Breastfeeding Beyond The First Year(Part 3/3)

BREASTFEEDING BEYOND THE FIRST YEAR (Part 3/3)
It may pose a unique set of challenges, but overcoming them provides dividends for your baby, writes a mother who shares her experience

By Anita Daubars | Reprinted with permission from Today’s Parents Magazine

Click here to read Part 2 and more photos

BREASTFEEDING & FERTILITY
Lactation delays the return of a woman’s menstrual periods after birth. This lactational amenorrhea lasts for varying periods of time in different women, averaging about 14.6 months postpartum in mothers who totally breastfeed their babies for six months and thereafter introduce solids gradually.

The length of lactational amenorrhea is largely determined by the baby’s breastfeeding pattern: is breastfeeding token in nature and scheduled, with solid being introduced at an early age, or is it ad lib and round-the clock, with a later introduction to solids and with baby satisfying his nutritional and his sucking needs at the breast.

Breastfeeding has a contraceptive effect as it suppresses ovulation. Because of the uncertainty of when ovulation will begin again, nursing mothers are encouraged to find other means of contraception. As the nursling nurses less and consumes more food, a mother’s chances of conceiving increase.

Mother of two Irene Tan continued to express her breast milk for her toddler for several months after he had weaned from direct breastfeeding because of its health benefits. Another mother continued nursing her toddler who had food allergies because breast milk was nutritionally wholesome and nursing helped to soothe her child when she developed allergic reactions to suspect foods.

NURSING THROUGH PREGNANCY & TANDEM NURSING
When a nursing mother finds herself pregnant, she is faced with the decision of continuing to breastfeed through the pregnancy or weaning.

She needs to consider the following: her own parenting values and needs; the part breastfeeding plays in her relationship with the nursling; the nursling’s emotional needs and other nutritional and immunological considerations.

Pregnant nursing mothers face breastfeeding challenges such as sore nipples, breastfeeding agitation and a reduction in milk supply because of hormonal changes.

Ways to cope include limiting breastfeeds and supplementing feeding with other milk.

Tandem nursing is closely related to the practice of nursing through a subsequent pregnancy. Tandem nursing refers to nursing two or more children of different ages at the same time; this may not be physically at the same instant, but one after another.

Advantages of tandem nursing that mothers cite include an easier transition to being a big brother or sister and a tender relationship between siblings right from the start.

The biggest obstacle for extended breastfeeding mothers is criticism from others; instead of giving mothers advice, often, affirming them and expressing confi dence in their ability to make good choices is the most helpful.

A mother nursing her toddler needs encouragement; she may find that, among babies similar in age to her own, her baby is the only one still nursing. For such a mum, it is sometimes a lonely journey and it is crucial that she belongs to a community of women who nurse older babies.

Many a mother has been encouraged to stay the course of breastfeeding because of her friendships with other nursing mothers.

Many believe that children whose dependency needs have been met outgrow these needs and achieve independence. When they are able to do this at their own pace, they tend to be more secure than children force into independence before they are ready.

Source: Breastfeeding Beyond The First Year(Part 3/3)

Breastfeeding Beyond The First Year(Part 2/3)

BREASTFEEDING BEYOND THE FIRST YEAR (Part 2/3)
It may pose a unique set of challenges, but overcoming them provides dividends for your baby, writes a mother who shares her experience

By Anita Daubars | Reprinted with permission from Today’s Parents Magazine

Click here to read Part 1 and more photos

NURSING STRIKES
Another issue nursing mums face are nursing strikes. Features of a Nursing Strike: When the nursling refuses to breastfeed without apparent reason. This can occur at any age, lasting from two to four days although a mother in this situation might wonder if the refusal to nurse is a sign of her baby’s readiness to stop breastfeeding.

A baby who is ready to wean will usually be over a year old, will be consuming other food and drink well and will cease nursing gradually, dropping off one breastfeed at a time.

A baby on a nursing strike may not be consuming other foods well and his refusal to nurse will be sudden and upsetting for him.

The mother can figure out the causes of baby’s sudden refusal to nurse by asking: does the baby have an illness or injury that could be interfering with nursing? Has there been a change in the baby’s life?

To get baby back to nursing as before, mothers can try nursing when the baby is very sleepy and by giving him or her lots of quiet, affection, and skin-to-skin contact.

HEALTH CONCERNS
Many nursing mothers are concerned about their nursling’s nutritional needs. Breast milk, being species specific and nutritionally superior, forms an invaluable part of a toddler’s diet that includes varied complementary foods.

Breast milk contains nutrients for baby’s growth as well as immune factors such as antibodies, growth factors, digestive enzymes and hormones.

Once complementary foods have been introduced at around six months of age, the other benefits of breast milk continue.

As such, breastfed toddlers tend to fall sick less often than their nonbreastfed peers and illnesses tend to have a shorter duration.

Nursing toddlers generally have: fewer ear infections; fewer respiratory infections; better digestion with fewer intestinal infections and less constipation; heart health; protection against allergies; less exposure to potential allergens also reduces the baby’s risk of infections, which may trigger allergies; and an intellectual advantage.

EMOTIONAL DEVELOPMENT
Mothers sometimes wonder if breastfeeding into toddler hood would cause baby to be clingy as a toddler. However, being clingy towards his primary caregiver at certain times is typical of almost any toddler, regardless of whether he is breastfeeding.

Pediatrician Dr William Sears believes that children who are allowed to breastfeed for as long as they need have a less anxious attachment to caregivers.

Click here for next Part 3

Source: Breastfeeding Beyond The First Year(Part 2/3)

Breastfeeding Beyond The First Year(Part 1/3)

BREASTFEEDING BEYOND THE FIRST YEAR (Part 1/3)
It may pose a unique set of challenges, but overcoming them provides dividends for your baby, writes a mother who shares her experience

By Anita Daubars | Reprinted with permission from Today’s Parents Magazine

WHEN I was expecting my first baby, I had been keen to try breastfeeding my newborn. However, I never thought that my breastfeeding story would turn out the way it has.

I exclusively breastfed my daughter until about six months of age, then began introducing semi-solid food to her. It was around this time that we discovered her allergy to dairy and wheat products.

After taking food containing these ingredients, she would throw up continuously for many hours, and be irritable and fussy. She would also refuse to nurse or eat any other food. After a few hours, she would begin to nurse but would still refuse solid food.

This refusal lasted for many days after each allergic response; during this time, she relied on breastfeeding for her nutritional needs as well as to comfort her. As we identified the specific suspect foods and avoided them in her diet, her allergic episodes became fewer.

Breastfeeding continued to fulfill a large part of her dietary needs. My daughter’s first birthday passed but weaning her felt arbitrary and somewhat odd.

My faith in breast milk’s ability to nourish my baby in the gentlest way, my wariness of triggering further allergic reactions, together with nursing being able to meet my baby’s intense need for closeness motivated me to continue breastfeeding her for as long as it felt ‘right’ for us both.

Most babies do not have such allergic tendencies, and for each individual family, breastfeeding, extended or otherwise, takes its own shape and style.

Nursing mothers whose babies have passed their milestone first birthdays and who continue to find breastfeeding a fulfilling way to meet their babies’ needs face a unique set of challenges.

Those who have resolved early problems with baby’s latch-on technique sometimes find that their baby’s latch becomes more relaxed as she grows bigger, and they begin to have sore nipples once again. The mother then needs to reassess her nursling’s latch and initiate a better latch. The same applies for the nursling’s position.

Nursing toddlers tend to engage in ‘nursing gymnastics’, wriggling and squirming during nursing. They comfortably get into a myriad positions to breastfeed.

Mothers often have to emphasize to their toddlers to stay properly latched on throughout nursing. Toddlers also tend to be busy, distractible people.

Yet, continuing to nurse after the first year sustains the emotional connection between mother and toddler and serves as moments to touch home base and reconnect with their mothers between their outbound exploration trips. Many toddlers settle on having shorter breastfeeds.

According to the American Academy of Pediatrics (AAP), breastfeeding should continue at least until age one, and thereafter, for as long as is mutually desired by mother and child; extended breastfeeding provides significant health and developmental benefits for mother and child, and there is no upper limit to the duration of breastfeeding.

Click here for next Part 2

Source: Breastfeeding Beyond The First Year(Part 1/3)

PREGNANCY TIPS: I Caught The Flu, Is It Bad For My Baby?

GREAT EXPECTATIONS

By Dr Lai Fon Min
Consultant Obstetrician and Gynaecologist | A Company for Women, Camden Medical Centre
reprinted with permission from "Great Expectations" by Today's Parents magazine

I HAD A BAD FLU AND COUGH RECENTLY WITH A FEVER OF 38° C. I AM AFRAID IT MAY AFFECT MY BABY AS I AM THREE MONTHS PREGNANT. PLEASE ADVISE.

Influenza (commonly called “the flu”) is a common and contagious respiratory illness caused by influenza viruses. The flu can result in severe illness and life-threatening complications.

Influenza usually occurs in epidemics. What you are referring to as “flu” is more likely a “cold”.

Viral infections such as colds and flu are just as common when you’re pregnant as when you’re not, so many women end up worrying about whether a minor illness could harm their unborn child.

In general, there’s probably very little to worry about if it is short-lived and your baby is unlikely to suffer any ill-effects as a result. Because your immune system is affected during pregnancy, you may feel worse than usual.

Any severe or prolonged illness which causes you to be feverish and generally unwell may increase the risk of miscarriage. However, the “baseline” miscarriage rate in the first trimester may be as high as 20 percent, usually due to chromosomal abnormalities.

If your flu does not get better and you begin to cough up green/yellow sputum, experience shortness of breath, persistent chest pain, severe sore throat or a fever of 38 degrees, you should see a doctor. If you are less than 12 weeks pregnant, you should not take medication unless recommended by your doctor.

Source: PREGNANCY TIPS: I Caught The Flu, Is It Bad For My Baby?

Is Myopia In Kids Preventable? (Part 2/2)

Can You Prevent Myopia In Kids?
Parents guilty of passing on the myopia genes should not fret since they can still play a role in controlling their children’s myopia

By Jessie Kok | Reprinted with permission from Today’s Parents

Click here to read Part 1 of this story

Dr Gerard Chuah, senior eye surgeon at Total Eyecare Centre (Camden Medical Centre), and Dr Chew Wai Kwong, chief optometrist at Capitol Optical, answer frequently asked questions about myopia:


What exactly changes in the eyeball that causes myopia?
“Unlike normal children or adults, highly myopic people have elongated eyeballs which means the tissue at the back of their eyes is stretched,” says Chew. “Tissues like the retina, when highly stretched, become weaker and more vulnerable to retinal tear, resulting in higher risk of developing glaucoma and macular degeneration.”


Is it true that leaving the light on at night for babies may predispose them to myopia?
It is common for parents to leave a light on for babies while they sleep. While recent studies in America show that leaving a light on might lead to the development of myopia, more studies would need to be done to show conclusive evidence.


Are all cases of myopia irreverisble?
General cases of myopia are irreversible. However, another type of myopia – pseudomyopia – which occurs when there is excessive spasm of the focusing muscles in the eyes and more commonly seen in young children is reversible.


How is pseudomyopia treated?
When young children first visit an optometrist cycloplegic refraction is routinely done to eliminate pseudomyopia. Optometrists also rely on objective methods of retinoscopy and fogging to check on these cases.


How can eye drops assist in cases of myopia?
Currently, Atropine 1 percent eyedrops are used in some hospitals and clinics as a tool to address myopia progression. The Singapore National Eye Centre (SNEC) has ongoing studies to assess the role of the drops. There are promising preliminary results that show Atropine may help to retard the progression of myopia but more overseas and local studies are required for conclusive results.


Can certain types of food or supplements boost vision?
According to Dr Chuah, there is no conclusive evidence in studies that show consuming more vitamins and minerals can help to improve or control myopia, unless the child is severely malnourished. It is more important to get a child to relax her eye muscles by looking at faraway objects. “It’s got nothing to do with the colour of the object but more about letting the eye muscles rest after doing near-work,” he says.

Dr Chuah also highlights the efforts by the Ministry of Health in their myopia control programme that teaches students good eyecare habits such as taking breaks after 45 minutes of near-work and simple eye exercises.


A beneficiary of this programme is Kevan, who has successfully helped to control his children’s myopia. Now grown up and aged 11 and 13 respectively, Sarah and Sean have managed to control their myopia over the years through sporadic rests in between studying, and doing simple eye exercises as instructed by their father.


While Kevan does not expect complete recovery in his children, the improvement and control of his children’s myopia that gives him a sense of satisfaction.

“I know we cannot control hereditary symptoms,” he says. “But every parent can play a part when it comes to environmental factors to ensure the best management of childhood myopia.”

Source: Is Myopia In Kids Preventable? (Part 2/2)

Is Myopia In Kids Preventable? (Part 1/2)

Can You Prevent Myopia In Kids?
Parents guilty of passing on the myopia genes should not fret since they can play a role in controlling their children’s myopia

By Jessie Kok | Reprinted with permission from Today’s Parents

SARAH and Sean Ng were diagnosed with severe myopia by their optometrist at the age of four. The cute sight of the siblings in round, tortoise-shaped spectacles gradually turned into a source of concern for their parents, who noted the dangers their visually challenged children were facing.

“We took our children’s good vision for granted until Sarah’s optometrist told us about her severe myopia,” says Kevan Ng, the sibling’s father, who is himself short-sighted. “After a while, it became even more essential to childproof our home. Even telephone wires became hazardous with two little active blind moles around the house.”

Kevan’s case is not uncommon in Singapore. According to Capitol Optical, surveys done every three to five years show that the rate of children with myopia in Singapore is increasing. Myopia affects 25 percent of seven-year-olds, 50 percent of 12-year-olds and 80 percent of 18-year-olds on the island.

“Genetics cannot be controlled,” says Dr Gerard Chuah, Senior Eye Surgeon of Total Eyecare Centre at Camden Medical Centre, who notes the myopic risks in children are in proportion to genetics. “If one parent has myopia, the child would have a higher risk of myopia. If both parents are myopic, the risk becomes even higher for the child.”

Apart from genetic factors as in the Ng family’s case, Chew Wai Kwong, Professional Affairs Manager and Chief Optometrist at Capitol Optical, also believes that environmental factors play a part.

“Our gene pool and ethnic make up have not changed much in the past 40 years, and it is widely accepted now that the amount of time spent on near work and the computer, which now starts at a very young age, does have a direct influence on the development of myopia,” he says.

Parents guilty of passing on the myopia genes should not fret since they can play a role in controlling their children’s myopia.

But ignore the “looking at green objects” advice, since according to Dr Chuah, it serves no scientific purpose in controlling myopia. We look at the five most commonly asked questions posed to eyecare experts below.

Click here to read Part 2: Doctors answer FAQs on myopia

Source: Is Myopia In Kids Preventable? (Part 1/2)

Great Expectation: How To Plan For Your Family’s Future (Part 3/3)

How To Plan For Your Family’s Future (Part 3/3)
No matter what your income level is, early planning for financial security is always the best course of action. Here, some tips on how to get started!

Click here to read Part 1

Click here to read Part 2

TIP 5: TAKE CONCRETE STEPS TO ACHIEVE YOUR FINANCIAL GOALS
With your goals identified, you can start exploring the available financial solutions to achieve these goals. For example, when building up savings for your children’s education, you could consider:

1. Putting an appropriate amount of savings in a bank deposit
2. Buying an endowment plan or investing in another longer term investment product
3. Investing long term in some blue chip stocks or funds

As can be seen from above, different financial solutions are available to achieve the same goal. For example, if you plan to buy life insurance to give you and your family financial protection against death and permanent disability, there are a few types of common insurance plans such as whole life plans, endowment plans, term insurance or investment-linked plans to consider.

You should shop around and understand the key features of each product before deciding which product best serves your needs.

CHECKLIST FOR A BRIGHTER FINANCIAL FUTURE FOR YOU AND YOUR FAMILY

1. Set up a monthly budget.
2. Set aside an emergency fund consisting of six months of your monthly salary.
3. Identify your financial goals and objectives.
4. Know what your net worth (assets minus liabilities) is.
5. Protect your family and yourself against risks such as accidents and loss of income.
6. Know how much you need for your retirement and know how much CPF savings you will have when you retire.
7. Have a proper plan to reach your financial goals and objectives.
8. Put aside some money in investments to grow your wealth.
9. Review your financial plan regularly.

Some families may be more comfortable developing their own financial plan. However, it might be appropriate to engage a financial adviser (FA) to assist with planning if you need expert advice. However, do take note of the following when engaging a FA:

1. Deal only with FA regulated by the Monetary Authority of Singapore (MAS)
2. Engage an FA with proper qualifications and experience
3. Make sure you ask for documentation and keep your documents safely
4. When in doubt, always seek clarification and ask for more information
5. Beware of verbal promises and guarantees of unrealistic returns

Remember: Ultimately, your financial plan belongs to you and your family. It is your responsibility to ensure that you understand your plan and stick to it.

You can also log on to www.moneysense.gov.sg and check out The MoneySENSE Guide to Planning for Your Family’s Financial Future for more information and tools on how to get started.

This information is provided by the Insurance and Financial Practicioners Association of Singapore (IFPAS) and Life Insurance Association (LIA) as part of the MoneySENSE national financial education programme.

Source: Great Expectation: How To Plan For Your Family’s Future (Part 3/3)

Great Expectation: How To Plan For Your Family’s Future (Part 2/3)

How To Plan For Your Family’s Future (Part 2/3)
No matter what your income level is, early planning for financial security is always the best course of action. Here, some tips on how to get started!

Click here to read Part 1

FIVE TIPS TO BASIC FINANCIAL PLANNING FOR YOUR FAMILY

TIP 1: PREPARE AND STICK TO A FAMILY BUDGET TO KEEP EXPENSES IN CHECK

A budget is a useful tool for families to monitor their income and expenses. Without a budget, we may not be able to keep track of the many bills and expenses we incur.

Steps to prepare a family budget:
1. Create a list of all monthly income, e.g. salary and wages.
2. Create a list of planned or targeted expenses and a list of all actual monthly expenses. If an expense is not incurred monthly, pro-rate it on a monthly basis.
3. Set aside a fixed amount of savings every month. You should aim to save at least 10 per cent of your monthly income and have savings equivalent to six months of your salary as emergency funds at any point in time.
4. Make sure your expenses and the amount set aside for savings do not exceed your income. If you are overspending, reduce your expenses accordingly.
5. Review your budget regularly.

You may also wish to consider involving your family members in drawing up the family budget so that it becomes a shared responsibility.


TIP 2: DIFFERENTIATE BETWEEN “NEEDS” AND “WANTS”
Our decision to spend is usually motivated by “needs” and “wants”. “Needs” relate to the essentials in life, something you cannot live without, e.g. rent or mortgage or food. “Wants” are usually things that we desire, such as the latest IT gadget or a new fancy handbag. Do a reality check before taking the plunge. Ask yourself the following questions:

1. Do we really need the item?
2. Is it worth waiting and saving up for?
3. Is there a cheaper alternative?

TIP 3: IDENTIFY FINANCIAL PRIORITIES
Priorities change at different life stages. For example, a family with young children may have the following priorities:
1. Ensuring sufficient income to maintain household expenses
2. Saving for the children’s education
3. Retirement planning

Do review your priorities regularly, especially at different stages of your life and whenever your family circumstances change. These could include events such as starting work, getting married, buying a home, having children or reaching retirement.

TIP 4: TRANSLATE PRIORITIES INTO FINANCIAL GOALS
Once we have identified our priorities, we can proceed to take steps to make them our financial goals. For each goal, determine how much funds you need to accumulate and the time available to accumulate the funds.

For example, if your priority is to ensure adequate income for your family in case of unexpected events, you may wish to review your insurance policies and calculate the optimal level of insurance coverage required.

Similarly, if your goal is to save for your children’s education needs, you may wish to start by projecting how much tuition fees might be by the time your children start university and the time available to accumulate such funds.

NEXT: TIP 5 – TAKE CONCRETE STEPS TO ACHIEVE YOUR FINANCIAL GOALS

This information is provided by the Insurance and Financial Practicioners Association of Singapore (IFPAS) and Life Insurance Association (LIA) as part of the MoneySENSE national financial education programme.

Source: Great Expectation: How To Plan For Your Family’s Future (Part 2/3)

Great Expectation: How To Plan For Your Family’s Future (Part 1/3)

How To Plan For Your Family’s Future (Part 1/3)
No matter what your income level is, early planning for financial security is always the best course of action. Here, some tips on how to get started!

STARTING a family is probably the biggest responsibility you’ll undertake. Taking care of your spouse, your kids and your extended family requires much thought, attention and love. It also means having to manage your finances right.

WHY PLAN NOW?
Most of us are going to live longer. Fifty years ago, the average life expectancy in Singapore was just 61 years old. Today, the average life expectancy is 80 years old and many people will live beyond that. If we want to ensure our golden years are smooth and pleasant, we need to be self-reliant and start financial planning early. Our plans need to take into account rising costs, an ever-changing job environment, and most importantly, our growing families.

The lessons we learn from planning and managing our finances will also be invaluable to our children. Passing on good money management habits to our children should hopefully translate into lives less troubled by monetary woes. With increasingly smaller families, there will be fewer economically active persons to support an elderly one. Therefore, it is important to plan early for a secure retirement as well as reduce some of that burden for our younger family members.

Our financial security and that of our family’s is our responsibility, no matter what our income levels. A healthy CPF balance helps but may not be enough. Everyone should have a financial plan, tailored to our needs, lifestyle preferences, attitudes to finance and appetites for risk. Our plans might also reflect the different life stage we are at.

WHAT IS FINANCIAL PLANNING?
Financial planning should minimally comprise setting some financial goals or objectives and mapping out how we achieve them. A financial plan should minimally cover the following areas:

Cash-flow Management: this is about living within our means. Our expenses should never exceed our incomes and ideally we should be setting aside sufficient money and other assets to meet future financial goals.

Risk Management: this refers to taking precautions to make sure that our families will have enough income to live on in the event of unforeseen circumstances such as premature death, disabilities or illness.

Investment Planning: this relates to investing our savings to meet our investment goals and grow our wealth. There are many financial products and investments to choose from depending on a person’s appetite for risk and understanding of the different products.

Retirement Planning: this relates to building up wealth during our working years to achieve financial independence when we retire.

NEXT: FIVE TIPS TO BASIC FINANCIAL PLANNING FOR YOUR FAMILY

Source: Great Expectation: How To Plan For Your Family’s Future (Part 1/3)

Pregnancy Tips: Sex Before And After Pregnancy

GREAT EXPECTATIONS
By Dr Ann Tan, Consultant Obstetrician & Gynaecologist | Women and Fetal Centre, a member of Pacific Healthcare Holdings

Reprinted with permission from "Great Expectations by Today's Parents magazine

Until what stage of pregnancy can I still have sex?
Actually both sex and pregnancy are natural events and you can enjoy them concurrently so long as you do not experience any undue pain or bleeding. If you have any particular pregnancy problems of preterm labour/ incompetent cervix or multiple pregnancy, you should consult your obstetrician on the advisability of intercourse. The use of condoms may help to reduce the uterine reactivity by preventing semen from contact with the cervix.

How soon can I have sex after my baby is born?
There is no hard and fast rule and usually the woman is ready in four to six weeks post normal vaginal delivery and Caesarean section too! The vaginal wound is usually a little firm initially but should stretch out once activity is resumed while in the case of a Caesarean delivery, there should be no difference at all. For the latter, deep penetration may cause stretching of the Caesarean scar and that may initially be uncomfortable.

I am six months pregnant and find myself surprisingly more turned on than usual. Why is that?
The hormones of pregnancy are making you more curvy than before and it’s very natural that you might feel more sexy than ever before! Enjoy!

Source: Pregnancy Tips: Sex Before and After Pregnancy

Pregnancy Tips: What Are Fibroids and How Do They Affect Conception?

GREAT EXPECTATIONS
By Dr Lai Fon Min
Consultant Obstetrician and Gynaecologist | A Company for Women, Medical Centre
Reprinted with permission from "Great Expectations" by Today's Parents magazine

I HAVE BEEN TRYING UNSUCCESSFULLY TO CONCEIVE FOR THE LAST SEVEN MONTHS. MY GYNAE DISCOVERED I HAVE FIBROIDS. WHAT SHOULD I DO AND HOW DOES THIS AFFECT MY CHANCES OF HAVING A CHILD?

Uterine Fibroids (myoma or leiomyoma) are very common – they are benign (noncancerous) growths of the uterine muscle. The size and location of the fibroids are important. The large majority of them are very small or located in an area of the uterus such that they will not have any impact on reproductive function.

There are three general locations for fibroids:

(1) Subserosal – on the outside surface of the uterus
(2) Intramural – within the muscular wall of the uterus, and
(3) Submucous – bulging into the uterine cavity.

The only type that will have any impact on reproductive function (unless it is very large) is the submucous type that is within the uterine cavity. These are much less common than the other two types of fibroids.

Because of their location inside the uterine cavity, submucous fibroids can cause infertility or miscarriages and may be removed hysteroscopically (a slim instrument inserted through the cervix into the uterus).

Other causes for infertility should be considered before treatment is initiated for subserosal or intramural fibroids which do not distort the uterine cavity.

Studies of infertile women with submucous fibroids distorting the endometrial cavity found significantly lower pregnancy and delivery rates, compared with infertile women without fibroids.

It is important to note that removal of submucous fibroids led to a significant increase in the pregnancy rate compared with the case in infertile women without fibroids.

Source: Pregnancy Tips: What Are Firboids And How Do They Affect Conception?

Pregnancy Tips: Are Migraine Medications Harmful For Me?

GREAT EXPECTATIONS
By Dr Lai Fon Min
Consultant Obstetrician and Gynaecologist A Company for Women, Camden Medical Centre |
reprinted with permission from "Great Expectations" by Today's Parents magazine

I AM EXPECTING MY FIRST CHILD AT THE AGE OF 32. I AM PRONE TO MIGRAINES BUT AM AFRAID TO USE ANY MEDICATION AS IT MAY HARM MY BABY. PLEASE ADVISE.

Migraine does not increase the risk for complications of pregnancy for the mother or the foetus. Several studies have shown a tendency for migraine to improve with pregnancy. Between 60 and 70 percent of women either go into remission or improve significantly, mainly during the second and third trimesters. Management of migraine during pregnancy should first focus on avoiding potential triggers; for example, stress, change in sleep pattern, bright lights or excessive computer use, irregular meals, smoking, alcohol and certain foods containing red wine or MSG.

Consideration should also be given to non-drug therapies. If medication becomes necessary, paracetamol (Panadol) can be used safely. NSAIDs (aspirin, ibuprofen, naproxen) can be used as a second choice, but not for long periods of time, and they should be avoided during the last trimester. A common antimigraine drug is ergot in combination with caffeine – Cafergot. Ergot is contraindicated in pregnancy.

For treatment of severe attacks of migraine, chlorpromazine, dimenhydrinate, and diphenhydramine and metoclopromide can be used to help with the nausea and vomiting in severe attacks; metoclopramide should be restricted to the third trimester. In some refractory cases, steroids like dexamethasone or prednisone can be considered. Should prophylactic treatment become indicated, the beta-adrenergic receptor antagonists (e.g. propranolol) should be avoided.

Source: Pregnancy Tips: Are Migraine Medications Harmful For Me?

Pregnancy Tips: What Is Implantation Bleeding?

GREAT EXPECTATIONS
By Dr Lai Fon Min
Consultant Obstetrician and Gynaecologist | A Company for Women, Camden Medical Centre | reprinted with permission from "Great Expectations" by Today's Parents magazine

WHAT IS IMPLANTATION BLEEDING AND WHAT ARE THE SYMPTOMS?
Implantation bleeding occurs when an egg has been fertilised and implants into the lining of the uterus. Up to a third of women report some bleeding or spotting around the time of implantation.

It is typically small in amount, and not a “heavy” bleed. Implantation happens about a week (range 6-12 days) after ovulation. It may be accompanied by cramping or backache.

Implantation will appear before you expect your period and some may mistake it for spotting before their period begins.

Because there is typically so little and it is before you would expect your period it would be normal to think you are just getting ready to start your period.

However, if you think there is a chance you could have conceived in that cycle, please do a urine pregnancy test.

Source: Pregnancy Tips: What Is Implantation Bleeding?

Pregnancy Tips: What Is Dilated Renal Pelvis?

GREAT EXPECTATIONS
By Dr Lai Fon Min
Consultant Obstetrician and Gynaecologist | A Company for Women, Camden Medical Centre | reprinted with permission from "Great Expectations" by Today's Parents magazine

I’VE JUST HAD MY 20-WEEK ANOMALY SCAN AND HAVE BEEN TOLD MY BABY HAS A DILATED RENAL PELVIS. ALTHOUGH I’VE BEEN REASSURED THIS CONDITION WILL PROBABLY CORRECT ITSELF, I’M WORRIED.

Mild renal pelvic dilatation (swelling of the collecting system in the foetal kidney) occurs in 1 to 3 percent of pregnancies. It is more common in male fetuses. It is usually defined as an antero-posterior diameter of > 5 mm before 24 weeks and > 7 mm after 25 weeks.

Usually the condition will resolve on its own, but worsening renal pelvis dilatation may be due to some underlying problem in the urinary tract like obstruction, or certain abnormalities in formation of the kidney, for example, a duplex kidney or a multicystic kidney. If there is no family history of kidney disease, and there are no other abnormal findings on ultrasound, the outcome in the baby depends on whether the dilatation worsens as the pregnancy progresses.

If there are no other abnormal findings in addition to the dilated renal pelvis, there is no need to check for chromosomal abnormalities in the fetus.

If the dilatation remains static or is less than 10mm, then an ultrasound scan of the urinary system will be done three to four days after birth. If this is normal, a follow up scan should be repeated one, six or 12 months later.

Unfortunately, the clinical significance of persistent neonatal renal pelvic dilatation is unknown as long-term follow up studies are not available. Even if the dilatation persists, the likelihood of serious urinary tract problems is very low.

If the dilatation is > 10 mm in a follow up ultrasound scan after 28 weeks gestation, your baby will be continued to be monitored closely after birth and other specialized tests of urinary tract function may be necessary.

Source: Pregnancy Tips: What Is Dilated Renal Pelvis?