Are there any drawbacks to breast-feeding?
Dear Dr. Donya,
I have read your comments about breast-feeding and I find them very helpful. But are there any disadvantages in breast-feeding for my baby or myself? What shall I eat to get enough nutrients and everything she needs?
My baby is eight months old now and does not even know how to drink from a bottle. Must she take porridge first before anything else? Can I give her rice instead of porridge?
-- Angeline
Dear Angeline,
Regarding breast-feeding, as a mother you should wear a well- fitting bra that supports the enlarged breasts and prevents stretching of the skin and the supporting tissues in the breasts not only when you are nursing, but also day and night when the breasts are still large.
In terms of health, there is no disadvantage in breast- feeding. Gaining weight may be one common problem for you, but it will be very helpful if you exercise at least 30 minutes several times a week and take a walk with your baby.
Good food means a balanced diet, avoid smoking, alcohol beverages and caffeine. Calcium would be an issue if you take too little because your baby will need it for good bone and teeth development. So you should take a little extra, a non-dairy beverage and high calcium foods such as beans, peas, green vegetables (e.g. broccoli, kale), whole grains and fruits. Drinking enough fluid 10 to 15 minutes before you nurse your baby will also help keep your body fluid maintained.
Porridge is not a definite first food but may make it easier for your baby to swallow. If you want to give rice, she is now eight months old and she can chew soft rice, which is also good for her teeth.
-- Dr. Donya
Dear Dr. Donya,
Is it possible to contract measles even if you have been vaccinated? My friends' seven-year old daughter -- visiting from Australia -- had a high fever for nearly a week, was lethargic, not eating and had bright red hands and feet.
Blood tests in Bandung revealed nothing, so when they reached us in Jakarta, we took them to our doctor who said it was measles. Is this possible?
-- Jane
Dear Jane,
Yes, it is possible to get measles after vaccination. Vaccine failure occurs in as many as 5 percent of individuals vaccinated at 12 months of age or older; a possible response to the vaccine being inadequate.
The immune protection is around 90 percent to 97 percent if given to an infant more than 15 months old.
Measles are highly characteristic and their time of appearance and sequence are consistent. Around 10 days after exposure to infection, fever is the first sign then dry cough, runny nose, conjunctivitis (red eye) develop and fever still goes on over the next four days. Then, the rash will appear and the clinical signs will reach their maximum severity, the hacking cough is distressing with progressive increase in frequency and severity.
A rash starts from behind the ear along the neck then moves downward to body and legs taking around two to three days. Then, the fever will stop, other clinical symptoms subside but the cough can go on between seven and 10 days.
If the fever is still present after the rash reaches the legs, it may be a sign of a complication, such as pneumonia (lung infection) or otitis media (ear infection). The doctor who is treating the patient will be the one who can tell if she has measles. As I said, the rash is quite a characteristic pattern. Now, if the girl only had the bright red rash on her hands and feet, many diseases could be ruled out -- scarlet fever, infectious mononucleosis, typhus fever.
-- Dr. Donya