Archives

Breast-feeding cry

It has become a problem for the working mothers in the private sector establishments to effectively breast feed their babies in the first year as recommended by the WHO, to ensure the growth of a healthy baby.

We have had several letters from these working mothers informing us of the difficulties they face in getting adequate leave to continue breast feeding their babies after the four month mandatory maternity leave lapses. They say the employers often do not give them the two hour short leave they are expected to grant these mothers to go home for breast-feeding the baby and return.

They also point out, that their homes being generally miles away from their working places, and with the most unreliable, and improperly regulated public transport system we have got in this country, even the two hour short leave is not enough for this purpose.

In the light of these letters where the working mothers are crying to get a hearing from the authorities for the breast feeding rights of these babies, we decided this week to refer to an article on the same issue of breast feeding, which was published in a recent issue of the US Family Physicians (FP Report) made available to us by Dr. Dennis J. Aloysius, one of the doctors in our Medical Advisory Panel.

In this article on - A Campaign To Promote Breast-Feeding, Dr. Sheri Porter writes:

Breast is Best

Despite years of studies proving the benefits of breast-feeding, for babies and moms, experts are still trying to convince the public that 'breast is best'.As part of a renewed educational effort the Department of Health and Human Services released its HHS 'Blueprint For Action on Breast-feeding' last fall.

The plan recommends that infants should be exclusively breast-fed for six months and that ideally breast-feeding should continue through the first year of life.

Serious Public Health Challenge in US

Announcing the plan, Surgeon General David Satcher MD, Ph.D said "Low breast-feeding rates documented in the HHS Blueprint are a serious public health challenge, particularly in certain minority communities.

Racial & Ethnic Disparities in BF

Statistics for 1998 reveal racial and ethnic disparities in breast-feeding. In 1998 only 45 per cent of black-American women breast-fed their newborns and the figure dropped to 19 per cent after the babies were 6 months old.

By contrast, figures for American mothers as a whole were higher with 64 per cent breastfeeding after delivery, but only 25 per cent still nursing six months later.

Note by our Medical panel:- This kind of detail statistics are very useful in planning out strategies to tackle a problem. Unfortunately in our country we lack them.

Lack breastfeeding expertise

What's going on? For one thing many physicians solely lack breastfeeding expertise. Addressing this problem the HHS plan calls for increased training for healthcare providers on how to promote breastfeeding including continuing education requirements.

Only half rated effective

A 1995 study coauthored by Gray Freed MD, and published in the Journal of American Medical Association found, "overall physician involvement in breastfeeding promotion was endorsed by 90 per cent of respondents, yet only half rated themselves as effective in counselling breastfeeding patients. Back in 1993. Freed wrote in JAMA "It is indeed time to teach what we preach".

Critical Public Health Issue

Alicia Dormer MD - Physicians have a responsibility to promote breastfeeding, because it is a critical public health issue. Anytime a physician misinforms a woman and has her wean, that decision has a direct health impact on her baby and potentially on her.

Use teachable moments in your practice to normalise breastfeeding. Make it part of what you teach everyday in interacting with patients.

What you don't say counts too

What you don't say counts too. The omission of a statement has a powerful effect. If physicians don't talk about breastfeeding people may assume, it's not that important.

Sri Lanka's situation

With regard to Sri Lanka's situation in breast-feeding a five member core-group appointed by the Sri Lanka Medical Association (SLMA) in 1997 to review the Sri Lankan Code for Promotion and Protection of Breast-feeding stated.

Pre-schoolers malnutrition high

Although Sri Lanka stands favourably in respect of most of the health indices, our rates of malnutrition amongst the pre-schoolers are unusually high. The studies done by Profs. Priyani Soysa, Harendra de Silva, UNICEF, Family Health Bureau etc.

have shown that our children begin to deteriorate in standards for weight from the 6th to 10th month. They also show that these children show very satisfactory weight gain up to the 4th month.

Normal growth up to 4 months

According to the Demographic and Health Survey done in 1993, 92 per cent of infants maintained normal growth up to four months, but 20 percent were malnourished by one year.

The proportion rises to 30 per cent by the second year and an alarming 35 per cent by the third year. Analysis of reasons for this "fall-off" in weight reveals that, irrational early introduction of bottle feeding in addition to breast milk and the inadequacy of energy density of some traditional complementary feeds such as Cunjee are responsible.

Proper health education needed

Action that has to be taken is proper health education of the public in the correct preparation of home made complementary foods, ensuring adequate energy density and its frequency and quantum. However, it is not always feasible to give infants only home made complementary foods.

Commercial preparations have a place. It is not rational to place complementary foods. It is not rational to place complementary foods in the same category as formula feeds.The committee comprised - Dr. Dennis J. Aloysius (chairman), Dr. Lucien Jayasuriya, Prof. Harendra de Silva, Dr. Sarath de Silva and Dr. Reggie Perera (who is the present secretary Health Nutrition and Welfare Ministry).

Formula-free zone

Discourage bottle-feeding by making your office a 'formula-free zone'. That's not to say we can't prescribe formula if someone needs it, but we shouldn't give out samples and literature for Formula Companies.

Prof. Narada Warnasuriya:- We will carry next week an article on this issue based on an interview we had with Prof. Narada Warnasuriya, Professor of Medicine, Sri Jayawardenapura Medical Faculty, who was, in the WHO Special Committee which recommended 6 months maternity leave for working women for breastfeeding their babies.

========================

Why Men Die Sooner

From the time they're little boys, guys are taught to be "tough" and not to cry. That social training leads to middle-aged men ignoring chest pains that can warn of heart disease.

"Our culture prizes stoicism and courage among men, and teaches men to be somewhat unresponsive to their own physical pain," says Jean Bonhomme, MD, president of the National Black Men's Health Network. And here's what that ultimately means: "Simply stated, men live sicker and die younger than women," says David Gremillion, MD, director of the Men's Health Network.

But congressional players and some health advocates are working to get the government into the business of making men tuned in to wellness.

There wasn't always this disparity. In 1920, for instance, men and women's life spans were only a year apart - although women now live almost six years longer on average.

Furthermore, men are three times less likely to have visited a doctor in the past year, even after factoring out women's prenatal physician visits.

Men also have a higher death rate than women for each of the nation's 10 top causes of death.

Prostate cancer, which kills more than 32,000 men each year, is the most commonly diagnosed male cancer - but many men aren't familiar with it enough to say it correctly.

Prostate cancer accounts for 37% of all cancer cases, but gets only 5% of research funding.

"Women have more cultural freedom to talk about what hurts them," according to Bonhomme.

"We don't have enough public information about male health problems like prostate cancer."

What's Afoot on Capitol Hill

Veteran lawmaker Rep. Randy "Duke" Cunningham (R-Calif.) is a decorated fighter pilot who was shot down in enemy territory during the Vietnam War. But he tells WebMD that his life's biggest scare was hearing from his doctor in 1998 that he had prostate cancer.

Cunningham says that his getting cancer was part of the catalyst behind his introduction of legislation that would establish a new office in the U.S. health department to "coordinate and promote the status of men's health."

Cunningham's ally on the bill, Rep. Jim McDermott (D-Wash.), MD, tells WebMD, "Men tend to deny that they have anything, and they have this 'he-man' attitude which makes them not go for checkups and not do the things that would make their health statistics better. We are trying to make people more aware of what could be done if they would let people know they had a problem."

The bill has 76 co-sponsors in the House, including women and men, Democrats and Republicans.

The idea is to follow in the footsteps of women's health offices; there are at least six such bureaus scattered through the federal health bureaucracy.

No one has stepped up yet in the Senate with the bill, but the Cunningham legislation has an endorsement from the Society for Women's Health Research. "Our quest to improve medical care must include a sex-based approach to meet the unique treatment needs of both men and women," says the society's president, Phyllis Greenberger.

But Who Picks Up the Check?

But the National Women's Health Network is not endorsing the bill, says Amy Allina, the group's program and policy director. At the same time, she says, "We believe there are health issues that are particular to men and we encourage health advocates who are concerned about men's health to work to get more attention for those things."

That given, says Allina, "We still think it's necessary across the medical field to work to get more attention to women's health. We think that women's health has been under-researched. Clinical trials as well as the historical medical practice model have assumed male as normal and female as a small version of men."

However, she adds, "If we can fund offices of men's health without detracting from the work that's being done for women's health, I'm all for it."

But money - or lack thereof - is probably the key issue in getting a new office going.

"There are clearly plenty of people interested in these issues, but nobody wants to put any money up," says McDermott.

"That's going to be our biggest challenge, getting anybody to be serious about putting any money forward for this."

"This is something that can be done by the [U.S. health] secretary, just through reorganization," says Tracie Snitker, spokesperson for the Men's Health Network. A men's health office wouldn't take anything from the pockets of the women's offices, says Cunningham.

"That's not the intent, and I assure you, that won't be the final outcome either," he says. "I'm just as dedicated to women's health as I am men's health. It's just that men's health information has been limited and I want to bring it up to parity."

Avoiding a Battle of the Sexes

Politically, the bill's advocates are on more solid ground this year, Allina says. In the previous Congress, she says, the legislation first emerged "from the perspective of saying women are getting too much attention and men need more of it. Obviously we had some problems with that.

I appreciate that they've changed their approach to recognize that they can advocate for men's health without detracting from women's health." Some claim that the U.S. health department is already one giant office of men's health, but, says Bonhomme, "The government actually spends more on gender-specific programs for women than they do on gender-specific programs for men.

"A lot of men's health problems affect women and children as well," Bonhomme adds. "If men get sick and die prematurely, then families lose loved ones and income."

Cunningham is a member of the House's health appropriations panel, so he can have special sway over some health research matters.

But he is coy about declaring that the men's office bill is likely to become law this year.

"Unfortunately, things don't move fast around here," he tells WebMD. "You learn that if you want to run through a brick wall the very first day, you're going to come out with a lot of scratches, and you're going to look down the road and you've got a lot of walls to run through, so you'd better pace yourself."

Running Your Own Office of Men's Health

Indeed, Washington rarely surprises us with quick action, so as the politics swirl, what are some do-it-yourself steps for staying healthy as a man?

For starters, says Bonhomme, don't overlook pain.

"As men, we've learned to ignore pain," he says. "Sometimes that's good, but the same tolerance for pain that can help you win on the football field or the battlefield doesn't help you out when you're dealing with the healthcare field."

According to McDermott, "Ordinary folks should have a physical once a year and have their blood and urine tested, and a chest X-ray, so that they have a recent baseline for the time when something happens.

If somebody comes in to the doctor with a major catastrophe and they haven't seen a physician for 20 years, it's very difficult for the doctor to figure out what happened."

And don't forget clean living. A July study in the Archives of Internal Medicine showed that male, vegetarian Seventh-Day Adventists in California lived nearly 10 years longer than other Californians. Even non-vegetarian male members of the religion, which stresses exercise and avoidance of alcohol and tobacco, lived on average more than 7 years longer than other Californians.

Finally, there's always marriage, for you single guys. Studies have suggested that being married is healthful for men, as wives may prompt their husbands to take better care of themselves and to visit the doctor more regularly.

========================

Question Box

Mobile phone towers a health risk?

Mrs. Chandra Fernando from Rajagiriya has raised this question in a letter to us. Her Question is - Do these towers pose a health problem to people living closeby?

Health Watch

We have had a few more letters on this matter, and we are awaiting a reply from the WHO to whom we have referred these inquiries. We understand that the WHO has done a preliminary study on this. The moment we get the reply we'll publish it. Thank you for writing.

Letter Box

Omega-3 Fatty Acids & Small Fish

Mrs. H. M. Ismail from Weerakoon Mawatha, Kandy has posed this question?

"Doctors advice us to eat sufficient fish in our diet, to obtain Omega-3 fatty acids. They say small fish have more of this acid. But the problem is because of the bone content in this variety of fish we generally fry them, and not cook. And frying has the big disadvantage of intake of deleterious bad oils.

1. Is there any way to overcome this problem?

2. Also the varieties of small fish available in Sri Lanka in the order of their Omega-3 content?

3. Is there a way of making small fish soft, tasty and keeping them longer in the fridge?

Some years ago I've heard that by a process of boiling with salt water and vinegar you can do it. Is that correct?

Health Watch: We have referred your letter to our Medical panellist Dr. D. P. Atukorale, who delves into these nutrition matters. Please await his reply next week.

Thank you for writing.

Rennet of vegetable origin

I wish to refer you to the answer published in the "Health Watch" of 18.01.2002 to a question 'On curd and yoghurt', that Rennet is used in the production of cheese and not in the production of curd in regions of this planet not yet overpowered by Judeo-Christian-Islamic cultures which have no reservation of killing animals supposed to have been created for the benefit of man.

In fact, rennet of vegetable origin is now used in large scale production of cheese in environments nurtured by Hindi and Buddhist cultures which give a very important place to the concept of Ahimsa, which corollary wise entails one to refrain from killing directly or indirectly.

The bacterial mould traditionally used in villages in Sri Lanka for the production of curd has no connection with the rennet mentioned in the answer referred to in the first para of this letter.

- Albert P. Wickramasinghe.

Thank you for writing - Health Watch.

Prof. Nimal Senanayake to answer questions on stroke & diabetes

Dr. Mrs. Shirani Jayasinghe, Secretary of the Kandy branch of the Diabetes Association of Sri Lanka has informed us that Prof. Nimal Senanayake, Professor of Medicine of the Peradeniya Medical Faculty would like to hear from the Health Watch readers of any questions they may have on 'strokes and diabetes which they would like to get clarified from him.

Prof. Senanayake will be speaking on this subject, on February 24th, at the 5th AGM of the Kandy Diabetic Association, to be held at the YMBA Hall, Kandy.

Prof. Senanayake will reply to some of the selected questions from our readers, and also from the audience at this talk.

Questions could be sent to

Dr. Mrs. Shirani Jayasinghe,
Secretary, Diabetes Association (Kandy)
No. 59, Peradeniya Road,
Kandy.

Govt. Pensioners Association on Centenarians 65 Round the Corner

The President of the Govt. Pensioners Association K. A. W. Abeykone has written to the Health Watch informing of 65 of its Members who are in their late 90's, and thus just round the corner of reading their 100 years run in the living wicket, and thus entering the living centenarians list.

He has asked the Centenarian Friendship Association to send details of the Organisation, which had been posted to him about 2 months ago to the Polgasowita address given.

The Centenarian Study Team would like to have the addresses of this group of pensioners. Please send it to the Health Watch early. Thank You for writing. - Health Watch

========================

School books for the needy by Doctors' wives

Doctors' Wives Association last week distributed school books (especially exercise books) for the needy children in the Colombo district.

The distribution was done in five centres in Maradana, Wellawatte, Kirilapone and Ratmalana, by the following committee members of the Association - Mrs. Rynee Mendis, Mrs. Ranmala Walgampaya, Mrs. Ameena Sheriff and Mrs. Ranjani Thuraisingham.

Mrs. Chrissy Aloysius, president of the Association said the project was initiated following a letter that appeared in the Health Watch last year requesting help for needy children's education by doctors with their own contributions.

She said the funds needed for this book project were all contributed by the association members.

Picture shows Mrs. Aloysius distributing books at a Ratmalana centre.

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager