maryannewaweru

A Kenyan Journalist Writing About Health

Archive for the month “May, 2012”

Pregnancy Forum for Expectant Moms

Pregnant women love talking and sharing about their pregnancy journey. One woman in Nairobi, Lucy Muchiri, who is a consultant midwife has found a way to bring them all together, where they can not only share their experiences, but also learn about the different physical, emotional and hormonal changes they are going through as they prepare for the arrivals of their little bundles of joy.

Here is a review of one such session.

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Depo-Provera: An Injectable Contraceptive

What is Depo-Provera?

Depo-Provera (medroxyprogesterone acetate) is a drug very similar to progesterone, a hormone normally produced by the ovaries every month as part of the menstrual cycle. Depo-Provera is an injectable medicine that prevents pregnancy for up to 3 months with each injection (“shot”).

How does it work?

Depo-Provera prevents pregnancy by preventing ovulation (the release of an egg from the ovary). If an egg is not released, pregnancy is unlikely. Depo-Provera is given as 1 shot in the buttock or upper arm. The first shot should be given within 5 days after the beginning of a normal menstrual period, and shots should be repeated every 3 months.

Is it effective?

Depo-Provera is as effective as tubal ligation (having your tubes tied) and more effective at preventing pregnancy than several other methods, including birth control pills, condoms and diaphragms. It does not, however, protect against AIDS or any other sexually transmitted diseases.

Is the effect permanent?

No. Depo-Provera only works for about 3 months. The shot must be repeated every 3 months to prevent pregnancy. After a woman stops using Depo-Provera, her normal ovarian function returns after a short time. However, it takes an average of 9 to 10 months to get pregnant after getting the last shot.

How long can I take it?

You should not use Depo-Provera for more than 2 years unless no other form of birth control is right for you. Using Depo-Provera can cause you to lose some of the calcium that is stored in your bones. The longer you use Depo-Provera, the more calcium you may lose. The calcium may not return completely once you stop using it. This can lead to osteoporosis.

Are there side effects?

Most women have some changes in their menstrual periods while using Depo-Provera, including irregular and unpredictable bleeding or spotting, an increase or decrease in menstrual bleeding, or no bleeding at all. After 1 year of use, about 50% of women have no bleeding at all. The absence of periods is not harmful, and periods usually return to normal after Depo-Provera is stopped. If unusually heavy or continuous bleeding occurs, you should see your doctor. Other possible side effects include weight gain, headaches, nervousness, abdominal discomfort, dizziness and weakness or fatigue.

Can I use it if I am breastfeeding?

Depo-Provera can be used safely in women who are breastfeeding. Long-term studies of babies whose mothers used Depo-Provera while breastfeeding found no bad effects.

Who should not use Depo-Provera?

Women who have any of the following should not use Depo-Provera: liver disease, a history of blood clots (phlebitis) or stroke, vaginal bleeding without a known reason, cancer of the breast or reproductive organs, known or suspected pregnancy, or allergy to the medication in Depo-Provera

Information Source: Drugs.co.ke

 

Pregnancy Nutrition (part 2): Foods to Avoid While Pregnant

This is a follow up post to the one I did about Pregnancy nutrition: Foods to eat while pregnant.

Today, Nutritionist Catherine Kathure shares insights on unsuitable foods during pregnancy.

MT: What are the foods to avoid while pregnant?

CK: Specifically, there is no food that is harmful during pregnancy. However, the mode of preparation and the amount taken for some foods really matter and can be harmful to the pregnant mother and the unborn child. Some of the foods to avoid include raw or undercooked meat, poultry and eggs. These include processed meat. This is because they can cause food poisoning which in turn affects the growing baby.

Pregnant african american woman eating an apple

Deli meat or processed meat as well as unpasteurized milk should be avoided as it contains Listeria, which is known to cause miscarriage. Listeria has the capability to enter the placenta and may infect the baby, causing blood poisoning or infection which is life threatening. If you have to eat processed meat, ensure you reheat thoroughly before eating.

Sea foods with high levels of mercury should be avoided as they cause brain damage and developmental delay of the baby. These foods include; shark, king mackerel, swordfish, and tilefish. N/B: The bigger and the older the fish (any fish) the more mercury they contain.

Caffeine should also be avoided during the first trimester of pregnancy as it increases the likelihood of miscarriage, premature birth, low birth weight and withdrawal symptoms in infants and it is therefore safe to stay away from caffeine. It can be taken in moderation in the second and third trimesters (less than 200 mg in a day). Caffeine is also diuretic in nature (meaning it helps the body to eradicate fluids from the body) hence; it can result to loss of water and calcium which are important for the pregnancy. It is therefore advisable to take plenty of juices or water rather than caffeine-containing beverages.

Fresh juice and fruits

Alcohol should be also avoided during pregnancy since it interferes with healthy development of the growing baby. There is no amount that has been prescribed during pregnancy. Depending on the amount and the routine of alcohol use, it can lead to Fetal Alcohol Syndrome as well as other development disorders. If you realize you are pregnant, it is better to stop taking alcohol as well as during lactation as alcohol exposure to the baby is lethal.

Smoking and the use of other illegal drugs should completely be avoided as they have adverse effects on the development of the fetus.

Excess vitamin A should be avoided as it leads to toxicity which is teratogenic (can cause malformation of the fetus)

Heavy medication such as use of aspirin can cause blood clots.

MT: Does eating liver during pregnancy cause any harm to the unborn child?

CK: Liver is known to be a very good source of Vitamin A. vitamin A is a fat-soluble vitamin and thus any excesses in the body are harder to dispose than the water soluble ones such as vitamins B and C. Therefore excess consumption of liver may raise the levels of Vitamin A in the body thus making it toxic to the body (Vitamin A toxicity). This toxicity can lead to malformation of the baby.

However, this toxicity only occurs with retinoid (preformed vitamin A) such as the one obtained from the liver and not in carotenoid form (like the ones found in carrots). That’s probably the reason why people say liver is not good for pregnant women and not carrots, since they both supply vitamin A. In conclusion, liver itself is not bad in pregnancy but rather the amount that is consumed.

Pregnancy

MT: Should a pregnant woman diet?

CK: No. Dieting during pregnancy is not recommended at all. This is because during pregnancy there is an increased nutrient need for both the mother and the fetus. The baby’s health and development relies upon the mother’s nutrition. Dieting affects the overall development of the baby. A pregnant woman is supposed to gain between 11 and 14 kgs (which include fetus, amniotic fluid, placenta, increased blood volume, increased uterus and breast size) most of which reduce after birth. Hence, there is absolutely no reason to diet during pregnancy.

N/B: Exercises should not be confused with dieting. Exercising in moderation depending on the stage of pregnancy is important as it helps the mother to be strong and easy delivery.

Best wishes to all the pregnant moms.
Nutritionist Catherine Kathure can be reached on cate2010@gmail.com

images: dreamstime.com

Originally published in Mummy Tales.

Pregnancy Nutrition (part 1): Foods to Eat While Pregnant

Immediately I discovered I was pregnant with Kitty, one of the first things I did was to rush to the nearby kiosk and buy lots of oranges, spinach and sukuma wiki. I remember joking with Mama Wachira the vegetable vendor by telling her:

‘Tafathali kata kata haraka, iko emergency”.

The emergency was I was in panic mode because I hadn’t been eating that many greens or oranges, and I remembered that I had once written an article on a child with special needs -a child with Spina Bifida. I was young then, around 27 (is that young :) ?) and I remember the girls’ mum telling me to make sure I eat enough spinach, sukuma wiki and oranges if I was ever planning to have a baby as they contain good amounts of folic acid. She told me that if she’d had good amounts of folic acid before and during her pregnancy, she believed her child wouldn’t have gotten Spina Bifida.

So as I was speeding up Mama Wachira, this mom’s words are what were ringing in my mind. When I got home, I cooked the greens and hurriedly gobbled them up, then I drafted up a menu of the foods I would eat for the next nine months. In came in the nduma’s, ngwaci’s and all the fruits in the world -and out went the almost daily pizza’s, fries and kuku sama :( .

Courtesy: AfricaKnows.com

So why did I draw up a tentative menu? Because I wanted to make healthy choices for both me and baby. I wanted to focus on good nutrition throughout my pregnancy.

So anyway, if you are pregnant and want to focus on a healthy diet, here are some insights shared by Catherine Kathure, a Nairobi-based nutritionist who I spoke to.

MT: What are the nutritional needs for a pregnant woman?

CK: An average pregnancy requires extra calories during the 2nd and 3rd trimesters. This is due to increased energy needs for the mother in order to be able to perform her daily activities such as walking, as well as energy needed by the growing baby. Carbohydrate foods that provide for this energy include; maize, rice, potatoes, breakfast cereals, sweet potatoes and wheat products such as bread.

Sweet potatoes

A pregnant woman also needs to ensure she takes a sufficient amount of proteins, as these help in the formation as well as the repair of body cells. Foods rich in proteins include meat, eggs, beans, milk etc.

Milk and eggs

Vitamins are also crucial in her diet. Folate (a B vitamin) for instance is required for DNA synthesis and red blood cells formation. Inadequate intake can cause foliate-related anemia and in severe cases can lead to birth defects such as spina-bifida (where the development of spinal cord is impaired). A pregnant or a woman looking forward to conceiving requires about 600 mcg of folate. Major Sources of folate include; peanuts, asparagus, broccoli, beans, spinach.

Spinach

Adequate amounts of calcium are needed by her growing baby, as this helps in bone formation, as well as reduce her susceptibility to osteoporosis (where bones become weak). Sources of calcium include; milk, yoghurt, fish, broccoli, spinach and cheese.

Dutch cheese.

Iodine is also an important mineral since it is associated with fetal development. Sources of iodine include; table salt, bread and fish. Severe lack can lead to mental and physical retardation of the baby.

Whole cooked fish and salad

Zinc is required for DNA and RNA synthesis. Sources of zinc include meat and fish. Zinc is also found in small amounts in nuts and legumes such as beans.

Iron is required for the synthesis of greater amounts of hemoglobin needed during pregnancy and also for the provision of iron stores for the growing baby. Sources of iron include; liver, kidney beans, spinach and egg yolk.

Kidney  beans

N/B: To enhance iron absorption, foods rich in vitamin C should be consumed together with iron-rich foods. Caffeine and tea or sodas during meals should be avoided, unless they are taken 30 minutes before or after meals.

MT: Should a pregnant mom eat for two?

CK: When it comes to a pregnant woman’s diet, what matters is the quality of the diet and not necessarily the quantity. Therefore a pregnant woman should ensure that she takes a completely balanced diet in order to meet all her nutritional needs.

So there you are, hope this helps. Best wishes to all the pregnant women out there.

PS: The list of the above foods is not exhaustive.

Nutritionist Catherine Kathure can be reached on: cate2010@gmail.com

images: dreamstime.com

Originally published in Mummy Tales

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