Month: October 2021

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Back to School – A Battle Between Education and COVID-19

Back to School - A Battle Between Education and COVID-19

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Students are finally returning to school. But as parents, many are worried about COVID-19 safety. But while preparing to return to school, it is also essential to think about the other ways to keep your children safe and build an environment inclusive of everyone. 

Here are a few tips to help protect your children from this virus.

covid safety children school

If you have any questions regarding your child’s health or would like some medical advice you can consult a paediatrician or a general physician from the comfort of your home via the oDoc app. Click here to download oDoc now.

References:

  1. What Do Students Need This Back-to-School Season?, Raliance (2021)
  2. Be Back-to-School Ready, Weill Cornell Medicine (2021)
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Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

postpartum depression

Am I Just Having “Baby Blues” Or Do I Have Postpartum Depression?

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You’ve just given birth. You’ve created a new life. Your body and mind have gone through a huge transformation over the last nine months. And now you have this whole other tiny human being that you need to care for and nurture. Obviously, you cannot go back to regular scheduled programming and you shouldn’t have to!

Even if you’ve been waiting so long for your baby and it is everything you’ve ever wanted and dreamed about, you are still bound to feel overwhelmed, emotional and maybe even moody. Let us shout it from the rooftops: THIS IS COMPLETELY NORMAL AND VERY COMMON FOR NEW MOTHERS.

Postpartum “baby blues” are extremely common. You’re operating on very little sleep, your hormones are on a rollercoaster, you’re adjusting to the realities of parenting a new baby so it’s no wonder you’re experiencing mood swings!

postpartum depression

But still you might be worrying about whether it is normal to feel this way. You might be wondering if this low feeling will go away in a few days or if you have something more serious, such as postpartum depression.

Symptoms of “baby blues”

  • Anxiety
  • Irritability and grumpiness
  • Exhaustion
  • Feeling joy and happiness one minute and then sadness the next
  • Unsure of your ability to take care of your baby
  • Trouble eating and taking care of your own health

How long are “blues” expected to last?

One important distinction between the “baby blues” and postpartum depression is that the “baby blues” are temporary. You are most likely going to experience “blues” for the first few days after giving birth. Symptoms that last more than two weeks might signal that you could have potentially developed postpartum depression and it is time to have a discussion with your doctor.

Symptoms of postpartum depression

  • Anger and irritability
  • Extremely low energy and wanting to sleep all the time
  • Feeling numb and disconnected from the people around you
  • Feeling you’ve failed as a mother
  • Thoughts of self-harm and thoughts of harming your baby
  • Crying excessively
  • Trouble bonding with your newborn

Postpartum depression does share many of the same moodiness as “baby blues” but symptoms are usually more intense and disturbing.

baby blues

Treatment for “baby blues”

Just because postpartum blues are very common doesn’t mean it’s easy to go through. Here’s what you can do to cope.

  • Assure yourself that what you’re feeling is completely normal and is experienced by all new mothers
  • Sleep as much as you can, which means sleeping when the baby is sleeping, or having your partner or family member look after the baby for an hour while you nap
  • Eat healthily and regularly
  • Exercise can do wonders! Even if its just a walk outside.
  • Talk about what you’re going through with loved ones or other mums
  • Don’t be hard on yourself if you don’t have the energy to do housework or other chores. You just had a baby!

Treatment for postpartum depression

If your baby “baby blues” don’t ease up after 2 weeks or if you’re experiencing symptoms of postpartum depression, don’t wait till your next check up with your doctor. Get in touch right away.

You may feel ashamed or embarrassed that you’re feeling this way, especially after this magical thing has happened in your life but you’re not alone with these feelings. 1 in 5 women experience postpartum depression after childbirth. Your doctor may recommend medication and/or therapy. You can also make healthy choices in your lifestyle such as:

  • Talk to people you trust about what you’re going through
  • Cut back on other errands. Use your energy to take care of basic needs for you and your baby
  • Build community by speaking to other mothers, joining a depression support group or just reach out to trusted friends and family. Fight isolation.
  • Rest whenever you can. Reach out to close friends and family to take the baby shift so you can sleep for a few hours. This does not mean defeat.

Causes of postpartum depression

The exact cause isn’t clear but experts say that postpartum depression may be triggered by both physical and emotional factors.

  • Hormonal changes – While you’re pregnant, your levels of estrogen and progesterone are higher than usual. After you give birth, these hormone levels drop significantly. Such a drastic change in hormones can contribute to postpartum depression.
  • Sleep deprivation
  • Not eating meals at regular hours or eating an unhealthy diet
  • Social isolation
  • Underlying medical conditions
  • Alcohol and drug abuse

Risk factors of postpartum depression

Any new mother can experience postpartum depression after childbirth, even if its not their first baby. However, your risk increases if:

  • You have a history of depression
  • You’ve had postpartum depression after a previous pregnancy
  • You’ve had family members who’ve had depression or other mood disorders
  • You’ve experienced stressful events recently
  • You have difficulty breastfeeding
  • You have a weak support system
  • The pregnancy was unplanned or unwanted

Speak to a doctor on oDoc if you think you might be having the above symptoms. This is a judgement-free zone where your doctors will NOT shame you and will only help you to feel better. Click here to download the app. 

References:

  • Is It Postpartum Depression or ‘Baby Blues’?, 2021, WebMD
  • Do I have Postpartum Blues or Postpartum Depression, 2020, VeryWell Family
  • Everything You Need To Know About Postpartum Depression, 2016, Healthline
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We Need To Stop Saying Breastfeeding Is “Easy”

breastfeeding is hard

We Need To Stop Saying Breastfeeding Is “Easy”

And focus on supporting mothers instead

Nicole Parakrama | BSc Hons Molecular Cell Biology, UCL (UK) | 14th August 2021 |
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Just recently, we all tuned in to watch the Olympic Games held in Tokyo. We admired the beautiful performances of the athletes, and we acknowledged and celebrated all the sacrifices, hard work and preparation that led up to that day.
breastfeeding

What if we viewed breastfeeding the same way?

What if instead of glorifying only the ‘highlights reel’ of breastfeeding, we all agree that breastfeeding needs education, preparation and hard work to get through the first few weeks. What if we supported and empowered mothers on this journey filled with sacrifices and challenges and collectively took responsibility for it? What if we celebrated them loudly and genuinely when they achieved their goals?

The recently concluded ‘World Breastfeeding Week’ was triggering for a lot of mothers. For many women, any mention of breastfeeding brings back feelings of pain, anxiety and a lack of support. It serves as a reminder of the guilt and shame that they felt for stopping breastfeeding, the feeling that their bodies weren’t doing what they were meant to do.

Changing the Messaging

A Sri Lankan mum recently told me:

“Breastfeeding is hard… everyone tells you how painful labour is and how difficult pregnancy is, but no one tells you how hard breastfeeding is! All you see are images of moms with babies on their breasts and they make it look like it’s the easiest thing!”

Amy Brown, Professor of Child Public Health, Swansea University says: “When we gloss over the realities of breastfeeding, women feel unprepared for what it’s really like. If we tell women to expect easy, and they hit a hurdle, they may think they’re doing something wrong. . Women then end up depressed, blaming themselves, thinking they didn’t try hard enough because after all, isn’t breastfeeding easy?”

Without swinging towards ONLY the positive or the negative, perhaps the good, the bad and the ugly all need to be portrayed together. We need to find a balance.

So what are the benefits of breastfeeding?

  • We sometimes refer to breastmilk as “liquid gold”! Mums often joke that breastmilk is the cure for nearly everything:baby acne, sore eyes, heat rash,eczema and healing our cracked and sore nipples.
  • The composition of breastmilk is biochemically and nutritionally complete, giving numerous long term and immunological advantages.. It protects from infections, diarrhoea, UTIs, and chronic diseases like diabetes, childhood cancers, obesity, inflammatory bowel disease, asthma and allergies. In preterm babies, it reduces the risk of sepsis and necrotising enterocolitis (NEC).
  • For mothers, it has been proven to reduce the risk of hypercholesterolaemia, diabetes, hypertension, cardiovascular disease, as well as reduce the incidence of breast and ovarian cancer and osteoporosis. It stabilises endometriosis and confers partial contraception.
  • The process of breastfeeding stimulates the release of oxytocin, the bonding chemical. Babies don’t only breastfeed to eat, but also to help themselves settle: it provides them comfort and helps them regulate their emotions.
  • From a practical standpoint, breastfeeding is free and convenient! No stumbling around in the dark to boil water and prepare a bottle! Your baby has access to fresh milk straight from the source.

OK, I’m convinced of the benefits. Now hit me with the challenges of breastfeeding!

Here in Sri Lanka, we are seeing a rise of an ‘Instagram mum brigade’ who raise awareness on issues surrounding motherhood whilst sharing experiences and building community. They are finding their voices and being the support that they wished they had as new mums.

One of these Instagram mothers, Ameena (IG handle @raisingimaan) – expresses the challenges of breastfeeding so beautifully in a recent post. She said:

“Breastfeeding isn’t simply putting a breast into a baby’s mouth and transferring milk. It is SO MUCH more than that. And women pay for it with a unique currency of time, commitment, energy, mental and physical health, as well as bodily autonomy. That’s a massive price to pay. And to tell women that it’s all on themselves alone to manage. Frankly, it’s quite a raw deal”.

sore nipples
  • The first few weeks of breastfeeding, in particular, require a considerable investment of time. It IS time consuming, and new mothers can feel that all they do in the early days is feed!
  • In addition, the breastfeeding technique can take a bit of practice to get right. Mums need to experiment with different holds and find solutions for attachment and positioning issues.
  • There are potential physiological challenges, such as sore/cracked nipples, breast engorgement, blocked ducts, and mastitis/abscess which mums may have to navigate.
  • Feeling like there is not enough milk can be a significant challenge for many mothers in their breastfeeding journeys. However, as I have written about in a previous article, this is mostly a perception issue. In as many as 95% of cases, it is easily surmountable with the proper support.

How important is it to have a supportive community?

I cannot stress enough the huge role a supportive community plays in successful outcomes for breastfeeding. In “the fourth trimester”, women adjust to being mothers just as much as their babies adapt to life outside the womb. This postnatal period seems to be universally defined as 40 days.

Kimberly Ann Johnson, author of the book “The Fourth Trimester” says:
“Everything that a new baby needs, a new mom needs. So you know a new baby needs swaddling, you know a new baby needs a constant food source, you know a new baby needs eye contact, you know a new baby needs soothing. That’s everything a new mom needs.”

But the best way of caring for a breastfed baby is to care for their mother. Feed her, love her, support her by taking care of other stuff. Do housework, run errands, look after older children. The same goes for supporting women who are bottle feeding.

How can we as a society make breastfeeding easier for mothers?

As a society we can further encourage breastfeeding mothers when it comes to feeding in public. Public bathrooms are not acceptable places to feed infants! Establishments can train their staff on how to respond compassionately to a mother whose infant needs to feed, and to take a step further to provide a private space in which to do this, if required. Far too often this is left to the discretion of the staff, and so mothers have mixed experiences. Just one negative experience can be a huge setback to a mother’s breastfeeding journey, making her feel that she has to stop breastfeeding in order to leave the house and ‘have a life’.

Alongside all of this, the government MUST step up and make things easier for new families. In 2018, a significant amendment to the Shop and Office Act was passed in Sri Lanka which mandated the “provision of nursing intervals for nursing mothers” (previously only mandated in the state sector, although sometimes practiced informally in the private sector). This means that working mothers are now entitled to 2 paid feeding breaks of 1 hour per working day until their child is 1 year old.

This is a significant step forward – however longer, better paid leave for both mothers and fathers, as per the Swedish model, would do wonders for the well-being of the whole family, and in increasing breastfeeding figures.

If you are a new mum and are having trouble breastfeeding, you can speak to a doctor on oDoc. You can video call them from your home, baby in hand, even while breastfeeding! You can download the app here.

HOW I BECAME ‘THE MILK COACH’

When my first child was born, I was quite unprepared for what lay ahead. Particularly when it came to breastfeeding… I was naïvely expectant that I could just place him onto my chest, and let nature take its course. What a surprise I was in for! Cracked nipples from sub-optimal positioning, and my milk taking its own sweet time to come in, led to terrible pain. This pain became excruciating when my son developed oral thrush which travelled into my milk ducts. Fortunately, thanks to a lot of research and some wise mummy friends, I was able to power through the awful first few months. Most crucially, I was able to advocate for myself with health professionals, when the ‘system’ didn’t really support me.

This birthed a passion to counsel, support and advocate for my fellow Sri Lankan mums. To this end I am working to add to a science background (in Molecular Cell Biology) with an accreditation by La Leche League International (LLLI). My heart is to help YOU to achieve your breastfeeding goals – whether that is one week, one month, six months, or even a year and beyond.

Join the conversation, follow @themilkcoach on Instagram or Facebook.

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Hey, new mum! Is there a right way to do this?

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Hey, new mum! Is there a right way to do this?

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new mom with baby

Why is my baby crying so much? Are they supposed to sleep at this time? Am I doing this right? Is it supposed to be this hard?

New mums, these are a few of the questions you may have asked yourself, your mother, mother-in-law or your paediatrician. It is extremely common for new mothers to feel confused and question everything because becoming a first-time parent is a new and complex experience. So, we at oDoc have answered six of the most commonly asked questions to help you out.

 

 1. How often should I feed my baby?

Every child is different and there is no ‘golden rule’ for how often you should feed your baby. If you are breastfeeding, you may have to feed them more often as breast milk gets digested faster than formula. It is recommended you nurse every 1.5-3 hours if you are breastfeeding and every 2-3 hours if you are giving formula. As they grow older the time between feeds will increase. 

Newborns are most likely to nurse eight to 12 times a day for the first month; when your child gets to be 4 to 8 weeks old, they’ll probably start nursing seven to nine times a day.

2. How do I know when my baby is hungry?

It’s difficult to distinguish between the sleepy-cries, carry-me-now – cries and hunger-cries. But watch out for the following cues your baby might give if they are hungry

  • Leaning toward your breast or a bottle
  • Sucking on their hands or fingers
  • Opening their mouth, sticking out their tongue, or puckering their lips
  • Fussiness and crying 

These may indicate that it is time for their next (which would feel like their 100th) meal for the day. 

3. How can I increase my milk supply?

It is common to worry about not producing enough milk. In fact, it is very common amongst new breastfeeding mothers. So you aren’t alone. Data from the Centers for Disease Control and Prevention shows that approximately 75% of new mothers start off breastfeeding their babies, but many stop either partially or completely within the first few months. One of the most common reasons for this is the worry about insufficient milk production. Most women usually have sufficient milk production but if you are worried you could try the following: 

  • Try feeding more often – as your baby feeds, your pituitary gland releases hormones that are involved in lactation. 
  • Eat foods that are proven to increase milk production such as ginger, garlic and fenugreek.
  • Try feeding your baby from both breasts – stimulation of both breasts will increase milk production.
Mother holding her baby

 

4. Will I spoil my infant if I hold onto them too much?

No, absolutely not. Contrary to popular belief this is not true. You can’t spoil a baby by holding on to them or by giving them too much attention. In fact, giving them constant attention is crucial as it is the foundation for them to grow emotionally, physically and intellectually. So, next time someone says you are giving your baby too much attention, tell them you are just ensuring their needs are met, just like the good mom you are. 

5. Is this colour of poop normal?

This is probably a question you’ve asked yourself many times. Do you open the pamper and always examine the poop to make sure the colour is ‘normal’? But not sure what exactly the ‘normal’ baby poop colour is?  Below are what each coloured poop may actually mean (source: Healthline).  

Table comparing different colours of poop

6. How often should my baby poop?

Meconium, the newborns first poop, will pass in the first 24-48hours. After that, the bowel movement settles in, and the poop may be light brown, yellow, or yellow-green in colour. A baby should poop about 3 times a day when breastfed in the first 6 weeks. Some may even poop 4-12 times a day. After starting solids they can poop more than that. For formula-fed babies, 1-4 bowel movements per day, is expected. 

So next time these questions arise in your mind, we hope these answers will also pop up and calm you down a bit. We just wanted to say that we are sure you are doing an amazing job and there are many moms out there who are questioning the same things as you. If you have any questions regarding your baby’s health or would like some medical advice you can consult a paediatrician from the comfort of your home via the oDoc app. Click here to download oDoc now. 

Stay indoors and be proud of all you have achieved with your little one. 

 

Sources

Santos-Longhurst, A. (2018, May 7). 5 Ways to Increase Breast Milk Production. Healthline. https://www.healthline.com/health/parenting/how-to-increase-breast-milk

Brody, B. (2015, July 23). Baby Feeding Schedule. WebMD. https://www.webmd.com/parenting/baby/baby-feeding-schedule#1

UNICEF. (n.d.). Busted: 14 myths about breastfeeding. Retrieved October 12, 2021, from https://www.unicef.org/parenting/food-nutrition/14-myths-about-breastfeeding

Prime, D. K., Garbin, C. P., Hartmann, P. E., & Kent, J. C. (2012). Simultaneous Breast Expression in Breastfeeding Women Is More Efficacious Than Sequential Breast Expression. Breastfeeding Medicine, 7(6), 442–447. https://doi.org/10.1089/bfm.2011.0139

Canadian Breastfeeding Foundation. (n.d.). Herbs for Increasing Milk Supply. Canadian Breastfeeding Foundation. Fondation canadienne de l’allaitement. Retrieved October 12, 2021, from https://www.canadianbreastfeedingfoundation.org/induced/herbs.shtml



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How well do you know your breasts?

How well do you know your breasts?

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It’s that time of year again: when your social media is flooded with pink ribbons, radio waves are abuzz with tips and fundraisers gain momentum. October is breast cancer awareness month. 

As of 2021, Breast cancer became the most common cancer globally by accounting for 12% of all new annual cancer cases worldwide, says the World Health Organization. In Sri Lanka, around 3000 new cases are identified each year and breast cancer is the most common tumour. Turns out, in very rare instances, men too can get it.

breast cancer

Despite being so common, breast cancer is also highly treatable if detected early. We break down the steps you can take to assess and lower your risk levels.

What is breast cancer?

Breast cancer is cancer that forms in the breast of the cells. 

 

What are the symptoms of breast cancer?

Generally, symptoms of breast cancer are linked to a palpable or visible change in the breast tissue. Some common symptoms includes:

what is breast cancer
breast self-exam

This means that breast self-exams are extremely important. Regular exams help you get familiar with the normal shape and texture of your breasts so that any anomalies can be quickly identified. 

How to perform a breast self-exam in five steps

  1. Stand directly in front of a mirror, place your arms on your hips and look at your breasts. 

Look for: 

  • Breasts that are usual shape, size, colour
  • Breasts that are evenly shaped without any distortion or swelling

    2. Raise your arms and look for the same changes

Look for: 

  • Any fluid (watery, milky or yellow fluid or blood) coming out of your nipples

3. Lie down on a flat surface. Use your right hand to feel your left breast and vice versa. Use the finger pads of your hand to apply a firm and smooth circular motion (size of a coin) to your breast. Keep the fingers close together. 

Cover the whole breast from side to side, up to the collarbones and into the armpit. 

Feel for: 

  • Any lumps or bumps within the breast.
  • Feel for the texture of the lumps or bumps.
  • Check if the lump or bumps are movable.

4. Feel your breasts in the same manner whilst you are standing or sitting. This is ideally done in the shower as the water and soap allow for a smoother movement.

What to do if you discover a lump or any visible changes

Do not panic. Not all breast lumps or bumps mean breast cancer. In fact, most turn out to be benign (non-cancerous). Non-cancerous breast lumps can be caused by hormonal changes, injuries or a benign condition. However, it is vital that all bumps are discussed with a medical professional. 

Don’t be shy, speak to a medical professional. Early detection does save lives. So if you have noticed a lump lasting for longer than one menstrual cycle, it’s important to speak to a family doctor or a GP. The doctor will most often refer you to an imaging test. Ultrasounds are often the only test used for women under 30 whilst ultrasound and mammograms are used for women over 30. 

Do ask questions. Here are a few you can ask your GP to help you gain clarity.

  • What tests are needed to find out if the lump is cancerous?
  • In addition to a physical exam of my breasts, will you check the lymph nodes in my armpits and neck?
  • Should I get a mammogram?
  • Will I need a biopsy?
  • What does a biopsy involve?
  • How long will it take to get the results?
  • If the tests are negative but the lump is still there, what are the next steps?
  • If the tests are clear and the lump goes away, how often should I follow up with you?

If unsatisfied with answers or level of care, do get a second opinion. 

How often should I perform a breast self-exam?

Do it every month around 7-10 days after your period starts. This is when your breasts are as tender or lumpy and make sure to examine them before  you start menstruating as well. Therefore, you can understand the natural changes. 

If you are no longer menstruating, do it at regular intervals every month.

In both instances, make sure to journal the changes with date

What are the risk factors?

Risk factors are aspects that make it more likely that someone could develop breast cancer, however, having one or a combination of these factors doesn’t mean you’ll get it. A healthy awareness of risk factors will allow you to take steps to mitigate the risk.

    • Gender: women are more likely than men to develop breast cancer
    • Age: incidence of breast cancer increases with age
    • Personal history of breast conditions or breast cancer: if you have developed breast cancer in one breast, there is a higher risk of developing it on the other.
    • Family history of breast cancer: if a close female relative has experienced breast cancer, there is an increased risk however in most diagnosed patients, there is no family history of breast cancer
    • Genetic predisposition: the most well-known gene mutations are the BRCA1 and BRCA2 and can be passed from parents to children. Though these genes can greatly increase the risk, it is not inevitable. 
    • Obesity
    • Alcohol intake
    • Postmenopausal hormonal therapy: whilst women are on hormone replacement medications, they have an increased risk. However, once they stop the medications, this risk declines. 
    • Beginning your period at an age younger than 12
    • Beginning your menopause at an older age
    • Having never been pregnant
    • Having your first child at an age older than 30

How can I reduce my risk of breast cancer?

Whilst there are no hard and fast rules on ensuring one doesn’t develop breast cancer, the following non-exhaustive list is to help you mitigate your risk:

  1. Regular self-exams
  2. Consuming alcohol in moderation 
  3. Exercising at least 30 minutes four times a week
  4. Maintaining a healthy weight 
  5. Consuming a healthy, balanced, sustainable diet
  6. Limiting postmenopausal hormone therapy 
  7. Limit exposure to radiation

When it comes to breast cancer, early detection does help save lives. 

Make sure to carry out your self-examination, consult your doctor regularly and live a healthy life. Ignorance is usually bliss, just not here.

In 2022, Breast Cancer Awareness month focuses on the disparity of resources to fight this disease across the globe. If you are looking to take the first step, we are here

If you’d like to speak with a GP or a family doctor to discuss your questions or concerns, our oDoc partner doctors are available. Download oDoc here to get started. 

Sources

  1. Breast Self-Exam, Breastcancer.org (2022)
  2. What Is Breast Cancer?, CDC (2022)
  3. Breast cancer, Mayo Clinic
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