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係英國居住,通常見到朋友,鄰居或陌生人都會同你講一句 How are you ?來打開話題。我哋可以回答 I am fine, thank you 但其實我哋仲可以有好多嘢傾。

英國學校都有家教會或家長group,學校家教會有定期每月嘅家長聚會或者活動,最常見便是virtual coffee meeting 即網上聊天,或者monthly night pub for drop-in 即定期去pub或者cafe 見下面,傾吓計,有時間便可參加(可能係藉口俾自己去Clubbing輕鬆一下),還有些會約下大家去參觀博物館,行下英國名勝古蹟。

《熱門話題座談會》會搵多啲關於英國母嬰兒童健康嘅熱門話題同新聞,喺呢個度平台跟大家打開話題,傾吓計(請自備咖啡或茶)。

熱門話題座談會

重磅禮物

hot topic photo 032023.jpg

 (Image: SWNS )

@27/3/2023

在二月尾,英國一位已有兩子嘅媽媽Ruth(36歲)剛誕下一個大禮物。她的第三個嬰兒Tabitha出生體重12 lb 9 oz (約5.7 kg) ,而Tabitha一出生便打破了英國紀錄,成為本年度全英國最重嘅初生嬰兒。但Tabitha又未能打破英國紀錄, 因為現時全英國最重嘅初生嬰兒紀錄保持BB 係 Guy Carr (born in 1992) 出生體重15 lb 8 oz (約7.06 kg),而第二位是 George King (唔係英國皇帝,born in 2013),出生體重15 lb 7oz (約7 kg) 。

IMG-0594_edited.jpg

 (Image: SWNS )

媽媽Ruth 有鑒於之前在醫院生兩位哥哥(九歲及六歲),出生時分別係 9 lb 9 oz(約4.28 kg)和 15 lb 8 oz (約4.79 kg) ,今次第三胎選擇了在家水中分娩 (Water birth at home)。而佢亦是在預產期後兩星期半才自然分娩, Ruth仲形容Tabitha係”Well cooked” 。

整個分娩過程,Ruth選擇了NHS-funded aromatherapy(香薰)及accupuncture(針灸)去協助紓緩分娩痛楚,她租借水池(birthing pool),放在沒有地毯的客廳中。然後四週加上毛巾(towel)和防水布(tarpaulin),加上暖水和香薰油(aroma hot spa) 感覺更像去了Spa 。全程有助產士協助及為她打氣。 她話跟助產士討論birth plan時 ,她放棄去醫院(只是十分鐘車程)而決定家中分娩時,助產士同佢講: When you are pregnant you aren’t ill, it’s a really natural experience to be growing a baby and bringing it into the world (懷孕並不是患病, 這是一個自然嘅體驗去孕育和帶孩子到這個世界) 。

@express.co.uk

BL專題也有詳細解釋NHS birth plan嘅選擇

How to labour in water or have a water birth

不受歡迎的A

@2/12/2022

The UK Health Security Agency (UKHSA) 在星期五(2/12)黃昏罕有地發出警告,提醒家長們如果發現佢哋嘅小朋友有感染Strep A infection嘅跡象便要立刻求醫。

Strep A infection 在以往的冬季都會導至一至兩個兒童死亡。但係今年冬天, 係英國已有五個小朋友加上威爾斯有一個小朋友因為Strep A infection而去世。

 

衛生部就話沒有相關嘅證據證實有新品種流傳喺社區,這次較多兒童個案感染,可能因為細菌混入社區循環感染。相比起上年14/11至20/11,只有180 個因Strep A引發猩紅熱個案,但今年同期已經有851個案呈報,即有四倍感染人數,衛生部真係有啲擔心。

 

Strep A infection係甲類鏈球菌,常見會引發猩紅熱(Scarlet fever) 主要影響兒童病發初期通常出現發燒和喉嚨痛,偶爾會有頭痛、嘔吐和腹痛。舌頭表面或會出現草莓般(呈紅色和凹凸)的外觀。一般在發病首天或翌日,身軀和頸部會出現砂紙般粗糙的紅疹,其後紅疹會蔓延至四肢,通常在腋窩、肘部和腹股溝處尤其明顯。紅疹多在一星期內消退,繼而指尖、腳趾和腹股溝的皮膚會脫皮。猩紅熱有機會引致併發症如中耳炎、咽喉膿腫、肺炎、腦膜炎、骨或關節毛病,亦可對腎臟、肝臟和心臟造成損害,和引致較罕見的中毒性休克綜合症。傳播途徑可存活於患者的口腔、咽喉和鼻子,可透過飛沫或直接與受感染的呼吸道分泌物接觸而傳播。而潛伏期一般為1至3天。

 

衛生部亦補充,Strep A感染病徵包括有喉嚨痛、發燒、輕微皮膚感染,在大部份情況之下,只要服用抗生素就可以康復㗎。不過亦有少數嘅情況之下,當感染Strep A就會變得越嚟越嚴重。如果情況係持續發高燒,嚴重嘅肌肉痛或者係身體某個部份特別疼痛,有不能解釋嘅嘔吐腹瀉,就要搵緊急求醫。

@Guardian

倫敦推行緊急
小兒痳痺症疫苗計劃

Polio virus.jpg

 

之前衛生部門都話唔使驚嘅,但係呢哋佢見個樣本越來越多,細菌樣本來自Beckton catchment area, Enfield, Barnet 鄰近,還有south(immediately south of the Thames) and east,再加上有國家有病例跟英國發熱嘅樣本品種相近。衛生部門(UK Health Security Agency, UKHSA)就擔心啦會發現更多細菌樣本。所以決定要安排小朋友服食疫苗,疫苗計劃主要係為咗減低兒童受感染後情況而引致不良反應,例如癱瘓(paralysed);另外亦想提高兒童免疫程度從而減少擴散傳播風險。

London polia locations.jpg

新消息!住喺London年齡由一歲至九歲嘅小朋友,將會安排呢服食第一劑口服小兒麻痹症疫苗(IPV)。下個月開始,GP會陸續聯絡家長或者照顧者去安排小朋友服食疫苗。點解要一至九歲兒童服用疫苗?因為專家覺得10歲以下小朋友的自我護理比較差而容易增加個傳染風險。而一歲至九歲嘅小朋友亦會因應不同歲數而服用嘅疫苗相相關藥廠之疫苗建議(見附圖)。

 

係六月嘅時候,已經有新聞報道,話喺東倫敦及西倫敦嘅污水渠發現好多喺英國未見過嘅小兒麻痹症病毒品種,而現在已確認品種係屬於耶路撒冷(Jerusalem)、以色列(Israel)及美國紐約(New York State)。而紐約也證實最近有一位男性感染小兒麻痹症。

 

而自2022 年2月開始,倫敦嘅污水道啦已經發現有116宗小兒麻痹細菌樣本,有見及此,政府就要安排一個緊急嘅接種計劃(urgent immunisation campaign)。大概有100萬名兒係需要服食第一劑口服小兒麻痹症疫苗。

 

之後,佢哋會呢將小兒麻痹症加強劑(supplementary IPV booster) 疫苗加入去小朋友接種疫苗時間表入邊,希望能夠配合到小朋友其他疫苗接種時序。詳情可參考下面:

Joint Committee on Vaccination and Immunisation statement on vaccination strategy for the ongoing polio incident

 

@BBC news

倫敦以內發現Polio 樣本地區

polio vaccination age 1 to 9.jpg

建議不同歲數服用之小兒痳痺症疫苗

小兒麻痹症

Polio.jpeg

credit @ BBC news

兒麻痺症(Polio)是由脊髓灰質炎病毒所引致。此病具有高度傳染性,主要影響幼童。患者可能會出現發燒、頭痛、嘔吐、腹部不適、肌肉疼痛、頸背僵硬及麻痺等症狀。大部分患者都可以痊癒;但嚴重者可導致永久傷殘甚至死亡。病毒主要經口糞途徑由人傳人。病毒經口進入人體,最終會侵入中樞神經系統。1950年代小兒麻痹症係英國也很普遍,直至2003年都已經差不多在英國消失。

 

最近在倫敦東部及北部的排水渠(sewage )發現同一品種嘅樣小兒麻痹細菌,所以就引起UK Health Security Agent (UKHSA)關注。UKHSA 指出,今次連續發現嘅樣本都係一種英國自2004 後未出現過嘅品種,有機會係有人最近在海外接種過小兒麻痹疫苗,然後經排泄再出現喺排水渠。

英國衛生部門其實會定期檢查驗排水渠樣本,而今次嘅發現,引起相關部門擔心呢個病菌亦都有機會傳播出去或者成爲變種病毒:疫苗衍生「小兒麻痹症」("Vaccine-derived" polio)。

雖然感染風險係低,但係家長應該要留意吓小朋友有冇按時(一歲前、三歲及十四歲)接種小兒麻痹疫苗。全英國約有92%人口已經打咗疫,但倫敦接種率比較遜色,只有86%。而英國衛生部門亦有跟世界衛生組織(WHO)呈報。

 

雖然衛生部門話唔會太擔心,因為當年接種率高,所以自2003年後小兒麻痹症已經在英國絕跡。現在NHS 亦都會主動去聯絡家長,邀請佢哋五歲以下子女去接種疫苗。而家長也可以check吓佢嘅「紅簿仔」(Red book) 接種紀錄或預約GP去接種疫苗。

 

乜嘢叫「紅簿仔」(Red book)?Red book = PCHR, Personal Child Health Record 好似香港衛生署派俾家長嘅兒童健康成長紀錄手冊(男仔粉藍色,女仔粉紅色)。在英國,嬰兒出生不久就會收到呢本紅簿仔作為日後嘅健康記錄

@ BBC news

NHS新生嬰兒及兒童疫苗接種時間表

Red book.jpeg
Concrete Wall

Monkeypox 疫情  「蓄勢待發」

Monkeypox virus.jpg

update @ 25/5/2022

 

實monkeypox 疫情有增加趨勢, 目前全英國共有70個確診個案。Monkeypox 係一種過濾性病毒傳染病,病毒源自非洲中、西部國家。而首次發現呢個病毒是在猴子身上,所以命名為monkeypox。 英國第一次發現係2018年, 患者由Nigeria 尼日利亞(非洲中西部國家)傳過來,之後在2021 亦再次出現過。 而英國的出現嘅monkeypox個案, 大多數都係有曾經去過尼日利亞。

暫時知道monkeypox 有兩個品種,西非品種(West African strain)比較溫和,而另一個品種來自中非(Central African strain or Congo strain )係比較嚴重。現在國際性傳播嘅就係屬於西非嘅品種。根據UK Health Security Agency 指出,monkeypox病徵包括:發燒(fever) 、頭痛(headache)、肌肉痛(muscle ache)、淋巴腫脹(swollen lymph node)、發冷(chills),病徵會使身體覺非常疲倦(exhaustion)。其他病徵如身體出現紅疹 (rash),

由面部開始蔓延到去身體其他地方,包括性器官。而紅疹亦都會有唔同嘅階段發展出來,病徵跟水痘(chickenpox)或者係梅毒病(syphilis) 有些相似,而最終會結痂(scab),一般患上monkeypox 需要幾星期才能痊愈。

 

英國現時治療monkeypox 會使用抗病毒藥物(Anti-viral) ,而密切接觸者就需要接種天花疫苗 (smallpox Vaccination)作預防。NHS 亦指引密切接觸者要自我隔離三個星期。

 

點解要打天花疫苗,因為smallpox vaccination 對於預防monkeypox 有效,不過天花已經在呢個世紀絕種,所以一般國家的不會指定接種天花疫苗。要注意,在香港出生小朋友也只有跟香港疫苗接種計劃於第十八個月或小一時接種MMRV, 即混合針加了水痘疫苗(varicella vaccination) ,但對於Smallpox 或monkeypox是沒有防疫作用。 所以,大人跟小朋友一定要小心小心。


@theguardian

How you get monkeypox (NHS)

NHS新生嬰兒及兒童疫苗接種時間表

Blood Test

NHS 新增產前特別檢查

update at 30/3/2022

呢排NHS有好多針對產婦安全嘅新安排。繼生放寛孕婦選擇剖肚生產的限制,NHS 又將會提供產前抽血檢查給有傾向產前妊娠綜合症的高危的產婦作檢查。

妊娠毒血症(Pre-eclampsia Toxaemia, PET) 是一種不常見但嚴重的妊娠併發症,病發於懷孕中、後期,或剛生產後。若孕婦有糖尿病、血壓高或紅斑狼瘡的病歷、過往懷孕期間曾患有妊娠毒血症、近親有妊娠毒血症的懷孕病史、高齡、是次懷孕與上一胎相隔十年、懷有雙胞胎或多胎或肥胖,也屬於高危組別。孕婦除了有嚴重水腫外,孕婦血壓會上升(如血壓高於140/90mmHg)和出現蛋白尿的情況。又或出現其他病徵包括:嚴重頭痛、視力模糊或出現閃光、上腹疼痛、嘔吐等,便必須緊急就醫,接受監察和治療。

 

妊娠毒血症可引發子癇(痙攣)、或導致肝、腎、肺衰竭、凝血問題,對孕婦及胎兒的健康和性命構成威脅。

而NICE (National Institute for Health and Care Excellence) 指出,若能及早點確診PET, 有6%以上嘅孕婦可以得到適當治療及避免有生命危險。NHS 増加的血液測試叫PLGF test, PLGF (placenta growth factor) 是一種蛋白質用來幫助發展胎盤的新血管,如果PLGF水平太低,反映胎盤成長得唔夠好。助產士可以根據新指引去安排高危孕婦做PLGF測試,而測試結果可以即日知道,從而篩選有PET潛在危險嘅孕婦,能得到更加密切嘅監察或相應的產前安排。

 

@ BBC news

Sleeping Baby
Sleep, Baby & You

update at 25/3/2022

 

BB唔肯瞓覺,常常攪到父母好煩惱。而呢個問題往往跟新手父母的情緒抑鬱同焦慮有緊密嘅連繫。NHS 下星期會推出新指引讓Health visitor 同community nurses 去教新手父母點樣處理BB唔瞓覺嘅問題。

 

現時一般產後health visitors 未必受過專業訓練或唔夠信心去指導新手父母如何應付唔瞓覺BB嘅問題。Durham University Infancy and Sleep Centre 的Professor Ball 指出脾氣不好的BB其實係正常嘅。

 

NHS沿用澳洲 Possum Sleep Program 去發展一套新指引 "Sleep, Baby & You" , 用來教父母如何面對自己對BB 的期望,負面想法及鼓勵「有求必應」嘅育兒方法 (responsive infant care) 。

Prof Ball 話一般情況,父母會用「正常」(normal) BB 嘅表現「套」上自己BB 嘅睡眠習慣。事實上,BB 要慢慢哄住才能入睡,例如掃風後,再擁抱(cuddle)直至BB 靜下來才放在床上瞓覺,千萬不要在嚎哭時立即放回床上。

專家亦建議父母不要太堅持BB要日頭眼光光,夜晚就去瞓覺嘅想法。因為嬰兒離開母體不久,佢哋嘅生理時鐘也需要時間去適應另一個新環境。只要BB需要瞓覺時便讓他去睡(naps happen on the go) 。另一方面,新生兒不能夠瞓太耐,因為太熟睡會令BB唔覺肚餓,而血糖低。其實母乳好快被嬰兒吸收,胃部又細,所以多餐小食是正常的。Prof Ball 也指出,很多父母也不喜歡「有求必應」嘅育兒方法。如果不做sleep training, 新指引亦會提供其他建議。

 

@The Guardian

英國增加兒童肝炎確診

update @ 22/4/2022

近英國兒童患上肝炎(肝炎即是指肝臟細胞發炎liver inflammation)嘅跡象有突然增加。 一般肝炎區分為:甲型和戊型肝炎經由食物和水傳染,而乙、丙和丁型則主要由血液或體液傳染。但專家話呢一批小朋友所感染嘅品種也不能分類。專家發現有77% 兒童同時也對於另一種感冒菌腺病毒(Adenovirus) 呈陽性反應。

現時個案年齡介乎一至五歲,英國有75個; 蘇格蘭14 個,威爾斯15 個確診,而其中有8個小朋友更需要進行肝臓移植。所以英國衛生部門都好擔心,究竟咩原因會引致佢哋患上急性嘅肝炎。

 

專家從一方面去研究遺傳因子嘅影響;而另一方面就擔心係咪因為疫情引至好多限制(pandemic restriction) ,使到小朋友延遲暴露於一般常見嘅感冒菌感染,當佢哋一旦受到感染嘅時候,小朋友嘅免疫系統作出一些過於激烈嘅反應而引致肝臟受到影響。

 

現階段專家指出,小朋友仍然要維持良好嘅衛生意識,例如經常洗手,咁已經可以保護佢哋受到一般感冒菌或COVID感染。專家亦都提醒家長們,如果開始發現小朋友有沒有特別嘅肝炎病徵,如黃疸(尤其是係眼白同皮膚都呈黃色)就要盡快搵GP 求診。而其他肝炎嘅病徵,例如深黃色小便、皮膚痕癢、肌肉疼痛、冇胃口也需要留意。

@BBC news

Little Boy Playing Doctor

甚麼是

腺病毒(Adenovirus)

病原體

腺病毒是一組感染人類黏膜的病毒。因應不同的血清類型,病毒可引致呼吸系統症狀,亦可導致腹瀉、眼睛發炎及紅疹。腺病毒感染全年皆會發生。

病徵

不同血清類型的腺病毒可引致不同的病徵,例如咳嗽、流鼻水、喉嚨痛及發燒等呼吸道感染病徵;腹痛及腹瀉等腸道感染病徵;及眼睛發炎(俗稱紅眼症 )。兒童、長者及免疫力受損的人士較容易受到感染。

傳播途徑

腺病毒主要透過飛沫(如咳嗽或打噴嚏)、直接接觸患者的口鼻分泌物(例如與患者握手,或接觸受污染的物件表面),或進食受污染的食物或食水傳播;及可於學校及醫院等院舍內引致急性呼吸道及眼睛感染的爆發。

資料來源:香港衛生防護中心

SIDS factors.jpg

SIDS
真正原因?!

update @ 13/5/2022

 

兒猝死(綜合)症 (Sudden Infant Death Syndromes, SIDS) 一直都係育兒關注重要議題,尤其要學習如何照顧新生嬰兒嘅父母,照顧人員(陪月員, maternity nurses,保姆等) ,也要認識和學習如何避免SIDS發生。 因為好多好多研究也搵唔到有甚麼直接因素而導致SIDS,所以很多教學上會分析一些潛在因素(potential risks)去提醒每個嬰兒照顧者要如何避免。

澳洲科學家(Children’s Hospital at Westmead, Australia) 最近有重大發現 (研究報告發表於 The Lancet's eBioMedicine) 。研究員在嬰兒出生時抽取一種生物標記,酵素(Biomarker, enzyme): Butyrylcholinesterase, BChE, 之後再跟分別因SIDS及非因為SIDS而死亡的嬰孩中的BChE水平作比較。科學家發現,因SIDS而死亡的嬰兒出生時的BChE水平是比較低。 BChE 是腦部中重要的傳送途徑(pathway) 去喚醒(arousal) 嬰兒, 如果BChE水平較低, 嬰兒比較難喚醒或對危險情況下的自我保護能力較遲緩。

 

研究背後也有傷心故事,其中一位醫生Dr. Harrington 也是在29年前因SIDS 而失去她的小朋友,所以Dr. Harrington一直要尋找嬰兒較難喚醒嘅原因。現在她和團隊終於找到真相,而下一步便是研究為嬰兒檢查BChE水平及制定待特別方案如何去幫助這些嬰兒。Dr. Harrington話以前每當健康的嬰兒入睡後,父母也會好擔心BB 不會醒過來, 現在找到真正答案,希望能夠給予傷心嘅父母一點慰藉。

news@wtvm.com

甚麼是嬰兒猝死(綜合)症 (Sudden Infant Death Syndromes, SIDS)?

SIDS 是一種不明原因的死亡,通常是在睡眠期間,嬰兒多數看似健康的而且不到一歲。 SIDS有時被稱為嬰兒床死亡,因為嬰兒常常死於嬰兒床。儘管原因尚不清楚,但似乎SIDS可能與嬰兒大腦控制睡眠呼吸和喚醒的部分缺陷有關。@healthceo.com

 

三大要素導致SIDS :

很多科學研究已列出三大要素導致SIDS, 即是指當脆弱嬰孩 (Vulnerable Infant) 正處於重要發展時期(Critical Development Period) 而暴露於一些已知的外來刺激(Outside stressors) ,當嬰兒同時處於這三項因素,便有機會有SIDS。

甚麼是重要發展時期?

如嬰兒開始學習打滾動 (learn to roll); 睡眠模式開始成熟,即睡覺時間較長,較熟睡(sleep cycle is longer and deeper).

甚麼是外來刺激?

一些已認知的因素: (父母)吸煙或暴露二手煙當中; 體溫過熱; 窒息; 沒有與父母(或照顧者)同睡一房間; 疾病; 餵哺配方奶粉。

Sleeping Baby

539克 BB 畢業了

update@14/3/2022

 

當Lucas 媽媽,Sarah,在二十三週產檢時,姑娘發現Sarah 的子官頸已經開咗兩度(dilated) , 即係有生產嘅徵狀,所以要緊急生產。當時Lucas 在媽媽肚中只逗留咗二十三週四日出生便出生,係早產BB,出生體重只1磅(539克)。

 

preterm Lucas 2.jpg

 

一般足月(36週以上)嬰兒體重只要有五磅以上,便有足夠吸啜母乳的力氣。但Lucas只有二十三週,好多器官未完全成熟,尤其係肺部,正常要等到二十六週才夠力呼吸,加上基本低抗力也沒有。所以他一出生已有肺部下塌(lung collapse)同血中毒(sepsis)。醫生亦告知Lucas 媽咪,BB只有15% 存活率,著她作好準備。

 

小小嘅生命,已經歷左六次感染,兩次肺部下塌和接受數次輸血。經過醫護人員細心照顧,最後Lucas在新生嬰兒加護病房奇蹟地成長起來。他住在醫院142日(約五個月),終於穩定下來,體重増磅到8磅4安士(3.7公斤),可以跟媽媽返屋企。 Sarah 也想跟其他有相似嘅父母分享她的經歷:Hope is all I had from the start and it worked。

@ BBC News

photo credit: Family handout

preterm Lucas1.jpg

dad
baby blue

Update@10/2/2022

Postnatal depression (post natal depression) is also known as Baby blue. This term is not only reserved for postpartum mothers. According to a report from the Scottish Ministry of Health, one in ten fathers will suffer from postpartum depression.

 

One of the cases involved Peter, 39, whose wife gave birth to BB in 2016. He tried for a month, and every morning when he got up, he felt so weird (I woke up every morning with a knot in my stomach, you felt like there was a big dark cloud following me about). When he tried to pick up his five-year-old daughter from his grandmother's house, he suddenly hugged a girl and shouted for fifteen minutes. He knew that something was wrong with him, but he felt that it would be embarrassing to see a doctor.


Man Holding Newborn

A psychiatrist pointed out that in fact, about 8 to 15% of fathers will suffer from postpartum depression. The reason is that the life position has changed to new parents; the relationship between husband and wife has also become tense; coupled with the financial burden and lack of sleep. Moreover, most men tend to share their inner feelings less with others, so they will be less likely to seek medical treatment or specialist treatment. The NHS also mentioned that if parents already have mental health problems, or if they have been traumatized and have not received proper treatment, they are more prone to postpartum depression. In addition, there is a case that if the wife suffers from depression and has been admitted to the doctor, the husband will have depressive symptoms.

 

Health Scotland said they did not offer routine antenatal and postnatal depression screening for expectant fathers for the time being. And the NHS began to try to make a plan to help expectant dads to prepare themselves for the prenatal and postnatal period. But in fact, if fathers need information on postpartum depression, they can go to the NHS website to find them. Of course, the mental health of the expectant mother is very important, because this is an important factor affecting the mental health of the husband.

 

@BBC

Can pregnant women in the UK freely choose C-section?

Update @22/2/2022

According to normal NHS procedures, when you see a doctor or midwife around 26 weeks before delivery, a birth plan will be set with you, including choosing where to give birth, who can accompany the birth, and what pain relief methods to use. What to do if you need a caesarean section. In special circumstances, "if" a caesarean section (C-section) is required, how to arrange it.

 

According to the National Institute for Health and Care Excellence (NICE) guidelines, the NHS will only provide C-section surgery for fetuses in a breech position or malposition; placenta previa (Low-lying placenta); pregnancy toxemia ( Pre-eclampsia); genital herpes, untreated HIV; fetal hypoxia or heavy bleeding in pregnant women. If you choose C-section for non-medical reasons, you have the chance to be rejected. In order to encourage natural childbirth, generally only 20% of pregnant women can undergo surgery.


In an effort to improve the health of mothers and babies, the NHS recently decided to leave no restrictions, giving pregnant women the freedom to choose the C-section. This change stemmed from an unfortunate mother whose BB suffered a medical accident and died during childbirth (details are not mentioned). He wrote to one of the NHS Trust committees to reflect this unfortunate experience. The medical institution pointed out that during the 2021-2022 period, out of eleven medical accidents in July alone, there were already five involving pregnant patients (pregnant women).

A senior obstetrician pointed out that in the past, NHS used the median Total C-section rate to determine performance management, which was not correct and safe. In fact, every pregnant woman's method of birth should allow the pregnant woman to learn more about the benefits and dangers before making a decision.

 

@BBC News

NICE guideline for caesarean section

​Information from Bonds Lane MNS website Public Prenatal Checkup - Appointment Process (Chinese version)

熱門話題座談會: Image
Marble Surface

What is the impact of Tongue-tied baby?

Update @15/2/2022

Breast milk is the most precious nutrient, and mothers will try their best to learn feeding skills so that BB can suck as much as possible.

 

Clare, a British mother, also breastfed her first child until she was 19 months old. When feeding the second BB Lily this time, she felt completely different from the last time. Qu recalled that when BB was just born, every time she finished feeding, she felt so exhausted and wanted to shout. Because Qu felt that her daughter had a beak to suck at her like a sparrow, and after each feeding, her nipples were bruised and painful. Therefore, he suspected that Lily had a "tongue tie", so he contacted an NHS midwife to visit her home and perform a BB examination (because it is a general postpartum gynecological examination in the UK or a newborn BB examination, a midwife is arranged to visit the home). The NHS told him to wait and see, but the baby sucking problem is more urgent. If the newborn BB does not suck enough breast milk, it will affect the health. In the end, Clare couldn't wait for the NHS to arrange, and asked a private maternity nurse at her own expense (£400) to confirm the symptoms (tongue tie) and treat it, so that Lily could suck breast milk normally.

Tongue-tie, also known as Tongue-tie (Ankyloglossia ), is a frenulum formed by the connective tissue on the midline under the tongue, connecting to the tip of the tongue, causing a depression on the tip of the tongue and a central groove on the surface of the tongue, which may affect the lift of the tongue. In severe cases, it is more likely to cause difficulty in sucking in infancy or problems with pronunciation in the future.

The Tongue-tie symptoms of infants are usually found that the BB mouth is more difficult to stick to the nipple for sucking, the sucking process is intermittent, the BB is often hungry and the weight does not increase. There is a "click" sound when inhaling. Breastfeeding mothers may also experience nipple headaches or breakage after breastfeeding, insufficient breastfeeding, and even breast inflammation. The above situation is actually related to breastfeeding skills, but if the skills have been improved and the BB continues to suck breast milk insufficiently, it should be assessed by a midwife as soon as possible.

Newborn Baby with Mom

In fact, Clare feels that when the postpartum mood is the lowest (the lowest ebb), the NHS has already told the NHS that there is a problem with the BB, but when urgent support is needed, mothers still have to work hard to "get" proper diagnosis and treatment. Opportunity to miss the best time to breastfeed.

The NHS also has a simple tongue-tie division (Tongue-tie division), which can generally be carried out by doctors, nurses or midwives as long as the diagnosis is made. Since there are fewer nerve lines under the tongue, newborn babies will not be given painkillers or anesthetics during Tonge-tie division, and the bleeding from the wound is not much, and usually heals in one to two days. BB can also resume breastfeeding after completing treatment.

@BBC News

NHS Tongue-tie

Guidelines for Evaluation and Management of Tongue Tie (Chinese Version)

The problem of British school children's diet

Update@4/2/2022

 

It turns out that 3.3 million children in the UK are obese. Among European countries, the UK ranks first in the proportion of obese children in the population, so many reports are related to children's health problems. Coupled with the COVID-19 epidemic, which directly or indirectly affects British children's daily eating patterns, reduced physical activity, and poor eating habits, obesity in schoolchildren is on the rise.

 

Celebrity Jamie Oliver has always been concerned about this issue. Jamie established a charity organization "Bite Back 2030" in 2019 to recruit young people to speak out and promote how to improve school nutrition for school children. The goal is to reduce the obesity population of British school children by 50% by 2030.

School meals are free for all children in the UK before the age of six. If schoolchildren or families fall into the sponsored category, they can also enjoy free school meals through Year 6. But the UK government subsidizes free school meal per child at £2.34 a day, and this amount has not been reviewed since 2011. Recently, Jamie assembled a group of school principals and college directors to send a letter to Education Minister Nadhim Zaharia to persuade the government to face up to the healthy diet of school children and improve the nutrition of school meals.

 

And BiteBack2030 also released a report , which invited many young people to express their views on school meals ranging from small meals to large ones. This report is worth spending a little time to understand the thoughts of the new generation of young people in the UK. The report also pointed out some practical problems, such as poor families, where school meals are the only option. In fact, school children return to school 190 days a year, which means they eat school meals for more than half a year. Therefore, in addition to being good or not, school meals are really important in terms of nutritional value.

@TheGuardian

Does the child Zhong You have any vaccinations?

Update@1/2/2022

 

Since the outbreak of COVID-19 in March 2020, there have been reports of a decline in MMR vaccination rates among children. From July to September 2021 alone, 88.6% of children received their first dose and only 85.5% of their second dose. The World Health Organization (WHO) recommends that 95% of children be vaccinated against herpes in order to effectively reduce infection.

 

It is also for this reason that the UK Health Security Agency (UKHSA) and the NHS are concerned that thousands of children (i.e. around 1 in 10 five-year-old UK children have not yet received a second dose of the MMR vaccine) may become infected and cause complications.

 

disease. As for the reason for the low vaccination rate, it may be that parents are worried that arranging children's vaccinations will increase the workload of the NHS and do not have regular appointments; there are also multiple COVID restrictions that have also extended the NHS appointment period.

Many Hong Kong mothers also know that MMR is a type of vaccination, including Measles, Mumps and Rubella. The Hong Kong Department of Health will distribute a pink or pink-blue record book and a needle card to parents of newborn babies to allow them to record their children's growth records in detail. Parents will also vaccinate their children regularly according to the vaccination schedule.

 

But in the UK, childhood vaccinations are not compulsory, and parents can choose not to arrange vaccinations for their children. If you want to vaccinate your child, you will have to contact the GP yourself (by writing, calling or emailing) to arrange a time.

 

Therefore, the official also calls on parents to think about their children, and remember to take their children to take MMR on time.

 

We have carefully prepared the <NHS Newborn Infants and Children Vaccination Schedule> , with the Hong Kong Children's Vaccination Schedule for comparison .

@The Guardian

Healthy Eating

Dad's choice

update@26/1/2022

A father in the United States, because his wife was diagnosed with COVID, his six-month-old BB daughter also unfortunately contracted COVID, and her condition worsened. Since my father distrusted the hospital very much and did not want to send his daughter to see a doctor, he asked an online group to "discuss" how to "treat" a BB girl.

Dad asks if it is possible to give BB an anti-parasite with no clinically proven efficacy. Some netizens expressed support and suggested the amount. Dad decided to give medicine to BB. After that, the BB girl vomited immediately and her face turned blue.

Dad was so startled when he saw a girl, he asked netizens for help. Some netizens knew about BB's situation, but instead begged Dad to send BB girl to the hospital to see a doctor. In the end, the father sent BB to the hospital, and the baby girl's condition improved, but he did not forget to thank the netizens for their "help" in the end.

In fact, when your child is sick, no matter how much you don't trust the hospital, the decision of the parents is very important.

 

@walesline.co.uk

breast milk turns green

update@20/1/2022

Recently, a British mother, Ashmiry, shared her breastfeeding experience on IG. Ashmiry has two young children who recently suffered from COVID-19 in the family. He shared that the breast milk that remained low before the infection was compared with the breast milk after the infection, and it was found that the breast milk after the infection turned green. And because he felt relatively weak after being infected, and breast milk was precious and full of nutrients, he decided to drink green breast milk as a supplement.

Some health experts have pointed out that in fact, the mother is infected with COVID-19 and has never seen the COVID-19 virus in her breast milk, but has a higher chance of human-to-human transmission. Of course, the decision to continue breastfeeding depends on the mother's choice or the advice of a doctor (GP) or midwife (midwife).

If you want to dump more, you might as well go to <ZiNvJing> to open a group and ask people to dump.

Credit: Instagram/@ashmiry_

Is it good to catch COVID during pregnancy?

update@21/1/2022

COVID-19 has slowly become endemic in the UK. What if you are unfortunate enough to contract pts during pregnancy?

 

Nature Medicine recently published a report (COVID in Pregnancy Study)  Studies of pregnant women who have been infected with COVID-19 requiring hospitalization or intensive care. Scotland began arranging the COVID-19 vaccine for pregnant women in December 2020, while the study period was from December 2020 to October 2021.

The study analyzed the vaccination rates of pregnant women in three trimesters (first, second, and third trimesters) and the proportion of pregnant women who required hospitalization or ICU admission due to COVID-19 infection. The results indicated that vaccination rates were similar across the three pregnancies. In the first trimester (1st trimester) and the second trimester (2nd trimester), the rate of hospital admission or intensive care was not high, but the highest rate of hospitalization or ICU admission was required for infected pregnant women (not vaccinated) in the third trimester (3rd trimester). Then the sequelae such as premature birth, stillbirth or the death of the newborn baby after birth cannot really be ignored.

In Scotland in February 2020, pregnant women have been defined as a priority group for vaccination,

In April, a priority vaccination program was also offered to pregnant women. The NHS is also strong

Adjusting the vaccine has no effect on pregnant or nursing mothers. For details, please refer to

link below.

 

@Nature Medicine

NHS information on vaccinations for pregnant and breastfeeding mothers

Pudding banned from London primary school menu

update@23/1/2022

Newham, one of the boroughs in East London, has one of the most obese children in the UK, and the city government is worried about the health of the children. One of Newham's primary schools decided to remove pudding as a lunch dessert from their lunch menu. The reason is that they feel that after the students have eaten lunch, they are particularly irritable when they go to class in the afternoon, and there is a sugar crash.

 

Sugar crash actually refers to the sudden low blood sugar level that causes the body to appear distracted, irritable, fatigued, anxious, and so on. And this situation does not only occur in diabetic patients, in fact, ordinary people have the opportunity to occur. The reason is that whenever the body eats a large amount of carbohydrates, such as pasta, pizza or simple carbohydrates such as sugar or desserts, the body releases a large amount of insulin to deal with the excess sugar, and the blood sugar level will decrease. Sudden low (hypoglycemia).

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