The ABCs of health for your child – Part 2

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The ABC’s of child health are the health basics you need to pay careful attention to at home on a daily basis. Never mind the academics, if your child is unhealthy he or she can’t learn.

The ABCs

  • Healthy Nutrition
  • Fitness
  • Dental Health
  • Emotional Health

 

Get them moving…moving…

Studies show that if you get your child interested in any form of exercise activity when they are young, exercise and fitness are more likely to become a habit that lasts a lifetime. An hour daily of exercise should be the goal for your child. For younger children, playing outside with siblings or other neighborhood kids is all the exercise they’ll need. More structured exercise such as formal sports activities is a good way for older children to get their hour a day. Participating in sports also teaches them useful life skills like teamwork, discipline, and strategic thinking. Give them a choice and whatever type of activity you settle on, make sure it’s fun. If they enjoy it they’re more likely to stick with it.

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Useful fitness tips:

  • Make time to be active as a family.
  • Exercise together with your child
  • Limit sedentary activities to less than 2 hours per day – television, computer and video games
  • Be a role model

Good Reasons to Smile

Like other aspects of health the road to good dental health for your child is prevention. It starts with teaching good brushing habits and avoiding certain foods.

  • Brush twice daily
- you’ll be surprised how many adults don’t even practice this—
  • Avoid candy, juices, soft drinks
—
  • Soft baby brush once baby teeth are in —
  • Only a pea-sized amount of fluoride toothpaste is needed for 2 to 3 year olds —
  • Brush for them until 8yrs
- let them brush in the morning, you brush for them at night—
  • Dental checkups at least once yearly from age 2 – 3 (whenever they can sit still)

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Emotional Health


In African culture, the emotional health of a child is an area that’s often neglected. African parenting style is usually authoritarian, not because it works best but because it’s the only way that’s been modeled for us. This translates into a society with authoritarian leadership in every sphere that does not tolerate dissenting views, differing opinions or encourage “out of the box” thinking.

If 50% or more of your interaction with your school-aged child consists of scolding and correction, it’s time to re-evaluate your parenting style. If you’re often raising your voice when you talk with your child, perhaps it’s time to do things differently.

There are 5 Love languages – something every person needs to make them feel loved – Words of affirmation, Quality time, Receiving gifts, Acts of service, and Physical touch. For most people, one of these is primarily what makes them feel loved, and to a lesser extent one of the other four.

All children need to be affirmed – “that’s great honey”, “you did a great job”, “mummy loves you”- many times throughout the day. Your child needs quality time with you and lots and lots of hugs and kisses regardless of age. The occasional gift won’t hurt either!

 

Tips for parents
—

  • Be expressive of your love & acceptance as often as possible
  • Remember your child has pressures
  • Doing 15 minutes daily of an activity your child enjoys can reduce their stress level
  • Keep marital conflicts out of sight and hearing of your child — 
—
  • Listen and listen some more!
  • Don’t overreact

Children who have a clear sense of personal competence and feel loved and supported generally do well. Remember that children’s temperaments vary in their ability to cope with stress and daily hassles, learn to be very patient.

 

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The ABCs of health for your child – Part 1

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As parents, our responsibility to nurture our children requires a holistic approach – taking into consideration the whole child. Healthy living for your child requires that you place equal importance on your child’s physical, developmental, emotional and social wellbeing.

Africans, like Asians, are known for placing a lot of emphasis on the academic development of their children. This parental focus on academics is not necessarily a bad thing but can become an obstacle to the overall wellbeing of a child, if other areas of development are ignored.

The ABCs

  • Healthy Nutrition
  • Fitness
  • Dental Health
  • Emotional Health

In addition to well child doctor visits to make sure his overall development is on track, your child should receive all the recommended vaccinations. The ABC’s of child health are the health basics you need to pay careful attention to at home on a daily basis.

Helping Kids Eat Healthy


Good nutrition is essential to good health for all kids whether they’re babies or teenagers.

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Infants

  • Breast milk only until 6 months of age + vitamins
  • Begin Iron-fortified cereals, pureed fruits and vegetables at 6 months
  • Add lean meats and eggs when the above are well tolerated (8 months)
  • Begin table foods at 9 months (avoid small hard foods that can choke the baby)
  • Continue breast milk until 12 months if possible

Toddlers (1 – 3 years)

  • Growth and appetite come in spurts at this age so they’re often picky eaters
  • 4 -5 servings of fruit and vegetables daily for fiber and valuable nutrients
  • Fiber is essential for digestive health and is good for the heart
  • 2 – 3 servings of whole milk daily for calcium
  • Avoid the juice trap – it’s mostly sugar. Give Water! Water! Water!
  • Avoid the junk food trap because you’re desperate for him to eat anything!

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Elementary school age (4 – 10 years)

  • Eat most nutritious foods from all 5 food groups
  • 4 -5 servings of fruit and vegetables daily for fiber and valuable nutrients
  • 2 – 3 servings of low fat milk daily for calcium
  • Avoid the sugar trap – juice, soft drinks, candy, cookies, cakes, starchy foods
  • Watch out for fats and salty foods
  • Water! Water! Water!

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Preteens and Teens (11 – 18 years)

  • More calcium needed at this age for bone mass
  • Menstruating girls need more iron, boys need more protein for muscle mass
  • 4 -5 servings of fruit and vegetables daily for fiber and valuable nutrients
  • 2 – 3 servings of low fat milk daily for calcium
  • Avoid the sugar trap – juice, soft drinks, candy, cookies, cakes, starchy foods
  • Watch out for fats and salty foods
  • Water! Water! Water!

In the next blog post we’ll review fitness, emotional and dental health for your child.

Sexually Transmitted Infections – Dangers of stigmatization

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Sexually Transmitted Infections (STIs) or STDs, also known as venereal diseases, are infections or diseases that are passed from one person to another through sexual contact – usually spread by having vaginal, oral, or anal sex. Bacteria, viruses, or parasites that are on the skin or mucus membranes of the genital area or are present in semen, vaginal secretions, saliva or blood, can be transmitted from one person to another.

What are the symptoms of STIs?

Many STIs have only mild symptoms or none at all. Symptoms in women could easily be mistaken for a urinary tract infection or common yeast infection. Usual symptoms of STIs include burning sensation during urination, itching, swelling or sore in the genital area, pelvic pain/painful intercourse and vaginal/penile discharge. Sometimes women may have a change in color, odor and/or thickness of their usual vaginal secretions.

 

 

The stigma of STIs

Research conducted in Kenya and Nigeria showed interesting findings. Men were more likely than women to seek treatment for STIs. Women tend to bear the bulk of the stigma attached to STIs, with infections often being seen as a sign of promiscuity. As a result, women may choose not to confide in anyone, even if they have an unusual discharge or a sore.

 

The majority of young women who reported at least one STI symptom were married and may have been infected by their husband. Married women, out of fear of possible repercussions, may choose to treat their STIs themselves rather than risk going to a public health facility that might share their information with their husband. In fact, many women who experience such STI symptoms as vaginal discharge and genital itching do not regard them as serious or as the result of sexual intercourse and, therefore, do not believe that they need to be treated.

 

Stigma-related violence or the fear of violence and other stigma prevents many people from seeking testing (especially HIV testing), returning for their results, or getting treatment, possibly turning what could be a manageable illness into a death sentence and continuing the spread of STIs.

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Testing

If you suspect you have an STI, it’s important to get tested. The sooner you know, the sooner you get treated and the less likely you are to spread the infection. Testing can be done at health centers, general hospitals, family planning clinics, state teaching hospitals, private health facilities and designated HIV test centers.

 

Anyone who tests positive for any STI should get tested for HIV and other STIs and follow up with testing for partners. Doctors often recommend treatment for you and your partner but keep in mind that the STI may have been contracted from a former sexual partner.

Anyone who tests positive for HIV should:

  • Get screening and treatment for other diseases like Tuberculosis, Malaria and other STIs
  • Follow up with testing for partners and children

It is troubling that recent estimates report that only 51% of people with HIV know their HIV status. HIV testing can be done confidentially or anonymously.

 

Treating STIs

Bacterial and parasitic infections, such as Chlamydia, Gonorrhea, and Syphilis can be treated and cured with antibiotics.

Viral STIs such as Genital Herpes (HSV-2), HIV/AIDS and Hepatitis B & C cannot be cured. They can be managed with medications to help reduce the signs and symptoms of the illness related to the infection as well as its complications.

  • For all of these sexually transmitted diseases, it is important to note that EARLY DETECTION is the key to a good outcome.

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How can you prevent STIs?

 

The only fail-safe way to prevent an STI is SEXUAL ABSTINENCE!

 

If you do have sex, lower your risk of getting an STI with the following steps:

  • Limit your number of sex partners – Your risk of getting STIs increases with the number of partners you have
  •  Be monogamous – Having sex with just one partner can reduce your risk for STIs
  • Get vaccinated – There are vaccines to protect against HPV and Hepatitis B.
  • Use a Barrier Contraceptive – Condoms are the best way to prevent STIs when you have sex.
    • Oral contraceptives and implanted devices, do NOT protect from STIs
  • Get tested – Be sure you and your partner are tested for STIs. Talk to each other about the test results before having sex
  • Avoid douching – It removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting STIs.
  • Do not abuse alcohol or drugs – Drinking too much alcohol or using drugs increases risky behavior and may put you at risk of sexual assault and possible exposure to STIs

 

These steps work best when used together. No single step can protect you from every single type of STI.

 

 

Sexually Transmitted Infections – An rapidly evolving danger

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There was a time when the worst things about having a sexually transmitted disease (or STD), were the physical discomfort from the symptoms and the embarrassment and stigma of having the condition. How times have changed!!

 

For starters, they’re not called venereal diseases or STDs anymore – they’re now known as Sexually Transmitted Infections or STI’s. More importantly, viruses such as HIV, Hepatitis B and C, Human Papilloma Virus (HPV), and Herpes have changed the STI landscape such that debilitating chronic illness, cancers, and even death are possible outcomes of having an STI. It is also now known that both Ebola and Zika viruses can be transmitted through sexual intercourse because they’re present in the semen of infected men.

STD

STIs or STDs, also known as venereal diseases, are infections or diseases that are passed from one person to another through sexual contact – usually spread by having vaginal, oral, or anal sex. Bacteria, viruses, or parasites that exist on the skin or mucus membranes of the male or female genital area can be transmitted. During sexual intercourse, certain organisms present in semen, vaginal secretions, saliva or blood, can also be transmitted from one person to another.

It may surprise you, that it is possible to get some STIs, such as syphilis, herpes, and genital lice from physical genital contact only, without actual sexual intercourse.

 

Why are STIs important?

 

There are different kinds of STIs and some are more serious than others. STIs are more than just infections of the genital tract. Most STIs cause damage to other parts of the body as well. If not detected and treated early, they can lead to serious complications. Some STIs are curable but others are NOT and can only be managed with the right medications.

 

STIs like HIV, Hepatitis B & C, Human Papilloma Virus and Syphilis can cause death:

  • HIV – AIDS, organ failure, cancers
  • Genital Herpes – death of infected newborn from overwhelming sepsis
  • Hepatitis B and C – Liver failure, Liver cancer
  • Human Papilloma Virus (HPV) – cervical, penis, anus, mouth and throat cancers
  • Syphilis – brain and heart damage

 

To complicate matters more, some STIs can also be transmitted by non-sexual routes, making them easier to spread. HIV, Syphilis, Zika, Hep B & C, HIV and Genital Herpes also spread:

 

  • Mother to child
    • Before and during childbirth
    • From a breastfeeding woman to her baby
  • Through the use of unsterilized IV needles
  • Through blood transfusions and other infected body fluids

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Who is at risk for STIs?

If you think only promiscuous people and prostitutes get STIs, you’d be wrong. Any one having unprotected sex is at risk of STIs. Having multiple sexual partners also puts you at risk. If you think about that, any one who began sexual activity before age 21, has more than a couple of sexual partners by age 30, and has had unprotected sex at any point, already places his or herself at risk for STIs. If you’re having unprotected sex because you think you’re in a monogamous relationship but your partner is having sex with other people, you’re at risk.

If you’ve had an STI or currently have one, you’re at higher risk of getting other STIs. Men who have sex with other men are another group at risk for STIs.

STIs in women

STIs cause serious health problems in women including infertility, miscarriage, ectopic pregnancy and damage to the newborn from exposure in pregnancy to infections like syphilis, Zika, Hepatitis B & C, HIV, and Genital Herpes.

 

  • If a mother contracts an STI, she can pass it on to her child before, during or after childbirth
  • Untreated syphilis in pregnant women results in infant death up to 40% of the time
  • Women have a higher risk than men of getting an STI during unprotected vaginal sex

 

In our next post we’ll look at barriers to treatment and what we can do to prevent STIs.

Recognizing Stoke

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A stroke occurs when blood flow to a part of the brain stops. If blood flow is cut off for longer than a few seconds, the brain cannot get needed blood and oxygen. Part of the brain can die, causing brain damage.

In Nigeria, one third of people die within the first 7 days after a stroke and a little less than half die within 6 months. Most stroke survivors (85%) are left with problems moving, thinking, and talking which may improve in the weeks to months after a stroke. For many, complete recovery never happens and they’re left with permanent disability.

Would you know if someone is having a stroke?

The symptoms of stroke depend on which part of the brain is damaged. In some cases, a person may not know that a stroke has occurred.

Most of the time, symptoms develop suddenly and without warning. If you’re lucky, symptoms may occur on and off for the first day or two allowing time to seek medical attention. Knowing what the symptoms are is really important and may be the difference between life and death for you or a loved one. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse:

Change in alertness (including sleepiness, unconsciousness, and coma)

  • Trouble with walking – Stumbling or sudden dizziness, loss of balance or loss of coordination.

Trouble with speaking and understanding – Confusion, slurred words or difficulty understanding speech.

Paralysis or numbness of the face, arm or leg – Sudden numbness, weakness or paralysis in the face, arm or leg, especially on one side of the body. Try to raise both arms over the head at the same time. If one arm begins to fall, it may be a stroke. Similarly, one side of the mouth may droop a smile is attempted.

Trouble with seeing in one or both eyes – sudden blurred or blackened vision in one or both eyes, or seeing double.

  • Lack of control over the bladder or bowels

Headache – Sudden, severe headache, with vomiting, dizziness or altered consciousness. The headache interrupts sleep and worsens with change in position, bend, strain, or cough.

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Ignore warning signs at your peril

Stroke isn’t something that happens to old people or other people – it can happen to you.

 

  1. The single most important thing you can do to prevent stroke is to control your blood pressure. Know what your blood pressure is, and if you have high blood pressure partner with your doctor to treat it properly. Regular check ups with your doctor are important.
  2. If you have high blood pressure you should receive monthly blood pressure tests from the hospital, health center or clinic. If you can afford it, it’s worth buying a small blood pressure measuring kit from a pharmacy and being taught how to take your own blood pressure weekly.
  3. The best way to prevent stroke from high blood pressure and diabetes is to take steps to lower blood pressure and blood sugar. These steps include a combination of medication and lifestyle changes, which include healthy eating, exercise, maintaining a healthy weight, avoiding smoking and limiting alcohol.
  4. Know the signs and symptoms of Stroke: FAST

Facial droop

Arm weakness or drift

Slurred speech

Time is brain…seek medical help immediately

Is there Stroke in your family? By Dr Biodun Ogungbo

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Stroke is sudden weakness of an arm, or leg, sudden blindness, sudden confusion, sudden problems with speaking, difficulty walking, sudden severe headaches, sudden collapse and death. Stroke is due to blockage of a blood vessel carrying blood to the brain, leading to injury or death of that part of the brain. Stroke also occurs when a blood vessel bursts open inside the brain. This is why it occurs ‘suddenly’ as the tap carrying food to the brain gets turned off! In both situations, the brain does not get the food and oxygen it requires.

Stroke: Time is brain

Stroke, is an emergency and requires immediate action to prevent brain damage and death. Stroke causes injury because vital nutrients are not delivered to the brain; and so brain tissue dies. This happens in real  strokes, but there are also minor strokes, partial strokes in which the brain does not die or become permanently injured. These people recover almost perfect function. But, see below.

Stroke: Big or small

 

Minor strokes, mini-strokes, small strokes and transient ischemic attacks (TIAs) are one and the same. TIAs are common events characterized by stroke symptoms that completely resolve. They were previously thought to be benign but research over the past decade has revealed the high risk of further strokes in these patients. Having a TIA is a risk factor for having a major stroke.

 

TIAs and strokes cause the same symptoms, such as paralysis (opposite side of body from the affected part of the brain) or sudden weakness or numbness. A TIA may also cause sudden dimming or loss of vision slurred speech and mental confusion. But unlike a stroke, the symptoms of a TIA can resolve within a few minutes or 24 hours. Brain injury may still occur in a TIA lasting only a few minutes, therefore it should not be ignored by patients, relatives or doctors. Small stroke is a warning from God!

 

Stroke is common in Nigeria

 

Every Nigerian knows someone within their family, on their street, at their place of work, village or town who has suffered a stroke. Stroke is next door and coming to a street near you! It is the most popular horror movie in life. That someone hale and hearty could suddenly go blind, deaf, become mute, have weakness on one side and die without prior warning is your worst nightmare. Stroke is a devastating illness, which maims and kills Nigerians daily.

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Is there stroke in your family?

Has a member of your family suffered a stroke? Mine have, in large numbers. Many people in my family have suffered devastating strokes and I am trying everyday to prevent stroke in myself. I run, jog, do sports, exercise and watch what I eat on a daily basis. Any indulgence, eating the biggest meat in the pot, the most amount of food, fat or oily food etc is frowned at in my family.

 

The risk of further strokes in higher in families with a history of stroke. If your father, brother or sister has had a stroke, be very careful. Similarly, history of hypertension, diabetes and heart attacks are important as risk factors for stroke in the family.

 

Can you afford a stroke?

 

We are not managing stroke well at all. We do not have the emergency numbers and ambulance services to deliver patients to hospitals within an hour of a stroke, so doctors can at least try to reopen the blocked vessels in the brain. We do not have the clot bursting drugs for removing the obstruction. Brain scans and other required tests cost an arm and a leg (pun intended). We do not have the means to investigate and treat acute stroke without asking for money.

 

So, if you come to one of Nigeria’s premier hospitals without as much as N100, 000 (One hundred thousand Naira), you may not get the immediate life saving care you need. Many come with just prayers and a breath expecting miracles.

 

Open a stroke account

 

It is vital to prevent stroke. If you don’t, you might as well open an account where you can save money should you suffer a stroke! The minimum deposit is N100, 000 but please save as much as N3, 000, 000. (three million Naira only). Regardless, just because you can afford it, is no excuse to have a stroke! What if you cannot write a cheque or even remember the account password? So, please look after your blood pressure, control diabetes, stop smoking, lose weight, exercise and keep fit.

 

Dr Biodun Ogungbo, Consultant Neurosurgeon in Abuja is a UK General Medical Council Registered Specialist in Neurosurgery and Nigerian Medical and Dental Council registered Surgeon. He has extensive surgical repertoire in elective and emergency surgery. He supports medical education and is active in health advocacy. He is interested in stroke and spine problems and has written extensively about these conditions.

Deworming – Is it really necessary?

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Sometimes, even with a clean environment and proper precautions, children can get infected by parasites such as tapeworm, roundworm, hookworm and pinworm and whipworms. Away from home, children are often exposed to contaminated environments in school, daycare, at the playground and in other people’s homes. Worm infections have severe health implications in parts of the world where it is endemic.

 

How worms damage your child’s health

Worm infections can cause major health problems for young children.

  • The worms use up the vitamins and nutrients that children need for growth.
  • This can then lead to malnutrition, low weight, Iron and Vitamin A deficiency and anaemia.
  • This ultimately harms the infected children’s future physical and intellectual development.
  • They cause loss of appetite, leading to reduced food intake, which further affects physical growth and development.
  • Infected children also are more prone to illness, as their immune systems are damaged.

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Deworming

Deworming simply means treating your child with a one-dose medicine to either treat an existing worm infection or to protect against potential infection. Deworming protects your child from the potentially devastating effects of worm infestation on physical growth and mental development.

 

For years, the WHO has recommended treating children from 13 months old, with anti-helminthics (worm-killing drugs) every 6 months in endemic areas of the world. This covers much of Africa and Asia. Deworming is not recommended for children less than 1 year old.

 

Deworming drugs kill adult worms, but do not kill the eggs. It’s therefore important to repeat the treatment every six months. Deworming medicines for children should be based on your child’s age and weight so it’s not advisable to simply pick up a generic brand and dose at the local chemist. It is safer to have your doctor prescribe the appropriate medicine and dosage for your child.

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How to prevent worm infestation

 

You can limit your children’s risk of getting infected by worms by taking some simple measures. Make sure they:

 

  • Wash hands well with soap after playing outdoors or with pets and before each meal
  • Do not eat unwashed salads, fruits and vegetables
  • Do not eat under-cooked meat
  • Do not play barefoot when outside or at daycare or school
  • Swim only where the hygiene standards are met
  • Only drink water that is boiled, bottled or filtered
  • Do not share water bottles in school

 

Keep your home environment clean and provide proper sanitation if at all possible.

 

If you have a household help who is in constant contact with your child, do ensure she keeps good hygiene as well. It might not be a bad idea to recommend that she deworms herself too.