Reply To Kathy

Dear Dr. Jason,

I'm into 6th week of my first pregnancy. I'm losing my appetite and this often cause gastric pain. I do drink liquid food but sometimes i still get gastric. May i know what should i eat and can i take actal when i have gastric pain? Thank you

Kathy

.......................................................................................

Hi, Kathy,

You are suffering from morning sickness due to your pregnancy. During early stage of your pregnancy, your body hormone suddenly increased. This pregnancy hormone will lead to a few changes in your body :

1) Dizziness and vomiting, particularly during early morning when you wake up from sleep

2) Indigestion or commonly we know as " Stomach wind "

3) Breast distension and pain

4) White discharge from your private part.

The presence of these pregnancy symtoms indicates that your baby is fine and in good condition.

In an unhealthy pregnancy, the mother will not suffer from these symptoms due to lack of hormone production.

So, actually it is a good thing to happen, Kathy.

There are a few things you can do to reduce your suffering :

1) Take small and frequent meals. Avoid over-eating to reduce gastric distension.

2) Since your appetite is poor and you can't eat a lot, try to eat in small portion, but always choose high nutritious diet, eg: egg, formula milk, protein based food, fruits and veges

3) Go for liquid diet if you can't swallow solid food eg: porridge, glucose based drinks

4) Reduce oily and deep-fried food.

5) Avoid the food that leave a strong smell in your mouth, eg: belacan, spices. Rinse your mouth with water after eating.

If the problem is not improving after modifying your eating habit, you need to consult your doctor. The doctor will prescribe some medicines which are safe to take during pregnancy.

It is safe to take Actal during pregnancy.

Baby Weight

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 Joris Sim

Joris Sim said:

Hi Dr Jason,

I was your patient for my first baby. I deliver on Nov 2009 (natural deliver). Your advice to me is wait another 3 year to have my second baby.
But now I have changed my mind and want to have my second baby soon.
What is major concern if I planned to pregnant during June or July?

---------------------------------------------------------------------------

The ideal birth spacing is more than 2 years.

You need 2 years to fully recover from the lost of calcium and vitamin from your body due to pregnancy.

The rule of 2 years is not applied to normal delivery only. For those with caesarean delivery, you still need to wait for 2 years to fully recover.

A poor birth spacing is harmful to your health as the risk of osteoporosis (brittle bone) is higher in the later stage of life.

Anyway, since you plan to pregnant again within 1 year after the normal delivery, you need to start your vitamin supplement by now. Folic acid supplement should be started 3 months before your pregnancy. You need to eat more high calcium diet, eg: egg, milk, yogurst and cheese.

Regular exercise before pregnancy is good to promote bone recovery.

A pregnancy class will be organised on 28/3/2010 in Safira Club. Bone scan machine is available on that day and it will be done free to all of the participants. I hope you can attend the event and check your bone density on that day.

Pregnancy Class

Registration is opened now for the antenatal class in Safira Country Club on 28/3/2010.

Please call Ms Shirley Lee H/P 0125087932 for registration.

Free bone scan machine is available to the participants on that day for osteoporosis scanning.

4 breast pump machines will be given to the lucky mothers under the lucky draw.

Cord Blood Storage (脐带血存储)

Should I store my baby cord blood ?

It is a very common question asked by my patients during the clinic consultation.
As cord blood storage is increasingly popular, partly due to commercial advertisement by the private cord blood banks, the parents must thoroughly understand its advantages before making any decision to subscribe to this service.

What is cord blood ?

Cord blood is the blood circulating in the umbilical cord to provide oxygen and food to the baby. Cord blood contains rich amount of stem cells. The estimated volume of cord blood for a matured baby is around 50 to 80 mls.


How the cord blood is collected, processed and stored ?

The cord blood storage in this country is operated by the 4 private companies. The patients who are interested to store their baby cord blood need to contact the private cord blood bank for the service.
Once the agreement is signed between the parents and private cord blood bank, the doctor in charge will collect the cord blood immediately after the delivery of the baby.

The container to collect and store the cord blood.

The cord blood is squeezed from the umbilical cord for collection

.

The cord blood will be stored in a plastic container and delivered to the cord blood bank for processing and storage.

.

During the proccessing stage, the cord blood is checked for any bacterial contamination, blood grouping and the amount of stem cells available.

The cord blood is frozen by liquid nitrogen for life long storage.

What is the different between private cord blood bank and public cord blood bank ?

A private cord blood bank is a profit based service where the patients store their baby cord blood for their own use.
A public cord blood bank is usually operated by the government to encourage cord blood donation to someone who need the compatible cord blood for disease treament. It means you donate your baby cord blood for someone else who needs it.

Unfortunately, the public cord blood bank is not available in Malaysia.


What type of diseases can be cured by cord blood ?

Cord blood is not a magic medicine to treat all the diseases. In fact, the numbers of diseases that can be treated by cord blood is very limited.
Until today, cord blood is only useful to treat blood related diseases, eg: Leukemia (白血病), Thalassemia (地中海贫血) , Aplastic anemia (再生障碍性贫血).
The treatment for other common diseases such as heart disease, diabetes, kidney diseases are not established.
Leukemia is not a common disease to happen. It is etimated that only 1 in 7,000 population may suffer from this disease. In other words, if 7,000 parents store the cord blood for their children future usage, only 1 of them eventually need to use it. The remaining 6,999 parents are going to waste their money.
Furthermore, leukemia and Thalassemia are the family inherited diseases. The chance of having the diseases are extremely low if there is no prior family history.


What type patients should store their baby’ cord blood?

1) Those parents with family history of inherited blood diseases , eg: Leukemia, Thalassemia

2) Those parents who have strong confidence in stemcell technology and they believe in the potential of this technology to treat more new diseases in the future.


What is the cost of storage ?

Different private cord blood bank charge different rate. Generally, the first payment is around RM 2500, followed by yearly subscription fee of RM 250 for 21 years.


What are the disadvantages of cord blood storage from medical point of view ?

1) Upon the delivery of the newborn baby, the newborn needs to expand the lung to breath. During this process, some amount of cord blood need to flow into lung vessel to assist lung expansion.
In cord blood storage, the umbilical cord will be clamped early for collection purpose. Early clamping of umbilical cord will deny the cord blood from flowing into the lung blood vessel.

2) Collection of cord blood may delay the placenta delivery by the doctor. As a result, the mother may suffer from more blood loss after the delivery.

3) Occasionally, the cord blood maybe contaminated by bacteria during the collection process.

As the educated parents, you need to make an intelligent and wise decision before spending your hard-earned money on a new technology which may not be useful in the future.

Safe Journey

As the Chinese New Year is coming, many of you will take the opportunity to visit your long distant relatives.

Long distant travel for the pregnant mothers is safe, but special precautions should be taken to avoid unneccessary problems to your pregnancy, especially to those who plan to travel by air flight.

Before you start your journey, make sure you take the important safety precautions as listed below:

1) Inform your obstetrician of your plans.

Because the most common pregnancy-related emergencies happen in the first and third trimesters, the second trimester is generally considered the safest time to travel.

2) Reconsider traveling if there are complications.

If you've experienced second- or third-trimester vaginal bleeding, have gone into premature labor in the past, high blood pressure during pregnancy and twin pregnancy, the doctor may recommend you to stay at home.

3) Air travel is safe for most women up to 34 weeks of pregnancy, provided there are no complications.

Some airlines will only permit women to fly with a fitness certificate from the doctor after 28 weeks (7 months) of pregnancy.

4) Avoid long distant flight to avoid prolonged exposure to X ray in high attitude. Any air travel more than 8 hours is not encouraged.

5) Before traveling, locate the hospital nearest to your destination. Be prepared for an emergency by packing your medications and a copy of your medical records.

6) Avoid swimming in the ocean. Ocean swimming can increase the risk of vaginal or womb infections, which could lead to preterm delivery.

7) Drink plenty of water when traveling or flying. Dehydration can cause the uterus to contract. If in a foreign country, stick to mineral water. This includes staying away from ice cubes, too.

8) Take anti-vomiting pills if needed for travel sickness. Anti-dizziness medications can be taken safely during pregnancy.

9) Move about and walking around while traveling.

To reduce the risk of water retention in your legs and feet, get up and walk around the cabin once every hour. Support stockings can also help. Wear flat, comfortable shoes.

10) Fasten your seat belt. Don't forget to buckle up, with your seat belt below your belly.

Wish all of you have a safe and memorable journey.

Happy Chinese New Year.

Happy Chinese New Year !

To all the readers, Happy Chinese New Year and Gong Xi Fa Cai !