Ancaman keracunan kanak-kanak di rumah

KANAK-KANAK yang suka memasukkan apa sahaja ke dalam mulut berisiko tinggi mengalami keracunan.

HAMPIR terlena dibuai mimpi, tiba-tiba kedengaran suara rengekan anak kedua di bilik belakang yang memanggil sambil menangis. Ini mungkin ada yang tidak kena, segera bingkas bangun dari tidur dan terus menerpa ke biliknya.

‘‘Ibu, Haiqal sakit perut,’’ kata Haiqal sambil meramas-ramas perutnya.

Tidak mungkin tersalah makan, kalau tidak silap semalam makan makanan yang masih panas dan tidak terdedah kepada parasit yang boleh menyebabkan keracunan. Apabila pergi ke klinik, doktor menerangkan bahawa bukan semua kes keracunan disebabkan oleh memakan makanan yang telah terdedah atau tidak cukup masak tetapi ada lagi faktor lain seperti ‘sediaan’ di rumah.

Apakah `sediaan?’ ‘Sediaan’ ialah sebarang barangan yang mengandungi etanol atau alkohol jenis kepekatan tinggi seperti sabun pencuci, pendandan rambut dan pencuci kuku. Selalunya, gangguan gastrousus (perut) adalah tanda yang awal apabila berlakunya keracunan.

Pusat Racun Negara menganggarkan kadar keracunan yang membabitkan `sediaan-sediaan’ di rumah adalah antara 16 sehingga 30 peratus daripada keseluruhan kes keracunan yang dilaporkan.

Daripada jumlah ini, lebih kurang 90 peratus membabitkan kanak-kanak dalam peringkat umur seperti: 1 hingga 3 tahun sebanyak 60 peratus, 3 hingga 6 tahun (20 peratus) dan 6 hingga 11 tahun ( 10 peratus).

Tempat yang paling bahaya mengakibatkan keracunan di rumah adalah di dapur ialah 50 peratus, bilik air (20 peratus) dan bilik tidur (10 peratus).

10 kategori utama keracunan membabitkan sediaan di rumah.

- Sabun dan bahan pencuci.

- Alat kosmetik dan ‘sediaan’ kegunaan peribadi seperti minyak wangi dan kolon badan.

- Hidrokarbon seperti minyak tanah.

- Tumbuh-tumbuhan.

- Alat-alat mainan seperti desikan (bahan pengering).

- Insektisid dan pestisid (racun makhluk perosak) seperti organofosfat dan karbamat.

- Alat-alat lukisan termasuk pen marker dan warna magik dan dakwat.

- Cat, varnis, pencair cat.

- Deodoran seperti pewangi udara dan semburan badan.

- Rodentisid (racun tikus) yang meningkatkan risiko pendarahan.

Bila sepatutnya mengesyaki kanak-kanak mengalami keracunan?

- Pernah memakan barang-barang yang beracun. Kanak-kanak berumur antara 1 hingga 5 tahun. Mereka dianggap berisiko tinggi kerana gemar memasukkan apa sahaja ke dalam mulut.

- Kanak-kanak menjadi sakit secara mengejut terutama sekali jika pesakit mengalami gelugut (konvulsi) tanpa demam atau tidak sedarkan diri (koma) tanpa sebarang sebab yang nyata.

- Kesakitan yang dialaminya melibatkan beberapa bahagian badan tanpa sebarang sebab nyata.

- Nafas kanak-kanak berbau sesuatu yang luar biasa atau terdapat tanda-tanda kotor atau melecur pada mulut dan bibir.

- Muntah darah tanpa sebab.

Sumber: UtusanMalaysia

To vaccinate or not?

WOMEN'S WORLD By Dr Nor Ashikin Mokhtar
Source: Sunday Star, December 16, 2007

Does your daughter need the cervical cancer vaccine?

THE other day, one of my patients, a 42-year-old mother, asked me about the new cervical cancer vaccine. I cautioned her that the vaccine would be less effective for her at her age, but suggested instead that she get her two teenage daughters vaccinated.

Why couldn’t they be vaccinated when they were older, she asked. I advised her that this vaccine offers the best protection when it is given to girls before they become sexually active. She was concerned about the safety of giving a vaccine to teenage girls, but I assured her that the vaccine is safe even for girls as young as nine.

When this vaccine was approved in Malaysia in 2006, it came as great news for women, who will now have better protection against cervical cancer, for themselves and their daughters.

However, some people have tried to turn this into an issue about sex. They say that giving the vaccination to young girls is like giving these girls permission to have sex.

Not only is this view factually wrong, it is also denying women the right to a medical development that can save their lives.

As a doctor and a mother myself, I urge everyone to stop thinking about this vaccine as anything to do with sex, and everything to do with eradicating cervical cancer.

How the vaccine works

The main cause of cervical cancer is the human papillomavirus (HPV), of which there are more than 100 different strains that can also cause other conditions like warts. So far, we know that about 10 of these HPV strains are linked to cervical cancer.

These types of HPV are transmitted through sexual intercourse. It is actually very common for men and women to be infected with HPV at some point in their lives when they become sexually active.

It has nothing to do with sexual promiscuity, and most of the time, the infection goes away on its own without causing cancer or requiring treatment. But if the infection causes pre-cancerous cells to develop, this could lead to cancer.

Fortunately, now that there is a vaccine, women will have even better protection against the virus.

The vaccine that was approved last year protects women against four different types of HPV – two types that cause 70% of all cervical cancers, and two types that commonly cause genital warts (the types are HPV-6, HPV-11, HPV-16, and HPV-18).

This particular vaccine will not completely prevent cervical cancer because there are other types of HPV it does not protect against. However, in the future, there may be newer vaccines that can protect against the other types of HPV as well.

As this is a new vaccine, we don’t know how long the effects of the vaccine will last. Currently, studies show that it offers protection for at least four years.

Who should be vaccinated?

The vaccine is most effective in women who have not been exposed to HPV before. In other words, women who are not sexually active – the most likely group being preteen and teenage girls.

In the US, the vaccine is recommended to be given routinely to girls at age 11 or 12. Malaysia does not necessarily have to follow in the footsteps of Western countries, where girls become sexually active at a younger age.

As a parent, you should discuss this vaccine with your daughter and your family doctor or gynaecologist and make the decision together.

Whether it is at age nine, 12 or even 26, girls should be given this vaccine before they become sexually active.

Here are some questions that women and parents of young girls frequently ask:

What is the most suitable age range for vaccination?

The vaccine can be given to girls as young as age nine, and the recommended age range is between 13 and 26.

How many shots of the vaccine are needed?

There are three doses of the vaccine to be given over six months. You must get all three doses within this timeframe, so that the vaccine will be effective.

What are the side effects of the vaccine?

The vaccine is safe and generally well tolerated. Some side effects that you may experience include pain, swelling, itching and redness at the injection site, and fever. A very rare side effect is difficulty breathing – if you experience this, seek medical help immediately.

Do I still need Pap smears?

Yes, every woman who has been vaccinated still needs to have regular Pap smears. This is very important because the vaccine does not protect against all causes of cervical cancer, or you may already have been infected with HPV before you were vaccinated. Pap smear can detect cancer and pre-cancerous lesions early, so that they can be treated before developing into cancer.

Can the vaccine cure HPV infection or cervical cancer?

No, it does not treat the infection or the cancer. If you have HPV or signs of cervical cancer, get your doctor’s advice for the appropriate treatment.

Do I still need the vaccine if I am already sexually active or have previously been infected with HPV?

The vaccine is still beneficial for you, because you may have been infected by other HPV types. Therefore, it can protect you against the four HPV types contained in the vaccine. However, it will not be able to protect you against HPV types that you have already been exposed to.

Can I be vaccinated if I am pregnant?

No, the vaccine is not recommended for pregnant women.

Can this vaccine protect me from other diseases?

No, the vaccine can only protect you from the diseases caused by the four HPV types it contains. It will not protect you from other sexually transmitted diseases! Therefore, it is very important to still practise safe sex.

The ‘sex’ issue

This vaccine does not give anyone a free license to have unsafe sex or be promiscuous. Let us remember that it only protects against a few types of HPV; it does not protect against HIV or other sexually transmitted diseases. Let us remember that it is not a form of birth control and will not protect against unplanned pregnancies.

But what it can do is provide a great deal of protection against most cervical cancers. So let’s not deny our daughters a chance to say “no” to cervical cancer.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.

Nine months

WOMEN'S WORLD By Dr Nor Ashikin Mokhtar
Source: Sunday Star August 19, 2007

So you’re about to be a mum ... congratulations!

IF this is your first baby, you won’t have a clue what to expect. Relatives and friends will all want to give you advice, but with so many people telling you all sorts of things, who do you listen to? Don’t be overwhelmed. Listen to your own body – it is “programmed” to support the needs of your growing baby over the next nine months. And just so that you’re not taken completely by surprise, this article will help you understand the weird and wonderful changes that will occur.

The first three months

Two weeks after you conceive, your body is already preparing for pregnancy, whether or not you realise it! One of the first signs is mild vaginal bleeding that looks like a scanty period. This happens when the fertilised egg implants into the lining of your uterus.

Due to hormone changes, your breasts will feel quite tender, as well as fuller and heavier. You may also struggle with “morning sickness” (though some women say they have sailed through pregnancy without a moment of nausea, lucky things!).

Although the bouts of queasiness, nausea or vomiting tend to be worse in the morning, they can actually occur throughout the day. It helps to eat frequent, small meals and drink a lot of fluids.

You will also feel unusually fatigued during this time. This is expected, as your body is producing more blood to carry nutrients to the baby, causing your heart to pump faster and harder, and your pulse to quicken.

With the extra blood going to your uterus, instead of to your brain, you may occasionally feel dizzy and lightheaded. Some fainting spells may be expected during any stage of the pregnancy. Get as much rest as you can, do not stand for prolonged periods of time and get up slowly after lying or sitting down.

There are some changes that your friends may be too shy to tell you about. Going to the toilet more often? Increased urination is common during the first trimester because your growing uterus presses on your bladder. Be prepared that you may inadvertently leak urine when sneezing, coughing or laughing (don’t worry, you’re not permanently incontinent).

Or perhaps you’re not going to the toilet as often as you should. Constipation can occur during the first 13 to 14 weeks of pregnancy, due to an increase in the hormone progesterone, which slows the digestive process. Drink plenty of fluids and eat more fibre, to prevent this.

The second trimester

You may find the next three months to be the most enjoyable stage of pregnancy! You will start getting used to carrying that lovely bump, as the baby is not big enough yet to crowd your abdominal organs. And so many people will stop you on the street to congratulate you!

It will be quite interesting to see your own breasts growing larger, as the milk-producing glands get bigger and a small amount of fat accumulates.

Some leg cramps, particularly at night, are to be expected, because your uterus is placing pressure on the veins that carry blood from your legs. Whenever you get cramps, stretch the affected muscle slowly. Later on in the pregnancy, you will find that your feet and ankles may become swollen.

As you have experienced earlier, your body is producing more blood. Increased blood circulation can soften your gums, so you may notice that your gums bleed a little when you brush or floss your teeth. Increased blood flow can also cause temporary snoring, nasal congestion or nosebleeds.

However, the increased blood circulation produces a wonderful side effect – it sends more blood to the tiny blood vessels just underneath the surface of your skin, so you will be positively glowing!

Last three months ... finally!

Do you feel like you’re carrying an entire football team in your womb? Your baby is getting larger every day, and kicking you in the ribs as he/she starts moving around quite a lot.

The baby is also pushing your stomach out of its normal position, and this can cause heartburn (a burning discomfort in the chest, caused by stomach acid going into the oesophagus). To prevent this, eat small meals and drink plenty of fluids.

You may also experience shortness of breath and find that you get winded easily. This is because your uterus is expanding right beneath your diaphragm, which is the muscle just below your lungs.

Without realising it, you’ve become one of those women walking around bent slightly backwards, with your hand constantly on your lower back. Carrying a little person inside you can put a real strain on your back, and you will find that you can’t stand or walk for too long. A hot or cold compress to the aching area may help, as will a massage from your partner.

You might want to avoid looking down at your ankles because they’ve probably turned into something from a horror movie. Swollen feet and ankles are common because your growing uterus puts pressure on the veins that return blood from your feet and legs.

Your legs will look a little scary as well, with all those veins poking out. Nothing to worry about – these are called varicose veins, where the veins grow larger to accommodate increased blood volume produced by your body. If your legs feel uncomfortable, sit or lie down with your legs elevated, or wear support stockings.

The increased blood circulation may cause small reddish spots to appear on your face, neck, upper chest or arms, and there may be tiny lines sprouting from these spots, making them look like spider legs. Don’t worry, these are just tiny blood vessels, sometimes called spider veins.

But what about those awful looking stretch marks on your stomach, breasts, buttocks and thighs? Unfortunately, they can’t be prevented because your skin will have to stretch to accommodate the growing baby. After birth, the marks will slowly fade in intensity. In the meantime, use moisturisers to cope with the itchiness.

Whew! By now, you’ll really be looking forward to the day when all this is over. But these nine months are only the beginning. After that, the next chapter of your life with your new baby will begin!

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.

Losing a baby

Why miscarriages occur, and what can we do to minimise its occurrence.

Women's World: By Datuk Dr Nor Ashikin Mokhtar.

AS an obstetrician, my job is to help pregnant mothers welcome their babies into this world. Therefore, I have always found that the hardest part of the job is when the pregnancy ends in a miscarriage, and my patients turn to me and ask, “Why did this happen?”

There are three things that you should definitely do during pregnancy to prevent a miscarriage: don’t smoke, don’t use illegal drugs and don’t drink too much alcohol. - AFP

If dealing with miscarriage is difficult for me, I can’t imagine how heartbreaking it must be for the women who have this precious gift snatched right out of their hands.

In this article, I will talk about how to recognise when you’re having a miscarriage and reducing your risk factors for miscarriage.

Defining a miscarriage

A miscarriage is the loss of a baby before the 20th week of pregnancy, with most miscarriages occurring in the first trimester. Up to 15% of all recognised pregnancies end in miscarriage – however, many more miscarriages actually occur, but women are not aware of them because they did not know that they were pregnant in the first place.

The most obvious signs of a miscarriage are vaginal bleeding or spotting, pain or cramping of the abdomen, passing of tissue from the vagina and fluids draining out from the vagina. If you are pregnant and experience any of these signs, go to your obstetrician immediately.

When a miscarriage occurs, the first instinct is to ask, “Why did this happen? What did I do wrong?” Relatives or friends may make things worse by telling you that you should not have eaten this or done that during your pregnancy.

Some old wives’ tales may blame a miscarriage on “bad” foods, sex, too much exercise, bad feng shui or even astrological signs! However, these are unfounded beliefs. Even we doctors do not really know the cause of most miscarriages.

We do know that they are often caused by chromosomal abnormalities in the unborn baby, but we do not know what specifically causes these abnormalities.

The result is that the baby cannot develop normally, and the body spontaneously terminates the pregnancy. There are some things that have been identified as definite risk factors for miscarriage. Although there are no guarantees against a miscarriage, you can try to change your lifestyle or seek medical advice to reduce as many of these risk factors as possible.

Here are three things that you should definitely do during pregnancy to prevent a miscarriage: don’t smoke, don’t use illegal drugs and don’t drink too much alcohol.

You may have certain medical problems, hormonal disorders or chronic diseases that can affect your pregnancy – talk to your obstetrician before you get pregnant about your options for medical or surgical treatment to treat these conditions.

Certain infections during pregnancy, such as rubella, can also cause miscarriage, which is why it is very important that you be tested for these infections and take precautions to avoid being infected while you are pregnant.

Finally, getting pregnant at an older age, and above, puts you at higher risk of having a miscarriage.

However, I wish to stress again that these are only risk factors; just because you are an older mother-to-be does not mean you will definitely miscarry.

What if I have repeated miscarriages?

Some women have several subsequent miscarriages, which can be very distressing for them and their families. I comfort my patients by telling them that 85% of women who miscarry go on to have a healthy next pregnancy. Unfortunately, there are some women who have repeated miscarriages, due to medical problems that have not been treated.

For instance, if the repeated miscarriages are caused by cervical incompetence, you can undergo a procedure to keep the cervix closed throughout the pregnancy. If you have a chronic disease like diabetes, you have to keep the condition under control (such as by maintaining healthy glucose levels) to reduce the chances of another miscarriage.

If you have several miscarriages, your doctor should conduct a complete medical check to try and determine the cause. Often, however, your doctor will not have an answer. Do not blame him or her, as miscarriages still remain a mystery in medical science.

It may be Mother Nature’s way of ensuring that your pregnancy will not go on to harm you or your unborn baby. This is not a time for anger and recrimination between you and your partner. You will both need time to grieve and to come to terms with the fact. Cast out thoughts such as, “I should not have eaten that food”, “I should not have done that exercise” or even “I should not have had sex during pregnancy”. Blaming yourself or each other will only make the pain worse.

In my next article, I will talk about the emotional impact of a miscarriage, and how women and men can cope with it.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.

Source: TheStar, Sunday January 13, 2008

Missing children - the do's and don'ts

Lowdown on Chikungunya

Here are frequently asked questions about the Chikungunya virus.

By S.S. YOGA (yoga@thestar.com.my)

Source: The Star - Wednesday January 30, 2008

RECENTLY, nine people were reported to have contracted Chikungunya fever in Singapore. And apparently last year there were 10 cases reported. “Chiku what?” you’re probably asking.

Chikungunya is thought to be derived from the Makonde (of south-eastern Tanzania and northern Mozambique) word kungunyala meaning “to dry up or become contorted.”

A girl looking at a model of an aedes mosquito, which transmits the Chikungunya virus.

The fever is a viral disease transmitted by the bite of infected female mosquitoes. In fact, the mosquito is from the Aedes species, the same that can transmit the dengue and yellow fever virus, among others.

Here in Malaysia it is very rare and there were only three outbreaks reported. The first reported outbreak was in Port Klang in 1999 and it affected 27 people. In April 2006, 37 people in a small village, Bagan Panchor in Perak were diagnosed with it. Then in December that same year in Ipoh, it was confined to a very small area and 30 people were afflicted. Those affected were either workers from India or Malaysian workers who had returned from India (where an outbreak had been reported earlier).

To get you up to speed on the disease and the Chikungunya virus (CHIKV) here is a list of commonly asked questions.

What are the symptoms?

Those infected often have fever, headache, fatigue, nausea, vomiting, muscle pain, rash (but no related haemorrhaging), and severe and sometimes persistent joint pain. The fever lasts a few days to a couple of weeks, but some patients have prolonged fatigue lasting several weeks.

Some patients have reported prolonged joint pain and arthritis. As you may have noticed, many of the symptoms are similar to dengue except for prolonged joint pain.

The incubation period (time from infection to illness) can be two to 12 days but normally it is three to seven days.

Recovery is expected but elderly folks take longer and some may take a year or more. The authoritative health organisations say that no deaths have been conclusively proven due to CHIKV. And good news of sorts – infection (even “silent” ones without illness) is thought to confer life-long immunity.

The incidence of CHIKV infection may be higher than reported because of misdiagnosis (due to the symptoms resembling dengue).

How do you get infected?

A mosquito spreads it after biting a person who is already infected, in the daytime. Monkeys and possibly other animals may also serve as reservoirs.

The mosquito involved is the Aedes aegypti (white spotted body and legs) and there have been cases where the Aedes albopictus (the Asian tiger mosquito) has been the culprit.

How is it treated?

There is no vaccine or specific antiviral treatment for the fever (as in dengue). Treatment is rest, ingesting fluids and medication for mitigating pain and fever. Aspirin should be avoided.

It is recommended that the patient’s movements be restricted so that exposure to mosquitoes is limited in order to avoid further spreading of the virus. Note that there is no direct human-to-human transmission.

How do you prevent it?

Do what is normally done to prevent mosquito bites – use insect repellents, mosquito coils/mats/nets, proper clothing (that covers your body) and so on.

But the best way is to stop the mosquito from breeding. As they breed in clean stagnant water, any place or receptacle which has still water should either be covered or drained (whichever is applicable). Properly dispose used containers (cups, bottles and so on) as they will collect water.

Sourced from the Centers for Disease Control and Prevention and WHO.

Isteri hamil, suami jangan kalut!

Assalamualaikum warahmatullah dan salam sejahtera,

Ketika seorang ibu mengandungkan janin di dalam rahimnya, benarkah hanya si ibu yang bertanggungjawap terhadap hidup si janin? Tentu tidak, Allah telah menentukan keberadaan nyawa si janin atas usaha dari dua manusia, ibu dan ayahnya. Kepada meraka berdualah, Allah menurunkan amanah yang sangat berat ini. Sayangnya, lebih banyak golongan ayah yang kurang menyedari tanggungjawapnya sepanjang tempoh kehamilan tersebut. Penyebab utama, kerana meraeka tidak mengalami beban itu secara langsung.

Ada sesetengah suami, apabila mendapat berita bakal menjadi seorang ayah, perasaan gembira tidak tergambar. Tetapi dalam masa yang sama, kelam-kabut juga sebab tidak tahu apa yang harus dilakukan. Ada pula suami yang releks dan membiarkan isteri menanggung seorang diri kepayahan berbadan dua. Perlu ingat, sebenarnya suami berperanan besar dan harus ‘sporting’ bersama-sama isteri memikul tanggungjawap tersebut. Selama sembilan bulan dalam kandungan ibu, janin sebenarnya lebih banyak terangsang secara psikologi kerana tidak mendapat perhatian daripada ayahnya. Setelah si bayi lahir, dapat dilihat dengan mata, dapat dipeluk, cium, barulah tumbuh kesedara suami bahawa ia adalah seorang ayah! Sesungguhnya kesedaran it sudah terlambat. Dan yang rugi bukan sahaja si janin tetapi juga ayahnya. Di bawah ini adalah antara peranan yang boleh dimainkan oleh bakal ayah untuk anaknya.

Keperluan fizik

Ibu bapa tidak boleh meremehkan faktor keperluan fizikal janin. Pertumbuhan sel-sel otak, kualiti pertumbuhan badan serta tulang sudah mula ditentukan sejak janin lagi. Jangan sampai ibu bapa menyesal kemudian iaitu ketika mendapati rendahnya kualiti pertumbuhan bayinya ekoran lalai mempertahankan keperluan gizi sewaktu di dalam kandungan.

Secara ringkasnya, ibu perlu makan lebih banyak dari kebiasaannya untuk disubsidikan kepada janin dalam rahim. Belum lagi masalah kualiti, di mana makanan yang harus masuk cukup kandungan protein, vitamin, serta zat-zat gizi lainnya. Dan kewajipan ayahlah utuk menyediakan semua keperluan ibu demi pertumbuhan janin tersebut.

Ayah harus ikhlas memberikan keperluan ini, walau itu bererti ia harus menyediakan makanan berkualiti bagi isterinya dua kali lebih banyak daripada biasanya. Jika hanya ada sepotong, tak ada salahnya ayah mengalah untuk memberikan kepada ibu untuk manafaat dua orang. Jangan pula lupa memberikan keperluan tambahan vitamin, penambah darah serta kalsium bagi ibu. Ayang yang bijaksana akan rajin mengawal pola makan ihu hamil, menyediakan makanan ekstra berkualiti dan memberikan motivasi kepada isterinya untuk rajin mengambil makanan-makanan berkhasiat tersebut.

Amalan pemakanan ibu hamil

Tips pemakanan untuk ibu mengandung:

o Jauhi makanan dan minuman haram.

Antara kesan memakan dan meminum benda yang haram berdasarkan kajian ahli sufi ialah:
o Jiwa menjadi kotor, terganggu ketenangan jiwa, gelisah dan tidak tenteram.
o Berat untuk melakukan ibadah.
o Hati menjadi keras, suka dengki, degil, suka membantah dan bersifat kasar.
o Hati berat untuk menerima kebenaran
o Susah melahirkan anak.

Antara kesan memakan dan meminum benda yang haram berdasarkan kajian pakar ilmu jiwa ialah:
o Anak anak akan cenderung mencuri.
o Anak anak pun akan cenderung makan dan minum benda yang haram juga.
o Anak anak akan cenderung membuat kerosakan dan pemberontakan.
o Anak anak cenderung kepada perkara yang tidak bermoral.

Menjaga dari makan minum yang syubahat, iaitu makanan yang tidak diketahui status halal dan haramnya, kerana yang tidak pasti itu lebih menghampiri kepada haram. Jangan makan berlebihan dan sembarangan. Makan makanan yang cukup zat dan vitamin.

Antara makanan harian yang mengandungi zat dan vitamin yang penting untuk ibu ibu yang mengandung ialah:
o Zat Besi
o Kalsium
o Protin
o Mineral
o Vitamin A
o Vitamin B Kompleks
o Vitamin C
o Vitamin D
o Vitamin E

Kasih sayang dan perhatian

Penelitian membuktikan janin dalam kandungan sudah biasa merasakan sentuhan kasih sayang orang tua yang mengelus perut ibunya. Diapun dapat menikmati suara lembut penuh kasih sayang yang diperdengarkan orang tuanya di perut si ibu. Pegkaji menyatakan bahawa setelah lahir, bayi akan lebih aktif memberi tindakbalas jenis suara yang kerap ia dengar semasa dalam rahim lagi.

Memang sentuhan kasih sayang daripada ibu sudah cukup memenuhi keperluan kasih sayang bagi si janin. Namun perlu diingat, untuk boleh memberikan perhatian dan kasih sayang penuh kepada janinnya, si ibu memerlukan suasana kejiwaan yang tenang dan bahagia. Ibu yang tertekan dan stress tidak akan mampu memberikan perhatian dan kasih sayangnya secara maksimum kepada janin. Di sinilah suami mempunyai peranan besar dalam turut menjaga kesihatan emosi isterinya agar tetap stabil, tenang dan bahagia. Sebagai orang terdekat yang menjadi belahan jiwa bagi isteri, ia boleh menjadi penentu kesihatan jiwa si isteri.

Suami harus memberikan perhatian penuh kepada masalah kehamilan isterinya. Misalannya saling berbincang mengenai perkembangan yang terjadi bulan demi bulan, bersama-sama mencari informasi mengenai kehamilan dan pendidikan anak dari pelbagai sumber. Suami juga boleh bertukar pengalaman, menemani isteri memeriksa kehamilan setiap bulan, membincangkan peranncangan masa depan badi si bayi hingga meluangkan waktu mendelus perut isteri sambil mengucapkan ungkapan kasih sayang.

Lebih baik jika suami memberikan hak-hak istimewa kepada isterinya semasa hamil. Bukankah isteri sedang mengalami perjuangan berat demi keluarga mereka? Suami boleh memilihkan hak-hak istimewa yang mendorong perkembangan kesihatan janin. Misalannya, dengan memberikan makanan tambahan berkhasiat, memberikan wang belanja tambahan atau membelikan sebanyak mungkin buku dan majalah yang memuatkan informasi mengenai kehamilan dan pendidikan anak.

Hal lain yang perlu diingat ialah dalam proses kehamilan terjadi perubahan kadar hormon yang akan memberikan pengaruh besar pada kebanyakan wanita hamil, di mana emosi mereka jadi tidak menentu. Ditambah lagi dengan beban fizikal yang tidak ringan, wajar jiaka mereka lebih banyak memerlukan prhatian dibandingkan sebelum hamil.

Pendidikan

Pendidikan sudah biasa diterima manusia sejak masih dalam kandungan. Ayah dan ibu punya kewajipan sama untuk memberikan pendidikan ini. Kerana janin berusia tujuh bulan sudah mulai terangsang apabila mendengar suara-suara di sekitar perut ibu, jadi anda boleh memperdengarkan sesuatu untuknya. Alunan ayat-ayat suci al-Quran adalah pilihan terbaik, dan jika tidak ada tape recorder atau ear phone yang boleh dilekatkan ke perut ibu, maka ayah dan ibu bergantian untuk mengaji dengan suara kuat dekat perut ibu. Suara-suara lembut yang mengukir rasa keindahan, merangsang pertumbuhan otak dan kecerdasan juga boleh diperdengarkan kepada si janin.


Badan isteri hamil perlu diurut

Membawa beban perut yang semakin membesar, ada kalanya isteri hamil akan mudah mengalami kepenatan yang terlampau. Selain perlu mendapatkan rehat yang secukupnya, badan isteri hamil juga perlu diurut untuk merangsang urat menjadi lembut. Urat yang tegang akan membuatkan isteri hamil lebih cepat sakit-sakit badan. Urutan juga mampu membuatkan isteri hamil berasa lebih tenang dan perasaan yang berserabut akibat tekanan kehamilan akan menjadi lebih ringan. Suami digalakkan mengurut badan (bukan di bahagian perut) isteri supaya dapat meringankan beban yang ditanggung isteri dan ia juga mampu meningkatkan ikatan kasih sayang dengan sikap prihatin yang ditunjukkan suami.

Di saat proses kelahiran

Suami yang bertanggungjawap pun tidak akan kalah sibuk dan tegangnya dalam mempersiapkan waktu kelahiran janin dibandingkan si isteri. Banyak yang harus dilakukan suami untuk bersedia menghadapi masa genting ini seperti menyediakan belanja melahirkan, keperluan hidup bakal anak, pemulihan kesihatan ibu hinggalah ke persiapan untuk akikah anak.

Seterusnya, suami pun bertanggungjawap mempersiapkan kekuatan mental isteri untuk melahirkan. Harus diingat bahawa ini adalah saat perjuangan hidup dan mati isteri bagi keluarganya. Suami harus banyak memberikan perhatian, dorongan, serta motivasi kepada isterinya menghadapi masa sulit ini. Beberapa cara yang boleh digunakan seperti mengikut isteri ke kelas pendidikan pra kelahiran yang banyak dijalankan di klinik atau pusat rawatan bersalin, hinggalah turut menemani proses kelahiran itu sendiri.

Adalah satu hal yang sangat positif, jika suami boleh hadir ketika isteri melahirkan anak. Kehadiran suami ini, walaupun sekadar menemani, memegang tangan isteri dan membisikkan kata-kata menghiburkan kepada isteri, akan memberikan dorongan kekuatan mental dan semangat ekstra bagi isteri. Walaupun tidak dapat mengurangi rasa sakit, namun kekuatan mental dan semangat yang diperolehi isteri akan membuatkannya lebih kuat menahan sakit, yang pada akhirnya akan memudahkan proses kelahiran.

Mengenai penglibatan suami ketika proses kelahiran, pengkaji mengatakan bahawa selain bermanafaat untuk isteri, ia juga bermanafaat bagi suami sendiri. Ketika suami menyaksikan kesakitan yang dideritai isteri, perjuangan beratnya melawan maut, maka kelak suami akan lebih menghargai dan memahami perasaan isterinya. Selain itu, akan tumbuh perasaan istimewa dalam hati suami terhadap si bayi, sehingga akan lebih mengakrabkan ikatan batin antara ayah dan anak. Jadi, sebagai suami dan ayah yang baik, bantulah isteri anda menhadapi saat-saat genting semasa hamil, ketika melahirkan dan waktu dalam pantang.

Petua untuk ibu hamil

1. Banyakkan membaca Al-Quran, terutamanya surah mariam, yusuff, yunus, ibrahim, al-kaffi, yasin, ar-rahman, disamping surah-surah yang lain, insya Allah anak kita akan cerdik dan mudah mendengar kata. Banyakkan beribadat dan tunjukkan akhlaq yang mulia. Jika tidak mampu membaca Al-Quran, usahakanlah diperdengarkan bacaan ayat-ayat suci ini oleh bapa bayi dan boleh juga dengan melekapkan earphone ke perut.

2. Lakukan senaman Kegel untuk menguatkan otot-otot rahim. Macammana senaman ini ya? Bila buang air kecil cuba tahan, begitulah bentuk senamannya. Lakukan setiap hari, mulakan dari jumlah yang kecil dan tingkatkan dari hari ke hari.

3. Ibu yang sedang hamil biasanya akan mengalami masalah bengkak kaki. Ada petua yang boleh diamalkan untuk mengubatinya. Ambil sedikit jadam dan campur dengan air masak. Apabila sudah hancur dan pekat, sapukan pada kaki dan betis selepas selawat tiga kali. Seelok-eloknya sapu sewaktu hendak tidur. Amalkan dan anda akan dapat manafaatnya, insya Allah.

4. Untuk memudahkan sewaktu hendak bersalin, cuba petua ini. Setiap kali mandi dan membasuh rambut, hisaplah air yang mengalir dari hujung rambut anda sambil berselawat dan berdoa. Seeloknya diamalkan ketika hamil.

5. Amalkan meminum air bunga/akar genggam fatimah dari kandungan berusia 36 minggu ke atas. Dipercayai bagus untuk 'membuka' jalan/laluan bayi.

Semoga bermanafaat!




Capaian entry berkaitan :

• Seks semasa hamil
• Selamatkah berlari semasa mengandung?
• Q&A : Posisi seks ketika isteri hamil
• Pendarahan sewaktu hamil?

G6PD Deficiency

G6PD deficiency is an inherited condition in which the body doesn’t have enough of the enzyme glucose-6-phosphate dehydrogenase, or G6PD, which helps red blood cells (RBCs) function normally. This deficiency can cause hemolytic anemia, usually after exposure to certain medications, foods, or even infections.

Most people with G6PD deficiency don’t have any symptoms, while others develop symptoms of anemia only after RBCs have been destroyed, a condition called hemolysis. In these cases, the symptoms disappear once the cause, or trigger, is removed. In rare cases, G6PD deficiency leads to chronic anemia.With the right precautions, a child with G6PD deficiency can lead a healthy and active life.

About G6PD Deficiency

G6PD is one of many enzymes that help the body process carbohydrates and turn them into energy. G6PD also protects red blood cells from potentially harmful byproducts that can accumulate when a person takes certain medications or when the body is fighting an infection.

In people with G6PD deficiency, either the RBCs do not make enough G6PD or what is produced cannot properly function. Without enough G6PD to protect them, RBCs can be damaged or destroyed. Hemolytic anemia occurs when the bone marrow (the soft, spongy part of the bone that produces new blood cells) cannot compensate for this destruction by increasing its production of RBCs.

Causes of G6PD Deficiency

G6PD deficiency is passed along in genes from one or both parents to a child. The gene responsible for this deficiency is on the X chromosome.

G6PD deficiency is most common in African-American males. Many African-American females are carriers of G6PD deficiency, meaning they can pass the gene for the deficiency to their children but do not have symptoms; only a few are actually affected by G6PD deficiency.

People of Mediterranean heritage, including Italians, Greeks, Arabs, and Sephardic Jews, also are commonly affected. The severity of G6PD deficiency varies among these groups — it tends to be milder in African-Americans and more severe in people of Mediterranean descent.

Why does G6PD deficiency occur more often in certain groups of people? It is known that Africa and the Mediterranean basin are high-risk areas for the infectious disease malaria. Researchers have found evidence that the parasite that causes this disease does not survive well in G6PD-deficient cells. So they believe that the deficiency may have developed as a protection against malaria.

G6PD Deficiency Symptom Triggers

Kids with G6PD deficiency typically do not show any symptoms of the disorder until their red blood cells are exposed to certain triggers, which can be:

* illness, such as bacterial and viral infections
* certain painkillers and fever-reducing drugs
* certain antibiotics (especially those that have “sulf” in their names)
* certain antimalarial drugs (especially those that have “quine” in their names)

Some kids with G6PD deficiency can tolerate the medications in small amounts; others cannot take them at all. Check with your doctor for more specific instructions, as well as a complete list of medications that could pose a problem for a child with G6PD deficiency.

Other substances can be harmful to kids with this condition when consumed — or even touched — such as fava beans and naphthalene (a chemical found in mothballs and moth crystals). Mothballs can be particularly harmful if a child accidentally swallows one, so ANY contact should be avoided.

Symptoms of G6PD Deficiency

A child with G6PD deficiency who is exposed to a medication or infection that triggers the destruction of RBCs may have no symptoms at all. In more serious cases, a child may exhibit symptoms of anemia (also known as a hemolytic crisis), including:

* paleness (in darker-skinned children paleness is sometimes best seen in the mouth, especially on the lips or tongue)
* extreme tiredness
* rapid heartbeat
* rapid breathing or shortness of breath
* jaundice, or yellowing of the skin and eyes, particularly in newborns
* an enlarged spleen
* dark, tea-colored urine

Once the trigger is removed or resolved, the symptoms of G6PD deficiency usually disappear fairly quickly, typically within a few weeks.

If symptoms are mild, no medical treatment is usually needed. As the body naturally makes new red blood cells, the anemia will improve. If symptoms are more severe, a child may need to be hospitalized for supportive medical care.

Diagnosing and Treating G6PD Deficiency

In most cases, cases of G6PD deficiency go undiagnosed until a child develops symptoms. If doctors suspect G6PD deficiency, blood tests usually are done to confirm the diagnosis and to rule out other possible causes of the anemia.

If you feel that your child may be at risk because of either a family history or your ethnic background, talk to your doctor about performing a screening with blood tests to check for G6PD deficiency.

Treating the symptoms associated with G6PD deficiency is usually as simple as removing the trigger — that is, treating the illness or infection or stopping the use of a certain drug. However, a child with severe anemia may require treatment in the hospital to receive oxygen, fluids, and, if needed, a transfusion of healthy blood cells. In rare cases, the deficiency can lead to other more serious health problems.

Caring for Your Child

The best way to care for a child with G6PD deficiency is to limit exposure to the triggers of its symptoms. With the proper precautions, G6PD deficiency should not keep your child from living a healthy, active life.

info: http://www.kidshealth.org/

Anak Cemerlang

Sebenarnya tiada suatu pun formula yang ideal dalam usaha membentuk anak-anak untuk menjadi orang yang cemerlang kerana setiap anak itu memiliki keistimewaannya yg tersendiri yang telah dianugerahkan oleh Allah s.w.t.

Merujuk kepada satu hadith sahih dari Rasulullah s.a.w, mathumnya :

Ada 4 tahap dalam mendidik anak-anak iaitu :

Dari bayi hingga ke usianya 7 tahun

Pada masa ini, anak hendaklah disayangi dengan sepenuh hati oleh ibubapa. dibelai dengan penuh kasih sayang, diajak bermain, bergurau dan seumpamanya dijaga seperti menatang minyak yang penuh. Natijahnya agar anak sentiasa sedar dan fikir bahawa ibu bapa adalah rujukan terbaik bagi mereka dalam semua hal yang mereka hadapi.

Dari usia 8 hingga 14 tahun

Dalam pada anak diasuh dengan penuh kasih sayang, anak mesti dididik dengan penuh disiplin dan diajarkan tentang pengagihan tanggungjawab tak kira di rumah atau pun di sekolah.

Dari usia 15 hingga 21 tahun

Ketika ini anak hendaklah didekati secara berkawan. Ibu bapa tidak lagi boleh marah-marah yang melampau pada anak kerana jiwa remaja mereka akan memberontak. Jangan sesekali mengherdik apalagi memukul anak-anak tersebut.

Dari usia 21 ke atas

Berikan kebebasan kepada anak dalam membuat keputusan sendiri atas apa yang ingin mereka kerjakan. Dalam pada itu, ibu bapa mesti sentiasa pantau, pesan, doa dan nasihat anak tersebut semoga hala tuju mereka betul. Hasil dari rujukan kepada Al-Quran, As-Sunnah dan kajian-kajian yang telah dilakukan oleh pakar-pakar dalam bidang ini, di bawah disenaraikan 21 kaedah terbaik dalam membentuk anak-anak kita menjadi orang yang cemerlang.

1. Mendidik anak dengan pesanan dan arahan setiap hari bersesuaian dengan tindak tanduk dan amalan yang ibu bapa inginkan. Jangan sesekali bosan dalam memberi pesanan kepada anak-anak. Menurut satu kajian, standard memberi pesanan dan arahan pada anak-anak pada setiap hari adalah sebanyak 200 kali. Barulah anak tersebut akan dapat dibentuk rutin kehidupannya mengikut apa yang ibu bapa mahu.

2. Banyakkan bercerita dengan anak-anak atas apa jua perkara yang baik-baik. Boleh mengambil iktibar dari Quran, kisah para rasul dan para sahabat. Malah ibu bapa pun boleh mereka cerita mereka sendiri. Yang pentingnya, ianya mestilah punya natijah yang boleh diteladani dan jangan sesekali bercerita tentang hal yang melalaikan.

3. Selalu bersoal jawab dengan anak-anak secara istiqamah (berterusan). Bertanya kepada anak tentang hal yang telah dilaluinya sepanjang hari dan apa pula yang telah dilakukannya. Dan bila anak bertanya pula, ambil kira setiap soalan yang diajukan dan sentiasa berusaha menjawab semua soalan tersebut secara hikmah.

4. Mendidik anak dengan merujuk kepada pengalaman yang telah lalu yang pernah dirasai oleh ibu bapa. Juga boleh mengambil iktibar dari pengalaman orang lain baik yang negatif mahupun positif. Ini akan lebih mudah menjelaskan mesej yang hendak disampaikan kepada anak-anak.

5. Mengasuh anak-anak melalui nasihat dan teguran . Nasihat dan teguran berlainan sedikit dengan pesanan dan arahan yang perlu dilakukan setiap hari. Nasihat dan teguran dibuat sesekali sahaja supaya anak tidak cepat bosan. Mungkin dalam seminggu sekali atau dua kali sahaja. Nasihat dan teguran adalah lebih menjurus kepada pembentukan:

• Aqidah anak-anak tersebut

• Ibadah dan amalan hariannya

• Akhlaknya

• Kerjasama di dalam dan di luar rumah

• Tanggungjawab yang perlu ada dalam dirinya

• Kesihatannya

• Sangka baik dalam diri

• Suci hatinya pada Maha Pencipta dan makhluk disekelilingnya

6. Banyakkan bermain dan bergurau dengan anak-anak dan sentiasa selitkan unsur-unsur nasihat yg bermanfaat di dalamnya.

7. Banyakkan memberikan latihan dan tugasan kepada anak-anak termasuklah dalam kerja-kerja di rumah. Tugasan diberikan mengikut usia, tahap kemampuannya dan bersesuaian dengan jantina anak itu. Kerja tersebut juga hendaklah diberikan mengikut waktu yang sesuai dan kena pada tempatnya. Sentiasa pantau kerja yang dilakukannya dan segera perbetulkan mana-mana kesalahan atau tabiat yang tak elok. Jangan kutuk anak kalau mereka buat salah dalam tugasannya dan jika memuji anak biar berpada-pada.

8. Amalan dan tindak tanduk ibu bapa menjadi contoh kepada anak-anak.

• Ibu pada yang sederhana memberitahu anak-anak apa yang mereka perlu lakukan.

• Ibu bapa yang baik memberikan penjelasan tentang apa yang dia minta anak dia buat.

• Ibu bapa yang cemerlang memberikan contoh tentang sesuatu perkara yang diberitahu dan dijelaskan kepada anaknya.

• Manakala ibu bapa yang mithali, sentiasa menggerakkan anak-anaknya untuk menjadi manusia cemerlang.

9. Sentiasa memberikan galakan dan amaran pada anak-anak iaitu dorongan ke arah yang positif dan berikan hukuman bila anak buat kesalahan dengan hikmah. Menurut kajian pakar-pakar psikologi, galakan diberikan 80% dan 20% lagi untuk amaran. Galakan yang banyak akan jadikan anak-anak lebih ceria dan anak-anak yang ceria lebih menjurus ke arah individu yang cemerlang.

10. Lakukan suruhan dan gesaan pada anak-anak dengan tidak perlu berulang-ulang kali memberikan peringatan. Gesaan dilakukan pada anak dengan sekali arahan sahaja. Ibu bapa perlu ada tindak susul pada anak atas apa yang diminta lakukan. Jika ibu bapa perlu beritahu anak banyak kali dalam sesuatu hal pada sesuatu masa, ia ditakuti akan boleh menjadikan anak seorang yang degil

11. Ambil berat kebajikan anak-anak. Ibu bapa perlu tunaikan hak-hak anak yang sewajarnya. Ibu bapa mesti menyediakan keperluan yang munasabah untuk anak-anak yang mana anak tersebut layak terima dan sesuai dengan kemampuan ibu bapa tersebut.

12. Ibu bapa gunakan firasat dan gelombang minda dalam mendekati anak-anak. Tak perlu tunggu anak menceritakannya pada ibu bapa bila berdepan dengan sesuatu masalah. Praktikalnya amat penting terutama bagi ibu bapa yang mempunyai anak-anak yang sensitif yang mudah tersentuh hatinya. Allah berikan kehebatan ini pada ibu terutamanya dalam menyelami hati budi seseorang anak. Gunakan juga kaedah ini untuk menasihati anak-anak pada sepanjang masa.

13. Menjana keyakinan dan kekentalan diri anak. Ulama dan ahli psikologi menyarankan bahawa antara perkara yang boleh dilakukan dan dilatih pada anak-anak termasuklah :

• ajar anak-anak menyimpan rahsia

• latih anak-anak berpuasa

• bentuk kemahiran sosial anak, contohnya dalam cara berkawan yang betul

• luaskan ruang lingkup pembacaannya supaya pengetahuan amnya hebat dengar pendapat anak

• ajarkan anak cara membuat keputusan yang baik dalam sesuatu hal memberikan pujian pada anak-anak berpada-pada

• ajar mereka cara berniaga

14. Kenalpasti kecenderungan dan minat anak-anak. Selain dari memerhatikan sendiri anak- anak tersebut, boleh juga bertanya kepada guru atau rakan tentang hobi anak-anak, mungkin ada yang ibu bapa terlepas pandang. Pupuk minat mereka supaya mereka selalu gembira kerana anak yang ceria mudah jadi orang yang cemerlang.

15. Pilih waktu yang sesuai dalam menasihati anak-anak . Waktunya termasuklah ketika :

• masa rehat dan bersantai dengan anak-anak

• beriadah atau berikreasi dengan anak-anak

• di dalam perjalanan

• anak hendak tidur, sedang tidur atau ketika baru bangun dari tidur

• selepas waktu mandi

• selepas solat bersama anak-anak

• selepas anak-anak membaca Al-Quran

• ibu bapa membaca Al-Quran, ditiupkan pada kepala anak dan dinasihatkannya

16. Ibu bapa hendaklah bertahap-tahap dalam mendidik anak-anak mengikut tahap intelektual dan usia anak-anak berkenaan. Didikan pada anak juga hendaklah singkat, padat, bermanfaat dan tidak membosankan.

17. Pastikan anak-anak mematuhi perintah Allah dan meneladani sunnah yang dibawa dan diajarkan oleh junjungan besar Rasulullah s.a.w. Ibu bapa sentiasa memperbaiki amal ibadah dalam keluarga selaras dengan tuntutan agama.

18. Isi waktu lapang anak-anak dengan perkara-perkara dan kegiatan-kegiatan yang berfaedah . Jauhkan sama sekali dari melakukan hal-hal yang melalaikan.

19. Beri ruang kepada anak-anak untuk berdialog dengan ibu bapa secara terbuka tetapi dalam keadaan dan situasi yang penuh hikmah.

20. Rangsang kecerdasan minda anak-anak dengan pemakanan yang seimbang. Pastikan :

• adanya diet yang betul dan vitamin tambahan yang bersesuaian.

• makanan adalah halal , bersih dan tiada unsur-unsur subahat.

• banyak beriadah/bersenam untuk menjaga tahap kecergasan badan

• ajar teknik belajar dan berfikir yang betul

21. Doakan mereka berterusan secara positif sampai bila-bila dari mereka kecil hingga ke akhir hayatnya. Ibu bapa perlu sentiasa ingat bahawa apa yang ibu bapa fikirkan dan cakapkan pada anak-anak adalah doa yang sangat mustajab

SOURCE : Haji Dato Dr. Mohd Fadzilah Kamsah

Come on, baby

When your pregnancy has reached term, but baby shows no sign of coming out, what can you do?

THE other day, I saw one of my patients, who was 40 weeks pregnant and nearing her due date. After examining her, I asked her how she was feeling.

“Well, doctor, this pregnancy thing is getting tiring. Is there any way to make the baby come out sooner?” she asked, half-joking.

She’s not the first pregnant woman to ask that question. By the 37th week, pregnancy has lost its glow and most women just want to be done with it so that there will be no more fatigue, swelling, leg cramps, backaches and sleep problems.

Some babies are ready to come out at 38 weeks, while others can stay in there until 42 weeks! Many first-time mothers deliver at 41 weeks.

Some patients have complained to me, “Shouldn’t doctors be able to accurately predict my due date?” The answer is yes and no. Due date prediction is not an exact science and it depends on many factors throughout pregnancy.

I always tell my patients that there is a reason the baby is staying in there just a bit longer. This is the time when the baby is developing, and forcing it to come out too early may interrupt his or her growth.

However, after week 40, there is no harm in trying to induce labour with natural methods. I will discuss a few of these methods in this article.

Stress and anxiety can suppress the flow of oxytocin, the hormone that stimulates contractions. Relaxing the body and mind may just encourage baby to come out. - Photo by Photos.com

Natural labour inducers

First of all, remember that you should never EVER try to induce labour before 38 weeks. You should also discuss any of these methods with your obstetrician before trying them. Some of these methods are merely primers – they are safe for almost all women at any time in the weeks before labour. Here are some of the common primers:

Relaxation – Stress and anxiety can suppress the flow of oxytocin, the hormone that stimulates contractions. Relaxing the body and mind may just encourage baby to come out. Try having a quiet day at home, taking a warm bath, getting a massage from your partner or listening to some soft music.

Sex – I don’t blame you if you’re not feeling too sexy at the moment, but this is actually not a bad idea. The semen contains prostaglandins, which help to ripen your cervix and prepare it for pregnancy. Orgasms can also trigger your contractions. Sex can also help you kill two birds with one stone – it is a stress reliever as well!

Walking – This is to help your baby move further into your pelvis for delivery. Other methods like bouncing or rocking on a birthing ball use similar principles of gravity to help the baby settle into the pelvis. If you have already started having contractions, walking will help to relieve the discomfort and encourage the process of labour.

Evening primrose oil – EPO contains the precursors to prostaglandins, which will help to ripen your cervix. You can take EPO supplements, but discuss the dosage with your doctor before starting. Some people may advise you to insert EPO into the vagina, but you should not do this because it could increase your risk of infection.

Raspberry leaf tea – It is believed that this can help make contractions more effective during labour. Raspberry leaf tea can be found at health food stores. You have to drink one to two cups a day starting any time during pregnancy. Don’t forget to drink water as well!

Then there are the inducers – these are the ones you should only try after 38 weeks. Most of these methods should only be done by your doctor or midwife, or under their supervision.

Nipple stimulation – Stimulating the nipples by hand or with a breast pump releases oxytocin, which can cause contractions. This should only be done with the approval or supervision of your doctor, so that you do not cause overly strong contractions that can cause your baby’s heart rate to slow down. Get your doctor’s advice on how to do this properly. But don’t worry, inadvertent nipple stimulation during foreplay or intercourse will not cause a problem.

Membrane stripping – This is a method of inserting a finger through the cervix and “sweeping” the membranes of the lower uterus to release the prostaglandins. Obviously, only your doctor should perform this – and there are risks involved with this procedure, so be sure to get all the facts before agreeing to it.

Acupressure – In traditional acupressure, it is believed that there are various points on the body that trigger labour. One point is located in the roof of your mouth, and sucking on a lollipop or your thumb may trigger that pressure point. The other point is four finger-widths up on your calf from the inside left ankle. Apply pressure for 15 seconds, release and repeat.

Inducers to be careful of

There are some methods that are passed on as traditional or cultural advice, but some of these do not hold water and may be dangerous for you and your baby. Castor oil is one method that is frequently cited, although I would not recommend it. Castor oil is actually a laxative and triggers spasms in your intestines. These spasms may irritate the uterus and cause contractions.

However, this side “benefit” of castor oil is not worth it – not only is castor oil smelly and foul-tasting, it will also cause painful diarrhoea and a risk of dehydration. Spicy foods are believed to work on the same principle, although they are more “gentle” in stimulating the bowels, compared to castor oil. Again, I would advise against using this method, because spicy food can cause painful heartburn.

Some people believe that certain herbs like blue and black cohosh can be used to induce labour. However, I would advise against it because there is not enough scientific evidence about the effectiveness and safety of these herbs. Blue cohosh may raise your blood pressure too much, damage your baby’s heart or cause uncontrollable haemorrhaging in the mother. Herbs aren’t always safe, even though they are touted as “natural”.

Finally, don’t stress yourself out about labour and delivery! Your baby will come out when he or she is ready, and your doctor is there to keep an eye on you. Use this time to relax, read, prepare yourself for impending motherhood and share your feelings with your partner. Soon, you’ll be a mum!

WOMEN'S WORLD By DR NOR ASHIKIN MOKHTAR, The Star, Sunday January 27, 2008

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Whooping babies

By Dr Zulkifli Ismail, TheStar 20/01/2008

The good news is, the incidence of whooping cough (pertussis) among newborns is very low. The bad news is, those who do contract it are getting it from infected adults. Here’s how you can protect your children.

It had been ten years since she gave birth to her son Zaki, and today, Sabariah is the proud mother of her new baby girl Zara. The weeks after bringing Zara home from the hospital were hectic: relatives and friends were popping in to visit the new baby every day. Sabariah and hubby Amir ran themselves ragged, entertaining the steady stream of well-wishers. One day, Sabariah started coughing and developed flu-like symptoms, with a tingling sensation in her throat. Blaming it on the stresses of being a new mother, she decided to treat herself with over-the-counter cough medications.

The majority of pertussis infections in newborns are actually caused by infected adults. - Reuters photo

Within a week, Sabariah’s cough became persistent and she became more breathless. She finally went to see her doctor and was diagnosed with pertussis, also known as whooping cough. At that point, baby Zara was starting to experience symptoms of the infection – she had bouts of severe coughing ending with a “whoop”, and each cough made her face red and left her more irritable and distressed. Zara too was diagnosed with pertussis.

Sabariah was told that her immunity had decreased over the years even though she had been vaccinated against pertussis as a baby. In the meantime, Zara had yet to complete her three-dose vaccination course against pertussis, which made her vulnerable to the disease. To prevent the infection from spreading, the doctor recommended an immediate booster vaccination for 10-year-old Zaki.

What is pertussis?

Pertussis is a serious infection of the respiratory system caused by the Bordetella pertussis bacteria. Even though this disease is preventable with vaccination, there is still between 30 and 50 million cases of pertussis infections worldwide annually, with 300,000 of these cases resulting in deaths.

In Malaysia, all babies are required to receive the DTP (Diphtheria, Tetanus and Pertussis) vaccine. The effectiveness of the vaccine has led to a dramatic decline in pertussis infections. In fact, the World Health Organization’s Immunization Profile of Malaysia reports that only six cases of pertussis were reported in 2006.

Infants receive their DTP vaccination shots at the age of two months, three months and five months, with a booster at 18 months. - Reuters photo

Full immunity against pertussis for newborns is only attained after the third dose of the vaccine, administered when the baby is five months old. Exposure to the bacteria at any time before full immunity is achieved can lead to an infection, which can result in deadly effects. The problem is, immunity doesn’t last forever; it decreases by the time a child turns 11 or 12 years old.

However, 12-year-olds are given a booster shot against pertussis, so it’s unlikely that they will contract pertussis and pass it on to a newborn baby. The majority of pertussis infections in newborns are actually caused by infected adults.

What are the symptoms?

Early symptoms of a pertussis infection mimic those of the common cold. These would include a runny nose, mild coughing, low fever and sneezing. Between one and two weeks into the infection, coughing intensifies into coughing spells. Most of the time, a whooping sound accompanies the coughing at the end of the bout, hence its name. Persistent coughing spells may also cause some children to vomit.

However, not everyone infected with pertussis will produce a whooping sound or a coughing spell. Babies may gasp for breath, subsequently turning red in the face. They may even stop breathing for several seconds during bad spells (“apnoea”). Some adults or adolescents may just develop prolonged coughs, without the whooping sound. These often go undiagnosed and are treated as conditions like the common cold or asthma.

How contagious is it?

A pertussis infection is highly contagious as it is spread through droplets in the air when an infected person sneezes, coughs or laughs. Thus, anyone located in the same room as an infected person risks catching the infection simply by inhaling, or by rubbing their noses and mouths with their hands after unknowingly touching the droplets. Also, an infected person can start spreading the bacteria from the early stages of infection, until about two weeks after coughing commences.

Can pertussis be treated?

While infected adults, adolescents and older children recover from pertussis with a course of antibiotic treatment, younger children and babies may need to be hospitalised. Complications that may arise include pneumonia, dehydration, ear infections and seizures. Serious complications of pertussis that can cause death in babies younger than six months of age include cerebral haemorrhage, hypoxia and encephalopathy (infection of the brain).

Can pertussis be prevented?

Fortunately, in preventing pertussis infections, modern science has brought us the pertussis vaccine. It is administered as a three-in-one vaccine known as DTP, a vaccination against Diphtheria, Tetanus and Pertussis. The DTP vaccination is one of the vaccines under the National Immunisation Programme of the Ministry of Health of Malaysia, which aims to immunise every child in Malaysia.

Infants receive their DTP vaccination shots at the age of two months, three months and five months, with a booster at 18 months. As the effectiveness of pertussis vaccinations typically last about five years, it is recommended for adults to be given boosters to prevent pertussis. This is especially important so that adults don’t act as reservoir of infection and pass it on to a baby who has yet to complete his or her full course of DTP vaccination.

The adult booster vaccine differs from the infant vaccine and has less diphtheria and pertussis components (dTp). Adult booster vaccines are encouraged for all adults who are in contact with infants. These include nursery teachers, day-care workers, maids and nannies, even health care workers especially paediatric hospital staff.

Lifelong immunity

If you are a parent, ensure that your baby is given the appropriate vaccinations against pertussis according to the local immunisation schedule. Ensure continued immunity against this infection for your children by making sure that they receive their booster shots at 12 years old. Adults are also strongly recommended to get booster shots every 10 years as well. Bring this up at your next visit to the doctor.

Ø Dr Zulkifli Ismail is a consultant paediatrician, immediate-past president of the Malaysian Paediatric Association and chairman of the Positive Parenting Management Committee. The Positive Parenting Programme is managed by Malaysian Paediatric Association and supported by an unconditional educational grant from GlaxoSmithKline. For more information, please visit www.mypositiveparenting.org