Reply To Anonymous

Hi Dr
I'm breastfeeding my 3.5mo bb and just had a sebaceous cyst removed today. I was presribed Unasyn 375mg antibiotics and for painkiller Biogesic 500mg. I don't know what's the name of the anaesthetic and antibiotic that was administered on me for the surgery.
The surgeon sd the medicines are suitable for pregnant women. But I worry it may not be so for babies.
A wk b4 the surgery I was prescribed by a GP Klasid and Papase to treat the supposed infection of the cyst. I was assured this was safe for the bb. But my bb reacted badly to it. (this prompted me to seek specialist treatment instead)
I've been pumping and disposing of my milk for the whole of today & the next 3 days. I feel so sad doing that bec I'm not the type who have lots of milk.
I wish to get your opinion if the prescription is really ok for bb.

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Hi! Anonymous,

Welcome to this blog. Your questions will make this blog more interactive and informative.

Let me summarise your problems:
1) Infected Sebaceous cyst which was recently surgically removed.
2) Currently on antibiotic Unasyn and painkiller Biogesic.
3) Breastfeeding to your beloved newborn while on treatment of antibiotic.
4) Low breast milk production.

Generally, antibiotics are safe for the breastfeeding mothers as the concentration of antibiotic that present in the breast milk is very low.

Furthermore, the doctor only prescribed low dose of Unasyn 375mg. The usual dosage of Unasyn is 625mg. With this low dose of Unasyn, the amount of medicine to go to breast milk is extremely low.

Biogesic is a painkiller. As far as you are comfortable and pain free after the surgery, you can avoid from taking this medicine. My suggestion is you need to complete your antibiotic treatment and stop the painkiller as far as you are pain free.

Before taking the antibiotic, you should breastfeed your baby and fully extract the breast milk by using the breast pump. Once the antibiotic is taken, you should abstinent from breast feeding for 4 to 6 hours to avoid any side effect to your baby. After 4 to 6 hours, usually the effect of the antibiotic is over and you can safely breastfeed your baby again. This is the precaution step you can take to avoid the harmful side effect of antibiotic to your baby.

Regarding the low breast milk production problem, you should drink more water and consume more fish protein to stimulate the breastmilk production. You should breastfeed your baby every 3 to 4 hours to enhance the production, avoid from wearing tight bra which may reduce the production due to pressure effect. Hormone injection (Oxytocin injection) sometimes is helpful to increase the milk production.

The Underweight Baby

A baby is considered underweight if the birth weight after 9th months of pregnancy is less than 2.5kg

What are the common reasons for the baby to be underweight?

The birth weight of the baby is genetically determined. If both parents are small size, most of the time the baby is small as well.

Sometimes, the baby is small because the growth potential is affected.

Among the factors that can influence the growth potential of the baby:

1) Mother’s living lifestyle is under constant stress
2) Lack of nutrition and vitamin
3) Pregnancy less than 1 year after the last childbirth
4) Placenta is not functioning normally to supply food to the baby.
5) Baby may has underlying congenital diseases, such as heart diseases
6) Baby acquires infection inside the womb.





What are the problems associated with low birth weight?

Sometimes, the underweight baby may pass motion inside the womb and requires emergency caesarean.
A low birth weight baby has a higher chance of jaundice (黃疸) in the first few days of life.
They are also prone to infection due to weak immune protection.
Some of the low birth weight baby may have learning disability and behavioural problem in the future.

A jaundiced baby under photo light treatment



What should I do to make sure my baby is growing normally inside my womb?

First of all, you need to modify your lifestyle during pregnancy period.

You are not advised to smoke, consume alcohol , take excessive coffee and tea.
You need to have 8 hours of sleep everyday.
During every visit to see your doctor, the doctor will monitor the growth of the baby by using scan to estimate the baby weight.
Sometimes, Colour Doppler Scan is done to assess the function of placenta and the blood flow in the umbilical cord.

Colour Doppler Scan

Baby Weight

There are still many questions asked by the readers about the baby weight according to the month of pregnancy.

Today I will repost my earlier article in this blog.

The estimated weight of the baby according to the month of pregnancy:

16 weeks ( 4th month)

Average Weight : 140g

Normal range : 80g to 200g

20 weeks ( 5th month )

Average weight : 310g

Normal Range : 230g to 460g

24 weeks ( 6th month)

Average weight : 560g

Normal Range : 445g to 970g

28 weeks ( 7th month )

Average weight : 1140g

Normal range : 800g to 1540g

32 weeks (8th month)

Average weight : 1750g

Normal range : 1300g to 2200g

36 weeks (9th month)

Average weight : 2240g

Normal range : 1880g to 3100g

40 weeks (10th month)

Average weight : 2900g

Normal range : 2300g to 3500g

Reply To Anonymous

Anonymous said:

Hi Dr Jason, I am 3 1/2 months pregnant now with my first child. I had a miscarriage beginning of the year. Is it ok for me to go for massage? Must it be those pre natal massages only? Can I go for thai massage but only on shoulder area as I feel my neck and shoulders are very tense. I read that aromatherapy oil shouldnt be used. Is it true?

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Hi! Anonymous,

Congratulation for your new pregnancy. Apparently your pregnancy is more than 3 months now. The chance of miscarriage after 3 months is very low. I believe this pregnancy is going to be fine and hopefully you will deliver a healthy and chabby baby.

Massage in pregnancy is safe as far as your tummy is not involved. General massage or even Thai Style massage not involving your tummy is acceptable. Shoulder ,neck and back massage is safe.

Don’t worry, if you really keen to relax the muscle by using the massage method, you can do so.

There is no medical evidence to prove that aromatherapy oil is harmful to your baby.

But if you want to be extra careful, you can choose powder massage.

Tubal Ligation (絕育手術)

Tubal ligation is a permanent birth control procedure commonly known as "having your tubes tied."

The procedure prevents pregnancy by preventing transport of the egg to the uterus and by blocking the passage of sperm up the fallopian tube to the egg.

How to perform this surgery?

There are 2 methods to perform this surgery:

1) Immediately after the childbirth. A incision is made below the umbilicus (肚臍).
Both fallopian tubes ( 輸卵管) are identified and ligated by using a string.

Fallopian tubes (輸卵管) are ligated and disconnected.

2) Keyhole surgery by using a laparoscope ( 腹腔鏡) equipped with a camera. Both fallopian tubes are clipped by staples.

Fallopian tubes are clamped by Staples

Who should do it?

a)Women who have completed their family and do not have any intention for further pregnancy.

b)Women with underlying medical illness that make them not suitable to pregnant.

How effective is Tubal ligation to prevent pregnancy ?

The failure rate of tubal ligation is 1 in 200. It means every 200 women who had tubal ligation, 1 of them may still get pregnant eventually.

What is the side effect of tubal ligation?

This surgery is a common operation and can be done safely by the doctor. Long term side effect is not commonly happen.
There is no medical evidence to associate tubal ligation with menses disturbance, sexual dysfunction and hormonal imbalance.

Antenatal Exercise (孕妇运动)

Exercise is important during pregnancy to promote physical and emotional wellbeing.
Regular exercise will improve blood circulation through the placenta and promote growth of the baby.
However, the pregnant ladies need to follow the safety guidelines to avoid unneccessary physical injury related to exercise.


Guidelines to ensure safety and well-being during pregnancy with your exercise program


Things To Do's



1) If you have been following a regular exercises program before your pregnancy, maintain that program to some degree throughout your pregnancy.

2) Exercises does not increase your risk for miscarriage

3) If you are a beginner, you should start very slowly and be careful not to over exert yourself.

4) Listen to your body signal for the level of exercises performed - the competitive element must be avoided.

5) Regular exercises sessions - at least 3 times per week - are safer than intermittent bursts of activity

6) Careful 'warm - up' should precede vigorous exercises which must be followed by -cooling-down' or gradual decline in activity.


7) Drink plenty of water and take frequent break.


8) Eat healthy diet that includes plenty of fruits, vegetables and complex carbohydrates.




Things To Avoid


1) Avoid jerky, bouncing, ballistic movement and activities.

2) Never exercises to the point of exhaustion or breathlessness. This is a sign of your body and your baby cannot get the oxygen supply needed.

3) Avoid exercise in extremely hot weather. Mother heart rate should not exceed 140 beats per minute and vigorous exercises should not be longer than 15 minutes.

4) Avoid rocky terrain or unstable ground when running or cycling.

5) Avoid contact sport (hockey, netball, volleyball).

6) Avoid lifting weights above your head and using weights that strain the lower back muscles.

7) Do not over bend any joints.

8) Stop exercises immediately if you experiences symptoms such as: chest pain, vaginal bleeding or uterine contraction, or if your membrane rupture, blurred vision, dizziness, fainting, irregular heart beats, increase swelling in your hand, feet and ankles, and Sudden change in body temperature.

9) During second and third trimesters, avoid exercises that involve lying flat on your back as this decreases blood flow to your womb.