Why do I still have breast milk?
Dear Dr. Donya,
I am 22 years old and have a daughter aged 30 months. I breast-fed her for 15 months. But up to now, if I press my nipples, breast milk is still there and sometimes I feel discomfort in my nipples. Is this normal or could it lead to complications? If the answer to the second question is yes, please advise me whom to consult?
I just had a papsmear and the results were normal.
-- Sam
Dear Sam,
After you stop breast-feeding, breast milk should stop in between two weeks and eight weeks, depending on the child's age when you stopped breast-feeding. Milk is produced as long as the breasts are stimulated.
Is pressing or massaging stimulating your breasts? If breast milk is still there after you have stopped stimulating them, you should consult your doctor or endocrinologist (hormone specialist).
Prolactin is a hormone that regulates the production of breast milk following childbirth. It also may suppress ovulation. The pituitary may produce too much prolactin as a result of the use of certain drugs such as tranquilizers or oral contraceptives or, rarely, as a result of a pituitary tumor called a prolactinoma. Prolactinomas occurs in both women and men. In women, the prolactin may cause a milky discharge from the nipple, infertility or irregular or absent menstrual cycles.
If your doctor suspects this condition, he or she can check your blood prolactin level.
-Dr. Donya
Dear Dr. Donya,
My nine-month-old son weighs about 7.4 kilograms and is 70 centimeters long. His birth weight was 2.9 kilograms and he was 50 centimeters long, and up until now is still being breast-fed, as well as being given formula milk. He also consumes porridge, made of various foods (chicken, liver, veggies, etc.) three times a day plus two snacks or fruit juice.
But still he does not seem to gain enough weight. One month ago, I went to my pediatrician but he says that my son's weight is normal. I'm beginning to worry since he does not meet the standard weight for a nine-month-old baby. Has he got a digestive problem? What should his normal weight be? What should I feed him?
--Fifiek
Dear Fifiek,
A weight of 7.5 kilograms for a nine-month-old child is quite low but his height is good. The average weight for nine months old is from eight kilograms to 10 kilograms; we cannot refer to the western standard scale because it depends on each country's individual scale.
Your son started lower than average when he was born. It is better if you have a growth curve and plot his weight and height each time that he gets a vaccination or checkup, such as at one month, two months, four months and six months old. Checking his growth since he was born until now is very helpful.
How is his development? Does your baby get to a sitting position and sit up without support? What kind of grasp does your baby use to pick things up? Can your baby stand when he is supported? Is your baby walking sideways while hanging onto furniture (cruising)?
Genetics plays a role too so how are your and your spouse built? Different kinds of protein such as fish, shrimp, beans and tofu can be given to him. Try changing the menu to improve his weight, and see if he slowly gains weight. Ask his doctor to do a complete examination and laboratory checkup to evaluate his nutrition status. Your baby may also be given a blood test. In some cases the blood test is to determine whether your baby has an iron deficiency. In areas where lead poisoning is a possibility, a simple blood test can determine if your baby has been exposed to dangerous amounts of lead.
Normally, if children have a digestive problem, they will show other symptoms such as diarrhea, rashes or anemia (low blood concentration or a pale appearance).
-- Dr. Donya
Dear Dr. Donya,
My daughter is two and a half and frequently catches colds and coughs. It starts with a runny nose and then coughing (sometimes fever also), which lasts for almost three weeks.
We did an allergy test (to check if she is allergic to house mites) and a blood test. But it was all clear. Finally the allergy doctor gave her steroids (Lameson) and she became fine. Now after one month, she's coughing and has a cold again.
What about dietary restrictions. Is hot fruit juice bad for her?
-- Monica
Dear Monica,
Does your daughter go to a nursery or day care center? Does she have complete immunization? Did the doctor tell you that your daughter has asthma? Now if you send her to a nursery or day care, you may consider waiting for another six months to 12 months. Immunization such as Hemophilus influenza type b (Hib) is important if she is in day care.
Regarding her symptoms, if she suffers colds for long periods she should be checked for a sinus infection because it is one of the most common problems that causes long illness without treatment. Her history also suggests an allergy.
Avoidance is still the main prevention. Pollution, contact with ill people and crowded areas should be avoided. Exercise such as walking, running, swimming or any outdoor sport can promote her immunity.
When suffering from colds she should eat nutritious foods and drink plenty of water. Unsweetened juices are acceptable. Warm juice, meaning at room temperature, is OK, but cooking the juice destroys vitamin C. Encourage your child to get more sleep than usual. Provide plenty of fluids. Warm liquids and humidified air may help clear mucus.
I would suggest prevention is the best policy. Keep her away from other kids when they are sick and stimulate her immunity with the right foods and exercise.
-- Dr. Donya