DEPRESSION IN PREGNANCY AND VITAMIN D DEFICIENCY

By Sam Maondu.

Being pregnant is a memorable, most exciting experience full of emotions that most women have gone through. Fetal movement and kicks are exhilarating and reassuring moments during pregnancy. It is not always easy, pregnancy can be a horrible experience considering the challenges that women go through especially for the first three months, during delivery and the postpartum period.

Antenatal depression and postpartum depression is a reality and it is more prevalent among the population with poor dietary intake of vitamin D, lack of direct exposure to sunlight through the use of sunscreens and avoidance of sunlight.

The purpose of this article is to show the relationship that exists between depressive symptoms during pregnancy and a low level of vitamin D in the body. Vitamin D is an essential and fat-soluble nutrient necessary for the healthy development of bones, helps in calcium absorption, development of strong body immunity, the transmission of electrical impulse in the body and hypothetically, vitamin D acts as a neuro-active hormone.

"Several studies have shown that vitamin D receptors are broadly distributed through out the human brain and its deficiency alters neurotransmitters that are known to be involved in the depressive symptoms. Most recently, it has been postulated that vitamin D modulates level of neuronal calcium ions that are responsible for onset of depressive symptoms." (NCBI, 2018)

Vitamin D deficiency and antenatal depression have been associated with diverse health outcomes including but not limited to a neurobehavioral disorder like autism,  downregulation of neurotrophic factors which may lead to psychosis, low birth weight, pre-eclampsia and small-for-gestational-age births. The complexity of this matter has yielded inconsistent study results with some of them delinking association of vitamin D deficiency with both antenatal and postpartum depression. There is compelling evidence linking this association. A systematic review of existing literature published at NCBI that involved review of 14 studies showed that 5 out of 9 of those studies showed a significant relationship between hypovitaminosis D and postpartum depression and 4 out of 7 of the studies showed significant relationship between hypovitaminosis D and antenatal depression. 


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BABY FACTS YOU MAY NEED TO KNOW

Here are some facts:-

NUTRITION
Breast milk is more superior than any other form of nutrition for the first six months to one year of life.
Skimmed and low-fat milk should be exed out in infants as they have too many electrolytes and protein levels. 
Whole milk can only be given to a bay after 1 year of age.
Bottle-mouth carries is common so it is advisable to use a cup and spoon during feeding rather than a bottle.

GROWTH.
Baby's weight doubles at 6 months and triples at  1 year of age.
The first tooth erupts at the age of 6 months.

SOCIAL INTERACTION
2-3 months baby smiles, makes a funny noise, sees and follows objects.
4-5 months baby can rollover. Watch for the risk of fall from the bed.
6 months start to sit with support, creeps.
8 months- crawls, sits without support, stands on support.
10 months- walks while holding on items, can move from face down to sitting position.
1 year- walks with one handheld.

SUDDEN INFANT DEATH SYNDROME (SIDS)

This is a name given to the sudden death of an otherwise healthy infant. It is common during the first year of life and occurs during sleep.

RISK FACTORS

1. Sleeping in a prone position.
2. Use of non-infant bed for sleeping.
3. Use of soft and fluffy bedding to cover the baby.
4. Low birth weight babies.
5. Babies of an alcoholic mother or cigarette smoker.
6. Exposure to tobacco smoke after birth.

 PREVENTION OF SIDS.

1. Avoid substance abuse.
2. Use baby cots for sleeping rather than non-infant sleeping surfaces.
3. Avoid covering the baby with excess bedding.
4. Adequate prenatal care.
5. Don't stuff extra bedding in the baby's cot.
6. Mothers not to sleep in the same bed with their babies.
7. Burp the baby after breastfeeding. 

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10 COMMON CAUSES OF INFERTILITY IN WOMEN

STI/ STD's- sexually transmitted infections are linked to infertility especially when they are left untreated. Both gonorrhea and chlamydia are sexually transmitted bacterial infections and when left untreated can have devastating and long term effects on the reproductive health of a woman. The infection may ascend to involve the fallopian tubes especially in women who take long before they seek medical assistance or those who don't experience symptoms to warrant them seek medical assistance. When the fallopian tube is involved they swell and during healing, scar tissue is formed which blocks the tubes impeding the passage of eggs and sperms. This causes infertility.

OBESITY- having extra weight more than a healthy weight may make it difficult for a woman to conceive. Obese women may have hormonal imbalances that trigger both ovulation and menstrual flow problems. Moreover, obese women are at risk of miscarriages, gestational diabetes mellitus, and premature labour.

LOW BODY MASS INDEX (underweight)- underweight women have been found to have low estrogen levels in the body. Estrogen primarily functions as a female sex hormone enhancing the development of secondary sexual characteristics. Extrapolating from this point, women who are underweight may have irregular menses or go through an anovulatory period of 2-3 months which may make it difficult to conceive.

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VIGOROUS EXERCISE- exercise helps us keep fit and healthy. Vigorous exercise, especially in athletes, leads to depletion and low fat under the skin which may be another reason for infertility.

ADVANCED AGE- as women age the chances of them becoming pregnant gets less and when they become pregnant at an advanced age they are at increased risks of pregnancy-related complications like miscarriage, abortions, high blood pressure, and others. 

SMOKING- I had highlighted before the darkest side of active and passive smokers. Nicotine in tobacco has been found to interfere with the body's ability to synthesize female hormone estrogen which is a significant hormone in ovulation. Female smokers have a 60% more risk of being infertile than non-smokers. Passive smokers are not exceptional so ladies keep off from men who are smoking.

ALCOHOLISM- I had blogged on the health effects of alcohol in pregnancy and there are more than just disabling effects of alcohol on the unborn baby. Alcohol doesn't affect only female fertility but men's fertility also. There is a universal recommendation that all women intending to become pregnant should stop taking alcohol for the safety of the baby. There no clear evidence that alcoholism affects female fertility but there is a relationship.

BIRTH CONTROL METHODS- different women respond differently to different methods on contraception just like the same way we have vegetarians and non-vegetarians. The best thing is to find which method of family planning suits you best. Each family planning method has got its pros and cons. Depo-Provera- an injectable contraceptive- is not recommended for people who are young, not had their first baby or those who are intending to become pregnant in the near future. It is a three-monthly injection but its contraceptive effect may persist for several months or more before the return of fertility. 

GENETICS- genetic abnormalities can also impede a woman from conceiving, carrying a pregnancy for 9 months or even prevent the fertilized ovum from being attached in the uterus leading to miscarriage. Just to digress slightly on this, women who have advanced in age may give birth to babies with a genetic problem in which the baby may have an extra number of chromosomes (down syndrome).

MEDICAL CONDITIONS- like endometriosis, polycystic ovarian syndrome

THYROID PROBLEMS- women who are infertile should be checked on their thyroid functions. 

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References:-
Obesity and infertility- NCBI. Link: https://www.ncbi.nlm.nih.gov/pubmed/17982356

WEANING AND PROTEIN FOOD ALLERGY IN BABIES

INTRODUCTION

It is a universal recommendation that all babies should be exclusively breastfed or given infant formula milk up to the age of six months. Mothers are encouraged to breastfeed their babies unless there are special considerations since breast milk has been found to be more superior to infant formula milk.

Breastfeeding has been associated with better immunity for the infant, reduced risks of sudden infant death, increasing bonding between mother and baby and breastfed babies have higher IQ than babies fed on formulas.

WEANING

From 6 months, start weaning the baby from breast milk by gradually introducing a solid diet. The digestive system for the baby is more developed now and can tolerate solid food in small amounts.

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Start with a soft diet like cooked mashed potatoes, yams, sweet potatoes, pumpkins, carrots, and others. Remember that the baby will not start by taking large amounts but small amounts then supplemented with breast milk or milk formula as tolerated.

As the baby tolerates mashed soft diet, introduce finger licks like ripe bananas to enable them to learn how to chew.

At the ages of 8 to 9 months, the baby has learned how to chew and maybe appropriate time to introduced soft chewable food like soft chicken meat; fish (make sure there are no bones).

Introducing cow or goat milk has certain considerations. From 6 months of age cow’s milk can be mixed with other foods for the baby. Having cow’s or goat’s milk as a drink should begin from one year of age. Skimmed milk is not a good choice for children less than 5 years of age.

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FOOD PROTEIN ALLERGIES IN BABIES.

Protein food allergies like milk, eggs and nut allergy seem to be getting common in babies than before. Allergy usually happens when the immune system registers the food protein as harmful and the body produces chemicals that produce signs of allergy.

Increasing hygiene standards have been hypothesized to be one of the contributing factors to the development of allergy. Increasing cleanliness puts the immune system of babies at throes of under stimulation with fewer bacteria and viruses to fight. This may cause the under-stimulated immune system to respond inappropriately to food proteins like milk, eggs or nuts causing an allergy.

There is this idea that delaying allergenic protein foods in babies like milk, eggs, and nuts help in the prevention of allergy development in babies and children is no longer valid. At the age of six months when the baby is gradually being weaned from breast milk, give baby one protein at a time and watch closely for any sign of an allergy. If the baby has an existing allergic condition, you may need to consult your pediatrician before introducing the protein foods to the baby. 

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 REFERENCE:

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/solid-foods-weaning.aspx