baby. The last formal ultrasound examination is usually
tal, should be booked between 11 - 14 weeks, and results are
performed at around 32 weeks, to evaluate growth and
available one week later. If the dates are uncertain, an earlier
development of the baby. Of course, if you have medical
visit is necessary to establish dates and book the appointment
problems, or there are concerns about the baby, the placenta
for the FTS at the correct time. After 14 weeks, the test
or the ﬂuid around the baby, then ongoing monitoring of the
cannot be performed, as the most important ultrasound sign,
pregnancy by ultrasound is required.
IN A NEWBORN Dr. Achini Nirosha Kumari De Silva MBBS, DCH, MD (Paed), MRCPCH(UK) Consultant Paediatrician
overload occur in a baby when breastfeeds consistently contain inadequate amounts of fat (lipid). Foremilk (which is released within the ﬁrst 5-10 minutes) is more “sugary and
It deﬁnitely is a nerve wracking experience when you have a
watery” compared to hind milk which has more fat (lipid)
screaming un-paciﬁable newborn to deal with. We cannot
and proteins. Higher fat levels in breast milk causes babies to
blame the baby, as his only way of communication. The
feel full and satisﬁed after a breastfeed. Lipid also slows down
parents, especially new ones, naturally become anxious when
the time taken by the intestine to digest the milk. A breast-
their baby cries too much. However, parents must try to avoid
feed that has too little “cream” or fat content results the baby
anxiety on such occasions. A new born can feel your anxiety;
not feeling full or satisﬁed by the breast feed and also causes
in turn he will become more agitated resulting in a vicious
fast and improper digestion of the milk so that the milk
cycle. Parents and other caregivers should remain calm and
ferments in the colon, causing low-grade inﬂammation and
try to analyze the reasons behind the incessant crying.
The common reasons for a baby to get agitated are hunger,
Babies who don’t feel full after a feed, due to inadequate lipid
wet or dirty nappy, abdominal discomfort before passing
intake, may quickly want more milk. In older breastfed babies,
stools or urine, insect bites, itchy rashes especially irritating
this can result in a cycle of overproduction. The baby feeds
nappy rashes, feeling excessively hot due to over wrapping or
very frequently, stimulating the breast to produce more milk.
cold due to exposure, nasal congestion and nose block.
This milk will be even more sugary and watery and lacking fat
There are conditions for which you need to take medical aid
or “cream”. The baby will then feel hungrier and the cycle
without a delay. For example if you see a lump in the groin
area which could be a hernia, any redness in the scrotum, ear
There are ways that mothers can increase the fat content in
infection or discharge. If any new born baby has fever, or a
their breast milk so that their babies feel full and satisﬁed after
pulsation/ bulging soft spot on the head (fontanelle) you
have to rush to the hospital.
1. Discontinue “comfort suckling” (when the baby makes
“Functional lactose overload” is another common condition
frequent rhythmic ﬂutter-like sucks and only periodic
which leads to unsettled babies. Signs of functional lactose
swallows toward the end of a feed). 2. Allow only “twenty minutes a side”–or similar instructions to limit the feed. 3. Always oﬀer the fuller side ﬁrst. 4. Always feed from both sides. 5. Avoid Breast Pumps: Because a breast pump acts as a vacuum but does not extract much of the low volume, lipid-rich milk, babies receiving signiﬁcant amounts of expressed breast milk may also develop functional lactose overload. Properly taught breast massage may have a role, to help mobilize the lipid fraction. So the next time your baby cries a lot, remember to look for the simple signs and watch out for the dangerous signs so that you can be sure that your baby will always be healthy and happy.
HEALTH& WELLNESS Muscle strains are common. They can occur when you stretch or reach out past your normal range while running, playing sport, gardening etc. A muscle tear is more serious as some of the muscle ﬁbres will be broken. Treatment Initial treatment for both injuries involves RICED. R Rest - stop the activity you are doing to avoid further damage I Ice - place crushed ice wrapped in a damp towel on the injured area for 20 minutes every 2 hours for the ﬁrst 48 hours. C Compression - ﬁrm bandaging helps reduce swelling and bleeding E Elevation - keep the aﬀected area raised as much as possible
D Diagnosis - it is very important to see your doctor or
Following an injury, your physiotherapist can help your
physiotherapist if the pain and swelling gets worse or you
rehabilitation. The earlier you get help, the faster your injury is
have not improved after a couple of days
likely to heal. Treatment will include an exercise programme,
possibly with the use of some gym equipment to increase
The best way to prevent muscle strains and tears is to include
your strength and co-ordination and restore any movement
a warm-up programme before starting any exercise, and then
lost in the joint.
cool down and stretch when you have ﬁnished the activity.
If you are a keen sportsperson your physiotherapist can help
Advice on warm-up programmes and cool-down activities
you with your training programme to decrease the chance of
can be obtained from your local gym trainer.
Starcare in the
Starcare Hospital celebrates 2 magical years of healthcare with many festivites
Win your Gift QUIZ CORNER
Answer the below questions
1. What can you put in a wooden box that would make it lighter? The more of them you put in the lighter it becomes, yet the box stays empty?
2. A man built a rectangular house, each side having a southern view. He spotted a bear. What colour was the bear ?
3. Near the beach there is a floating ship. Over the board is hauled down a rope ladder with 10 steps. The distance between every two steps is 30cm. The lowest step lays on the water surface. The tide is coming and every hour the water rises with 15cm. When will the water get to the third step of the ladder ? a) b) c) d)
After 2 hours After 4 hours Never After 14 hours
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Visit: www.starcarehospital.com, E-mail: firstname.lastname@example.org Contact: +968 24557200, GSM: +968 98252030, P.O.Box: 198, PC 101, As Seeb, Sultanate of Oman
Disclaimer This magazine does not attempt to endorse or promote any information presented. Please keep in mind that information about health matters changes constantly as new studies are performed and new treatments are discovered. Consult your physician or other health professional for your health related advice.
Published on Jun 5, 2013
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