Pregnancy and your child’s health live chat: 31.01.13

One thing all mothers and expectant mothers can agree on is that the health of their child is always on their minds. We invited our Health at Hand nurse and midwife, Jackie Hall, to answer your questions on pregnancy and your child’s wellbeing during our live chat on Thursday 31st January.
Health at Hand is our exclusive 24/7 service for members, offering direct telephone access to expert information and peace of mind. Our medical professionals are always available to answer personal questions, provide the latest information on treatments and research, or even just be there for patients and family members who need someone to talk to.

Our expert Jackie took the time to answer all your questions, including conceiving, breastfeeding and protecting your child’s skin during the cold weather. Here is what she had to say:

Jane asked: I'm on the pill Cerazette but have read some things on it affecting fertility for a few years after coming off it. Is this the case?

Jackie Hall: Cerazette does not normally cause any fertility problems. Once you stop the pill some doctors suggest waiting for a couple of months for your menstrual cycle to return to normal before trying for a baby. This is so the hormonal levels have a chance to normalise and you have more of an idea of your dates for the future pregnancy.

Jane: Thanks, I've also heard stories about Cerazette increasing the likelihood of ectopic pregnancy; what would the symptoms of this be if you were still taking the pill? Also, can it increase the chances of ectopic pregnancy even after stopping using the pill?

Jackie Hall: As Cerazette is a progesterone-only pill, it is not guaranteed to inhibit ovulation and therefore in this group there have been rare reports of ectopic pregnancy.  Symptoms would likely be a pain on one side of the lower abdomen, vaginal bleeding (usually darker blood) and often shoulder tip pain may develop.  There appears to be no evidence that the chances of ectopic pregnancy are increased once the pill is stopped; however, it is not recommended for someone with a history of ectopic pregnancy to take this type of pill.

Lis asked: I am 18 weeks pregnant and wonder what my chances of breast feeding are as I have had my large bowel removed and now have an internal J-Pouch. It’s very difficult for me to absorb nutrients. I wondered if nutrients wouldn't be passed onto my baby if I was breastfeeding.

Jackie Hall: Hi Lis, congratulations on your pregnancy and glad to hear you are thinking of breastfeeding. I would suggest you try breastfeeding your baby as there should be no reason for you not to breastfeed. The only thing to bear in mind is if you are taking any medications or need extra dietary supplements, I would suggest you discuss this further with your own doctor and midwife.

Julie255 asked: I'm six months pregnant and for a few weeks when I sit upright I get a numb/pins and needles sensation under my left rib cage. It’s not painful but it is uncomfortable to sit. It can only be relieved by reclining or lying down. Is this okay, and will it continue for the remainder of pregnancy?

Jackie Hall: Hi Julie255, congratulations on your pregnancy and sorry to hear you are getting an uncomfortable pins and needles sensation in your ribs. As the pregnancy progresses and the baby gets bigger, pressure from the weight of the baby along with the increased growth and stretching of the muscles and supporting ligaments can cause various discomforts. It may be that there is pressure on a nerve when you are upright which will hopefully improve as your pregnancy progresses. It’s reassuring that it goes away when you rest lying down. I would suggest you let your doctor or midwife know so they can just check all is well.

Caitlin asked: Can long term use of the pill cause fertility issues?

Jackie Hall: Hi Caitlin. After stopping hormonal contraceptives, some women have no periods and ovulation. This infertility, however, has been shown by most studies to be only temporary. Oral progestogen-only preparations do not appear to have a significant effect on fertility; smaller studies have also indicated that injectable progestogen-only contraceptives have no long-lasting effects on fertility. It has been suggested that a return to ovulation occurs significantly earlier in prior norethisterone enantate users than in medroxyprogesterone users. Infertility may also be related to the presence of pelvic inflammatory disease.

209039 asked: Hi, my six year old son is prone to getting croup cough. He's had it on a regular basis since birth and the doctor has always said he would grow out of it but so far there's no sign of that happening. He’s had it maybe four or five times last year and is only now just getting over it. Last year, one bout of it turned into tonsillitis and this time it's making him sick with all the coughing. They say he has enlarged adenoids for his age but just to keep an eye on it for now. I guess he's too young to have his tonsils out; is that a less common action to take now, and would it help if we considered it at a later date? I just find it frustrating that it happens so often and there's nothing we can do about it as it's obviously horrible to be helpless when he's suffering through it! 

Jackie Hall: Sorry to hear your son suffers with croup. Croup is spread in a similar way to the common cold so it is difficult to prevent. I would suggest good hygiene at all times, such as washing hands and cleaning surfaces.  Also, make sure that all his childhood vaccinations are up to date to help prevent some of the infections that can cause croup. I understand it is frustrating and also worrying when he is unwell. The best help is to try and stay calm, sit your son upright as much as possible and give him lots of cool drinks to lower the temperature if this is raised. Your doctor will advise if any further treatment is needed, including with the tonsillitis. Usually surgery is only done if it becomes a chronic condition. I wish you and your son all the best

Ruth asked: Hi Jackie, the internet and magazines are always full of different things that are apparently bad for you when pregnant. Just wondering what foods you recommend avoiding?

Jackie Hall: Hi Ruth. Yes, the internet can be a bit of a minefield. Avoid mould-ripened cheese such as brie, camembert and some goat’s cheeses. Also avoid soft blue veined cheese, such as Danish Blue or Gorgonzola; these may contain listeria - a type of bacteria which, although rare, can lead to miscarriage, stillbirth or severe illness in the new-born baby. Hard cheeses are fine to eat such as cheddar, parmesan and even stilton. Other cheeses such as cottage cheese, cream cheese and mozzarella are also okay to eat but just make sure they are made from pasteurised milk. Avoid all types of pate as it may contain listeria. Make sure eggs are thoroughly cooked to avoid risk of salmonella, and be aware some mayonnaise contains raw egg, too. Cook all meat and poultry so it is steaming hot but avoid liver and liver products. Some types of fish, such as shark, marlin and swordfish, are also best avoided, and limit the amount of tuna to no more than a couple of tuna steaks/four medium-sized cans of tuna a week. 

Caroline asked: I can’t get my kids to eat fresh fruit and veg and am worried that their diets aren’t balanced enough – what can I do?

Jackie Hall: Hi Caroline. It is very common for children to be fussy eaters and be reluctant to try new foods. Persevere and stay calm! Children may need to be offered the new food more than once before they will even try it, and forcing or pressurising a child to eat rarely works. Just keep offering a wide variety of foods and they will eventually eat more of them. Make it fun, cut fruit into shapes with cookie cutters, play rainbow game - how many different coloured fruits and veg can your child eat in one day, you could make a chart to record this. Add faces to sandwiches made from veg and fruit. Keep a bowl of fresh fruit easily accessible and open for the child to take from. Keep bags of chopped fruit and veg in the fridge, or add a bowl to the dinner table to dip into. Involve your child preparing and with picking and choosing the fruit and veg. You could go fruit picking when available and even grow vegetables. Make smoothies together. Also set a good example and eat plenty of fruit and veg yourself.

Cerys (@RainyDayMum) asked: We’ve all got dry skin at the moment from outdoor play in the winter. What is best to use on the kids’ hands to help protect them and repair?

Jackie Hall: It’s great to hear of children having fun playing outdoors even in the winter. To start with, a good idea is to cover the hands with a warm pair of gloves. To help protect and repair, any good hand cream applied will help rehydrate the skin and give a protective layer and prevent moisture loss. Ointments tend to be thicker and more protective, although they can be greasy.

Maryanne (@mamasmiles) asked: I would love to hear your top tips on getting kids through cold and flu season!

Jackie Hall: Try to ensure a healthy diet and a good balance between sleep and activity. Encourage your child to rest and make sure they drink plenty of fluids. Water is fine, but warm drinks can be soothing. If they have a blocked nose you can make their breathing easier by raising the pillow end of your child’s bed or cot by putting books or bricks under the legs or placing a pillow under the mattress.  Paracetamol liquid or ibuprofen liquid can help ease a fever and pain, always check the dosage instructions on the packaging. Never give aspirin to children under 16 years old. A warm, moist atmosphere can ease breathing if your child has a blocked nose; take your child into the bathroom and run a hot bath or shower, or use a vaporiser to humidify the air. Keep the room aired and at a comfortable temperature, and don't let your child get too hot. If a small child or baby has a temperature let them wear just a nappy or underwear.

Bernadette (@Momto2PoshDivas) asked: My daughter has eczema and it gets aggravated by water but she loves playing in the bath. I would love tips on what I can use either in the bath or after to help her skin.

Jackie Hall: Emollients can be added to the bath water or applied to the skin after the bath. These are substances that soften and smooth the skin to keep it supple and moist. They stop water from being lost from the skin. If you add to the bath take care though as they can make the bath and child slippery! There are, of course, many other treatment options for eczema and I would suggest you discuss this further with your child’s doctor.

Trisha (@Inspire_labs) asked: How much water do we (and our kids) really need to drink a day? Some people say the water in food counts, so we don’t really need eight glasses.

Jackie Hall: Yes, the body does get fluid from the food we eat, however most healthy adults should aim to drink six to eight medium glasses of fluid daily. This can come from other beverages such as tea, coffee and fruit juices. An individual may require more fluid if they are very physically active or the weather is hot, use thirst as a guide.
There are no specific recommendations for children; however it is very important they replace lost fluid taking into consideration activity and weather. Healthy drinks should form part of a healthy diet. The type and amount of fluid will also depend on the age and size of the child.

Kelly asked: My daughter is 11 and consistently gets pain in her ankle; she does a lot of dancing, could this be the cause?

Jackie Hall: Kelly, sorry to hear your daughter is suffering with ankle pain. I would suggest you follow up on this with your daughters GP who will hopefully be able to assess the extent of the pain, possible cause and offer treatment as required.

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