Dear Doctor ‘P’ 16

Send your questions to: pregnant@integral-advisory.com
Answers are provided jointly by our team of doctors

Our Team of Experts
Dr. Blasio Omuga
Lecturer, School of Nursing Sciences, University of Nairobi Consultant Obstetrician/Gynaecologist Based at Doctors’ Plaza, Clinic No. 18. Kenyatta National Hospital

Dr. David Kiragu
Consultant Obstetrician/Gynaecologist Based at KAM Health Services IPS Building, 1st Floor, Kimathl Street. Nairobi

Dr. Weston Khisa
Consultant Obstetrician/Gynaecologist Bared at Hurlingham Family Health Clinic Nyaku House, Hurlingham. Nairobi

Dr. Kituyi Adelaide
Consultant Paediatrician Based at Afya Royal Clinics Uchumi Hyper, Mezz Floor, Ngong Road. Nairobi

Breast milk leakage
I am 32 weeks pregnant and a first time mum-to-be. Lately, I have noticed that my breast milk is leaking. This has worried me. I need to know if this is a normal occurrence. If not, what causes it and how can I prevent it?
Bernadette

It is normal for breasts to be active and leak during pregnancy-especially after the 16th week of pregnancy. This is caused mainly by oestrogen (a hormone involved in the female menstrual cycle) and progesterone(the female sex hormone essential to normal life and to maintaining pregnancy).

More so the case if the mother-to-be stimulates or massages the breasts/nipple. There is no danger posed by breast milk leakage, and it resolves on its own. It is nevertheless advisable to avoid squeezing the breasts.

Loss of breast firmness
I recently got married and we are planning to have a baby. However, I am worried about the changes that occur to a woman’s breasts during and after pregnancy. How does it happen that a woman’s breasts become less firm? What changes does suckling bring to a woman’s breasts and is it a must that the breasts have to sag? Is there anything that can be done about it?
Wambui

A woman’s breasts enlarge during pregnancy and the breastfeeding period. This causes stretching of the supporting ligaments and after breastfeeding, the ligaments do not perfectly retreat to their original position.

Wearing a well fitting brazier during pregnancy and the breastfeeding period might help. In extreme cases, breast surgery may be undertaken, though not common in East Africa.

The best however, is to adjust psychologically to the natural breast changes and have a non-surgical approach to their management.

Is it meconium?
I have a three-day-old baby and I have noticed that he is too fussy. I am suspecting it could be meconium causing him pain as it clears off his system. How long does it take for meconium to clear off a baby’s system?
Joanna

Meconium is the first baby stool that gradually transitions to normal baby stool. Generally, meconium does not cause a newborn pain while clearing off the baby’s system.

A firm meconium plug (the hardened stool) may cause Irritation or pressure during the first few days of a child. This plug may produce total intestinal obstruction. Once the plug is passed the condition is quickly resolved and usually does not recur.

Colic (distension of abdomen or intestines by gas) caused by swallowed gas or indigestible milk can also cause pain in the abdomen.

As there are many possible reasons, seek the help of a paediatrician to identify the exact cause of your baby’s discomfort.

Bitter taste in my mouth
I am seven months and two weeks pregnant. Since my third month of pregnancy, my mouth always has a very bitter taste. This is my first pregnancy. I would like to know the reason l am experiencing this.
Violet

During pregnancy, many changes occur from the onset. These are related to smell, taste and eating habits. Bitter food may appear sweet to the palate and vice versa. As an expectant woman, you will realize that almost every part of your body is changing. This is partly influenced by hormones.

There is also slight reduction in immunity in an expectant mother. Due to this, Candida albicans, a fungus, may colonise the mouth and cause the bitter taste. In most cases, these changes are natural, temporary and disappear after pregnancy. You may consider using mouth sweeteners. If the bitterness becomes unbearable, seek professional help.

END:PG16/06