B3 MD

by Dr. Thea-Nicole Davis MBBS, DM (OB-GYN), Jamaica

Dr. ea-Nicole Davis is our Consultant Obstetrician and Gynecologist who answers your questions and addresses your concerns on medical matters pertaining to bumps, babies and beyond. Dr. Davis is mother to 3 yr old Imani. She is an avid reader who, like all our contributing writers, has a passion for children and parenting. Dr. Davis lives in Mandeville, and practices in both Kingston and Mandeville, Jamaica.

Dear Doc, I’m a coffee drinker. However with my pregnancy now, I’ve managed to eliminate coffee totally, thinking that Teas would be a good replacement. But they seem to contain just as much caffeine. Any suggestions?

Caffeine intake during pregnancy can be potentially harmful for your growing baby and has been reported to be associated with several adverse pregnancy outcomes, including early pregnancy loss, preterm birth, and impaired fetal growth. Coffee, tea, cocoa and some carbonated soft drinks are the main sources of caffeine intake. It is recommended that pregnant women limit caffeine consumption to less than 200 to 300 mg per day to potentially reduce their risk of possible adverse reproductive effects. Coffee contains 50 to 70 percent more caffeine than tea and other products. As a guide one cup of coffee contains approximately 100mg-200mg of caffeine depending on how it is prepared e.g. Instant versus brewed. Green tea (6 oz) contains approximately 40 mg and Black tea (6 oz) 45 mg. Avoiding caffeine as much as possible is however the safest option.

I think this magazine is great, and your column is very informative. I wish I’d had this with my first 2 pregnancies. On my third now, and I’m very curious about cord blood banking in Jamaica. Is it available here or anywhere in the Caribbean?

Firstly I would like to thank you for highly rating this extraordinary magazine. Cord blood banking is relatively new to the Caribbean and unfortunately at this time there are no cord blood banks available within the Caribbean region. However, cord blood can be taken at the time of delivery here in Jamaica and sent to a cord blood bank overseas. This is accommodated by your Obstertrician and Gynacologist who will contact the cord blood bank of your choice who will then send a special kit and instructions to collect the cord blood. Once collected it would be sent immediately via a courier service to the bank. Two main types of cord blood banks exist, public cord banks and private cord banks. In addition to these two main types of cord blood banks, some private and public cord blood banks provide a service called directed cord blood banking in which cord blood is reserved for a sibling or family member with a known potentially transplant-treatable disease.

I recommend that you contact the Cord Blood Registry at www.cordblood. com. You can also see a listing of other collecting units worldwide at www. bmdw.org.

The day I entered my final trimester my skin changed. My underarms, neck, and bottom are blotchy and about 5 shades darker. I feel unattractive and miserable. Please tell me this will pass soon, and is there anything that’s safe to use now, that will help.

Most pregnant women develop some degree of increased skin pigmentation (colour) that usually resolves after pregnancy. The cause of this increased pigmentation is reported to be hormonally related. Common areas include the nipples, underarms, genitalia, buttocks, inner thighs and the neck. The good news is that for the majority, post delivery, these areas become less pigmented over a period of several months. Unfortunately, this condition is not deemed treatable during pregnancy as it is self-limiting. To minimise the pigmentation in the mean time I recommend that you use a sunblock daily that protects against both UVA and UVB rays with SPF 30 or higher and limit exposure to the sun. After pregnancy and breastfeeding if your skin remains significantly discoloured without any signs of improvement then consult with a dermatologist who may recommend the use of topical skin lightening agents, glycolic peels or laser treatments. Please remember however that these changes will not occur over night and patience is the best remedy for this condition.

Apart from my prescribed pre-natal vitamin and folic acid, I’m also taking Vitamins B, E and Cod Liver Oil. Am I overdoing it?

Supplementation of your diet with prenatal vitamins is indeed essential for not just your general health but also for your developing baby and the placenta. At a minimum, the daily multivitamin-mineral supplement you take should contain key vitamins/minerals that are often not met by diet alone, such as: iron, calcium and folate. In addition to these, pregnant women also require adequate amounts of vitamins A, B complex, E, C D, and zinc. Most commercial “pre-natal” vitamins already contain all these essential vitamins/minerals in their required amounts therefore additional vitamins/ minerals are not necessary. Some vitamins can be potentially harmful when taken in large quantities. These include, but are not limited to iron, selenium, vitamins A and D.

WANT TO STOP FINGER-SUCKING?

1.Give your child a good reason to stop. “Let’s try to stop before school starts”, as opposed to “ You better stop sucking that dirty finger before everybody laughs at you!”

2.Anticipate. Prepare. Plan. Get to know when your child will suck his finger. Does it happen when he’s tired or hungry or sad? What are the triggers? Once you’re aware of the signs, you can offer a practical alternative before the finger-sucking starts.

3.Help your child to recognize when, and perhaps why he is sucking his finger.

Discuss alternative ‘comfort-habits’, and try implementing them on a slow and steady basis.

4.Do not pressure your child. Take your time, and let him take his. Just be sure to remain consistent. And let him know that you’re there to help him, no matter what.