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| Sunday, 5 May 2002 |
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| News Business Features Editorial
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Give your baby mother nature's best... Nothing can equal the all-round advantage of breastmilk in the first couple of years of your baby's life, not even the most expensive brand of artificial infant formula. Breastmilk is not only the best food but also the best health and care a mother can give her baby. Breastfeeding during the first two years of life is one way of ensuring that your baby achieves normal growth and development. It is also good for you, as the mother, because it is healthier, convenient and emotionally satisfying. here are some rules on breasfeeding... Breastfeed within the first thirty minutes of life * Doctors recommend that you start breastfeeding soon after delivery, preferably within half an hour after birth or as early as you can. * Early breastfeeding encourages the flow of breastmilk, and establishes a close mother-child bond. Colostrum, the richest nutrient you can give your baby * Colostrum, the first milk is a yellowish watery substance, produced in the first few days after delivery. * Colostrum is rich in nutrients and has antibodies. * It is your baby's first protection against disease. * You may think that the amount of colostrum is small, but it is enough for your baby. * It is much too valuable to be discarded. Give nothing but breastmilk in the first four months * Mothers should exclusively breastfeed for the first four months of her baby's life. * Breastmilk alone has been shown to give all the nutrition a baby needs from birth until four months of age. * By introducing water, tea, coriander, glucose water and other liquids, you increase the risk of exposing your baby to infections. * According to nutritional experts, neither water nor other fluid is needed even for babies living in hot climates, as breastmilk gives all the water your baby needs. * Breastmilk also protects the baby against diarrhoea, coughs, colds and other illnesses. Let your baby set the routine * Always remember that your baby has to be fed on demand especially at night particularly for the first four months. * Your baby should be given breastmilk, as and when he or she wants. Demand feeding will also increase your ability to breastfeed because the flow of milk will improve. Every mother can breastfeed * Mothers who think they do not have enough breastmilk, tend to give their babies artificial infant formula during the first four months of life. * Because of this the baby does not cultivate the habit of sucking. * This sets off a vicious cycle where, when your baby suckles, less breastmilk is secreted. * Inadequacy of breastmilk rarely occurs. If you have any doubts seek advice from your doctor or health worker. It is essential you do this before switching to alternatives. * Generally, close mother-child contact, immediately after birth and frequent sucking help to remedy the 'dry spell' caused by initial worries about breastfeeding. Don't rely on artificial support * Using pacifiers, dummies, bottles and artificial teats for feeding or pacifying the baby should be avoided at all times. * Most babies find the sucking action of drinking milk from a teat easier than the sucking action of drinking milk from the breast. * Once babies are accustomed to the easier motion it might make them reluctant to drink from the breast. Therefore, although your baby may prefer to drink milk from a bottle it should be discouraged. Know the proper methods of breastfeeding * All mothers need to know proper methods of breastfeeding * Your family doctor, nurse, midwife and other health workers are the best people to consult. Proper positioning of your baby at the breast helps improve milk supply and makes feeding easier. This is also an effective way of preventing painful and swollen breasts, and cracked and sore nipples. * Express milk and keep it for baby when you go out. * It is specially important to encourage your baby to suckle the whole or part of the areola, not just the tip of the nipple, for maximum benefit. When to start complementary foods After the first 4 months of breastfeeding, other solid/semi-solid food is essential to complement breastfeeding. * Remember that when complementary food has been introduced, breastfeeding should not stop. * In actuality, breastmilk should remain the main meal for the first 6 to 8 months with other foods acting to complement it. * This gradual process of introducing adult food to your baby's diet while breastfeeding at the same time is important. * Breastmilk contains enzymes for digestion and helps digest the new food until your baby's stomach has grown accustomed to it. Allergy and its causes Asthma and food allergy: Is there any link? Asthma can be triggered by a number of factors including dust, moulds, pollen, animals, air pollutants, weather changes, exercise, colds, certain medications and foods. Food-triggered asthma is uncommon occurring only among 6-8 per cent of children with asthma and less than 2 per cent of adults with asthma. After many years of scientific and clinical investigation, there are few confirmed food triggers of asthma. Sulphites and sulphating agents in foods (present in fresh and dried fruits, wines, shrimp and bottled lemon or lime juice) and diagnosed food allergens (such as milk, eggs, peanuts, tree nuts, soy, fish and crustacea) have been found to trigger asthma in some people. The important thing to remember though is that most people consume a wide variety of food additives and ingredients daily with only a very small number being associated with adverse reactions. Breastfeeding and allergy There are many good reasons to promote breastfeeding. However its effectiveness in helping to prevent food allergy is controversial. Some studies show that breastfeeding has a protective effect against food allergy while other studies show that breastfeeding may only delay the time until food allergy eventually appears. Food allergens eaten by breastfeeding mothers have been found in minute quantities in their breast milk. It is believed that some infants experiencing allergic reactions on their first known ingestion of a particular food may have been actually sensitised by previous exposure to small amounts of the food allergens in their mother's breastmilk. Courtesy: Food Facts Injections: how safe are they? Injections are one of the most common health care procedures. Each year some 16 thousand million injections are administered in developing and transitional countries. The vast majority, around 95% are given in curative care. Immunisation accounts for around 3% of all injections, with the remainder for other indications, including injections of blood and blood products and contraceptives. In certain regions of the world, use of injections has completely overtaken the real need, reaching proportions no longer based on rational medical practice. In some situations, as many as nine out of ten patients presenting to a primary health care provider receive an injection, of which over 70% are unnecessary or could be given in an oral formulation. Patients prefer injections because they believe them to be stronger and faster medications. They also believe that doctors regard injections to be the best treatment. In turn doctors over-prescribe injections because they believe that this best satisfied patients, even though patients are often open to alternatives. In addition prescription of an injection sometimes allows the charging of a higher fee for service. Better communication between patients and providers can clarify these types of misunderstandings and help to reduce injection overuse. Unsafe injection practices A safe injection does no harm. Yet breaks in infection control practices are common, causing severe infections which put human lives at risk. Reuse of syringes and needles in the absence of sterilisation exposes millions of people to infection. Syringes and needles are often just rinsed in a pot of tepid water between injections. In some countries the proportion of injections given with syringes or needles reused without sterilisation is as high as 70% Other unsafe practices, such as poor collection and disposal of dirty injection equipment, expose healthcare workers and the community to the risk of needlestick injuries. In some countries unsafe disposal can lead to re-sale on the black market of used equipment. Diseases Because injections are so common, unsafe injection practices are a powerful engine to transmit bloodborne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Because infection with these viruses initially presents no symptoms, it is a silent epidemic. However, the consequences of this silent epidemic are increasingly recognised. * Hepatis B virus: HBV is highly infectious and causes the highest number of infections: unsafe injections account for 33% of new HBV infections in developing and transitional countries for total of 21.7 million people infected each year. * Hepatitis C virus: Unsafe injections are the most common cause of HCV infection in developing and transitional countries, causing two million new infections each year and accounting for 42% of cases. * Human immunodeficiency virus: Globally nearly 2% of all new HIV infections are caused by unsafe injections with a total of 96,000 people infected annually. In South Asia up to 9% of new cases may be caused in this way. Such proportions can no longer be ignored. HBV, HCV and HIV cause chronic infections that lead to disease, disability and death a number of years after the unsafe injection. Those infected with hepatitis B virus in childhood will typically present with chronic liver disease by the age of 30 years, at the prime of their life. This has dramatic effect on national economies. A recent study indicated that each unsafe injections cause an estimated 1.3 million early deaths, a loss of 26 million years of life, and an annual burden of US$ 535 million in direct medical costs. Safe and appropriate use of injections can be achieved by adopting a three part strategy: (1) Changing behaviour of health care workers and patients Twenty years into the HIV pandemic, knowledge of HIV among patients and health care workers in some countries has driven consumer demand for safe injection equipment and irreversibly improved injection practices. With growing knowledge of HCV and HBV, similar patterns of consumer demand for safe injections should emerge. HIV prevention programmes can be expanded to include injection safety components. (2) Ensuring availability of equipment and supplies Simply increasing the availability of safe injection equipment can stimulate demand and improve practices. Because the cost of safe disposable syringes is low (less than 5 US cents per unit) when compared to the fee paid for receiving an injection (50 US cents on average), patients are usually willing to pay a little extra for safety once they personalise the risks. (3) Managing waste safely and appropriately As waste disposal is frequently not an integral part of health planning, unsafe waste management is common. However, when it is appropriately planned, significant results ensue. National health care waste management strategies require a national policy to manage health care waste, a comprehensive system for implementation, improved awareness and training of health workers at all levels, as well as the selection of appropriate options for the local solutions. (WHO News) Eggs and Blood cholesterol by Dr. D.P. Atukorale It is common knowledge that consumption of eggs increases your blood cholesterol level and high blood cholesterol is a very important major risk factor for heart attacks in Sri Lanka and other developing and developed countries. Egg yolk is very rich in cholesterol and an egg weighing 60 gms contains about 250mg of cholesterol (Food and Nutrition by Prof. T.W. Wickramanayaka, Third Edition). This is more than a days ration for cholesterol for people at high risk of getting heart attacks. A two egg breakfast thus contains 500 mg of cholesterol. But egg white which contains about 0.25% of fat does not contain cholesterol. Chicken on the other hand has less cholesterol and less saturated fat than red meat such as beef. A three ounce serving of skinless chicken breast has only one gram of saturated fat while same size serving of red meat has 2 grams of saturated fat. Consumption of saturated fat of animal origin increases the level of LDL cholesterol (bad cholesterol) and if you have coronary risk factors such as smoking, hypertension, diabetes, family history of heart attacks and a low HDL cholesterol (good cholesterol) you should avoid chicken especially if your LDL cholesterol level is high. It is a big advantage to eat cooked white chicken meat as compared to fried chicken because chicken meat soaks in more fat during the process of frying than your arteries can handle. It is advisable to reduce the consumption of fried chicken if you are a candidate for heart attacks. Grilled chicken is less harmful than fried chicken if you are cholesterol conscious. As mentioned earlier, you should avoid consumption of chicken skin if you have high blood cholesterol. If you don't have any coronary risk factors such as hypertension, smoking, family history of heart attacks,diabetes, obesity, low HDL cholesterol, high LDL cholesterol you can consume 2 to 3 eggs per week. If you have had a heart attack or any vascular problem you must get your LDL level below 100 mg% and it is advisable for you to avoid consumption of egg yolk and avoid excessive consumption of chicken. You and your doctor... Water and sour stomach Q: Does drinking water or other liquids make one's stomach more sour? A: The free use of liquids at meal times does tend to slow up digestion and may result in what is commonly called sour stomach. Very often a noticeable improvement in digestion may be realised in a few days by avoiding liquids at meals, and especially very hot or very cold liquids. Dark skin Q: The complexion of my face is slightly darker than the rest of my body. How can I have them match? A: The pigmentation, or colouring, of the skin deepens when in contact with the sun's rays. Inasmuch as the body is covered with clothing it will naturally be lighter. You could use an umbrella when in the sun to shade your face. However, your whole body needs a certain amount of sunlight for maximum health. If it is possible, a short sunbath-occasionally would be beneficial. Constant headaches Q: My daughter has had intermittent and terrible headaches for a long time. They began when she was fifteen. They start over one eye, and the pain extends to her temples. What can we do for her? A: Your daughter probably has megrim headaches, which usually come on about this time, and are aggravated by nerve strain and shocks. Attacks are usually one-sided and spots sometimes appear before the eyes when they come on. One is usually sick at the stomach from them. This type of headache is very commonly hereditary. Your daughter should have a thorough examination to see if there can be any cause established for these headaches. She may have eye-strain. Her kidneys may not be working right. Her blood pressure may be elevated, or there might be some intracranial condition to account for it. Therefore, her eyes should be carefully examined, not only at to sight but as to the visual fields and fundus. This cannot be determined by mail. For the ordinary headache many find they can obtain relief by a good hot foot bath, with an ice cap to the head or back of the neck. This treatment can be continued for fifteen to twenty minutes, followed by a good brisk walk outdoors and breathing deeply. We would advise trying this before taking an aspirin. If headaches are frequent or constant, then it is necessary to see your physician. How can I grow taller? Q: I am sixteen years old and my height is 4 feet, 11 inches. Please suggest some exercises in order to increase my height by at least one inch. A: There are no exercises that we know of that can increase height appreciably. The height one will be is decided before he is born, and there is little that can be done about it. At sixteen you can look forward to growing some more yet. Our advice is, eat the right food, get proper rest and exercise, and do not be too concerned how tall you are. Do's and don'ts in Food poisoning Poisoning accounts for some 25,000 hospital admissions and over 2000 hospital deaths, annually, in Sri Lanka. The number of victims seeking treatment from Western or Ayurvedic private medical practioners is not known, while correct data on deaths occurring outside state hospitals, are also not available. It is important to remember that almost any substance taken in excess can be toxic. Children are poisoned from a comparatively small amount of such poisonous substances in addition to the deaths from chemical and plant poisons, snake venom also kills 2 persons a day. Poisons can enter the body in different ways. The commonest method is by deliberate or accidental ingestion. Some can cause poisoning by entering the body through the skin or by breathing their fumes or vapours. Certain poisons can cause serious toxic features, several hours of sometimes a few days or even months, after poisoning. Therefore, even when a small quantity of poison has been taken spilled over the skin or inhaled, the patient must be seen by a medical officer. Remember, even a teaspoon of some poisons such as concentrated pesticides, if swallowed, can cause death. Clinical features of poisoning vary depending on the type of poison, its concentration and whether it is taken by mouth or pilled over the skin or inhaled. Common early features of poisoning Burning pain of mouth and throat, abdominal pain, vomiting, diarrhoea, frothing from mouth or nose, difficult in breathing, slow or rapid breathing, burning pain of skin or eyes, blurred vision, increase or decrease of pulse rate, muscle twitching, fits, headache, small pupils, dizziness, loss of consciousness. The first aid mentioned here should given if there is a delay in taking medical advice or in transport of the victim to the nearest hospital. A - Remove all contaminated clothing if the poison has been spilled over the face or body, wash thoroughly with soap and water. B - Till transport is arranged, rest the patient. Reassure him. Say that he will feel better when he is admitted to the hospital and treated. C - Take the bottle or the packet of poison to the hospital and hand it over to the doctor. Identification of the poison correctly, is essential for quick and effective treatment. D - If the patient is semiconscious or unconscious, turn him to the left side. Keep the head low if possible. This will prevent any vomitus entering air passages. Acids Toxicity depends on the concentration. Concentrated acetic acid (rubber acid) and sulphuric acid (battery acid) are extremely toxic and cause corrosive burns of mouth, gullet and stomach. The latter may even be perforated causing peritonitis. * Do not induce vomiting. Give plenty of water to drink. * Do not give sodium bicarbonate (baking soda) etc. to neutralize acid. Alcohols Ethyl Alcohol - This is found in all alcoholic drinks in various concentrations. Even small quantities of arrack or whisky can cause serious toxicity in children. Drunkenness and coma are the features of intoxication. * Induce vomiting if not vomiting already. All poisoned children and adults, who are not fully conscious, need medical attention. Treatment Gastric lavage may be done, if the airway can be protected. Methyl Alcohol - This is used as a solvent and in illicit brews like 'Kasippu'. More toxic than ethyl alcohol and can cause blindness. * Induce vomiting if not vomiting already. Alkalis Toxicity depends on concentration. Concentrated alkalis (e.g. sodium hydroxide) can cause corrosive burns of mouth, gullet and stomach. * Do not induce vomiting. Give plenty of water to drink. * Do not give acids to neutralize toxic effects. Amonia Concentrated ammonia is a corrosive poison. Most household cleaners contain very diluted ammonia and therefore are mildly toxic. Antibiotics Overdose of these can cause abdominal pain, nausea and vomiting. Allergy to some drugs (e.g. penicillin) can be serious, with symptoms of difficulty in breathing and collapse. * Induce vomiting, if conscious. Medical attention necessary in all children and in adults with allergic features if more than 10 tablets/capsules were taken or symptoms have developed.
Anti-depressant drugs These are prescribed for patients with depression and are very toxic in overdose. They can cause irregularities in the heart beat, fall of blood pressure, fits and coma. * Induce vomiting, if the patient is fully conscious and is not in fits. (Courtesy: National Poison Information Centre and Winthrop Health Care Service) |
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