Health Watch

No substitutes for mother’s milk!

Nadira Gunatilleke

The National Breastfeeding Week ended yesterday. What is the best food for the infant? The whole world has only one accurate answer to this question. It is breast milk, mother’s milk. Sri Lanka tops the South Asian region in breastfeeding during the first six months of an infant. This is about 85 per cent now and the local health authorities are working hard towards achieving 100 per cent breastfeeding.

According to medical professionals attached to the Health Ministry, only breast milk should be given to an infant during the first six months. Then it should be continued with other types of food until the end of first year. The government has initiated the feeding hour and has legally made it a right of the baby (and its lactating mother) in order to promote breast feeding. Under present rules and regulations, lactating mothers can take two hours off per day (either one hour in the morning and one hour in the evening or two hours in the morning or evening) to breastfeed their infants. Under the present law, this relief should be given to all lactating mothers in Sri Lanka working in both state and private sector.

The immunization capacity is comparatively high among the children who had been breast fed by mothers. There is a significant growth in their intellectual level too. Mothers should be made aware not to be deceived by certain advertisements which promote various milk powders indicating a high level of intellectuality. Breast milk (mother’s milk) is the best food / drink that can be given to an infant during its childhood. Breast milk changes throught out the day adding nutrients to it depending on the varieties of food taken by mother. According to the National Policy, infants should be fed only with breast milk within their first six months. But it is not an easy task because of the anti breastfeeding campaign carrying out by various institutions and organizations especially infant milk powder promoters. Here we are going to talk about how some ignorant mothers feed their infants with cow’s milk to make them more intelligent!

What is breast milk? According to scientific researches, human milk is noticeably thinner and sweeter than cow’s milk. Whole cow’s milk does not contain sufficient vitamin E, iron, or essential fatty acids, which can make infants fed on cow’s milk anaemic. Whole cow’s milk also contains excessive amounts of protein, sodium, and potassium which may put a strain on an infant’s immature kidneys. In addition, the proteins and fats in whole cow’s milk are more difficult for an infant to digest and absorb than the ones in breast milk. Evaporated milk may be easier to digest due to the processing of the protein but is still nutritionally inadequate. Some infants are allergic to one or more of the constituents of cow’s milk, most often the cow’s milk proteins. These problems can also affect infant formulas derived from cow’s milk.

Environmental pollutants found in breast milk are usually not harmful. Expressed breast milk can be stored for later use. It is recommended that the milk is stored in hard-sided containers with airtight seals. Some plastic bags specifically manufactured for the storage of expressed breast milk are designed for storage periods of less than 72 hours - others can be used for up to 6 months if frozen. Therefore mothers can easily give breast milk for their infants even when they are working or stay away from the infant. Lactating mothers also benefited by breastfeeding. They can safeguard themselves from breast cancer by breastfeeding their infants. Milk deposits in breasts can lead to cancer in women at a later stage. This can be avoided by breastfeeding.

There are many problems when it comes to infant formula. First of all we can talk about the allergies. Many infants and children are allergic to cow’s milk. Therefore when they fed with infant formula made out of cow’s milk they show allergic reactions. Sometimes these allergic reactions can be fatal.

The other fact is the quality of these infant formulas. In 2006 an earth shattering news broke out all over the world about contaminated infant formula and other milk products. The milk was contaminated with Melamine, a very toxic substance! Sri Lanka took all precautionary measures to prevent any damages and commenced to test all milk products before putting them into the market. Some products were taken out from the market. A large number of infants got killed in some foreign countries after consuming infant formula contaminated with Melamine.

It is hilarious to see how some television advertisements show one or two years old toddlers engaged in serious mathematics by drinking infant formulas produced using cow’s milk! But the funniest and most pathetic part is there are some mothers who are lured by such advertisements!

Breast milk is a genuine natural product given by nature for babies. Therefore it does not have any type of ill effects. Only good nutrients are in breast milk. Therefore it the sole responsibility of mothers and (also fathers’) to feed infants with the golden gift of nature, without listening to infant formula promoters and some `nurses’ and `doctors’ in private hospitals !

Women and stress:

Finding tools to conquer the Stress Beast

Dr.Samantha Wettimuny, Psy.D.

We women are notorious for putting ourselves last on the list for the day. Our children, our husbands, our in-laws, our parents, our jobs, our bosses, our Old Girl’s Societies and Lady’s Clubs all come before our own wellbeing. What is the result? Poor physical health, poor nutrition and the dreaded S-word: Stress.

Anxiety is cousin to stress. Anxiety is the body’s natural reaction to a perceived threat to ourselves or someone we love. However, when anxiety about one has not yet accomplished or about the volume of tasks needed to be completed can start to wear at a person over time and develop into stress. Some of the most common symptoms of stress are fatigue, difficulty sleeping, headaches, muscle tension, hair fall, sexual dysfunction, gastrointestinal issues and chest pain or heaviness. Of course, it is vital to rule out a medical cause for these symptoms first, so before assuming your symptoms are purely related to stress, it is a good idea to schedule an appointment with your doctor.

The long-term effects of stress are unpleasant and costly. The most common stress-related diseases are high blood pressure, heart disease, diabetes, and obesity. Stress can also lead to irritability, withdrawal from others, increase in alcohol or other substance use and sad mood or even full-blown depression.

Stress management

Stress can be tackled with any technique that will allow you downtime. Downtime is when one has nothing to think about or worry about but to relax or to practice a relaxation or stress management technique. That means the phone is off, the television is off, the Blackberry is set to silent and the children are husband are safely and quietly occupied in another room.

For women, one of the most difficult things that the women complain about is not having the time for downtime. But I often ask women in my office, do you have time to sit and think about being stressed? Do you spend time feeling frustrated, unfocused and waste time correcting your mistakes? Do you spend time doing other activities to deal with stress, such as overeating or punching pillows and crying? Then you have time for a stress management technique, too! Often early mornings before the rest of the household is awake or at night once everyone is safely in bed are the best time for a busy woman to catch a few minutes to herself. Other times are during bathroom breaks. After taking care of business, one can easily spend an extra three minutes to practice a stress management technique before someone sends in a search party.

Meditation

Many stress management techniques are already built into many of our religious practices. Anapanasati, or mindfulness of breathing is a meditation technique recommended by the Buddha to practise mindfulness of inhalation and exhalation and to develop concentration. As one focuses on breathing and breathing alone, one lets go of all the stressors for a period of time, giving the mind a chance to focus on itself and the body in order to eventually let go of it. Any of the other types of meditation, such as Metta meditation, Samatha meditation or Vipassana meditation are also suitable.

Meditation is also found in the Christian and Catholic religions as well. Contemplation on Bible passages or scenes or on religious figures, such as the Virgin Mary or Jesus on the Cross can help focus the mind and bring one closer to God. Prayer in Christianity can be a very useful mechanism for relaxation and stress management. Praying the Rosary for Catholics, or using the Serenity Prayer by all Christians are one way to guide contemplation and thus refocus the mind’s efforts.

The obligation for Muslims to pray five times a day is a wonderful opportunity for calm and prayer not just once a day, but five times! Recitations of the Qur’an and dhikr are an opportunity to focus the mind on a Higher Power rather than on one’s stress. Hinduism has gifted the world with yoga, a practice widely accepted in both the East and the West as a way to release stress through discipline, focused breathing, postures and meditative focus of the mind.

If one prefers a more secular approach, meditation and mindfulness exercises are becoming more and more widely accepted by the medical community as effective treatments for a variety of mental health issues, including stress. Jon Kabat-Zinn, Ph.D. has used mindfulness techniques to develop a program to reduce stress in a variety of populations. Another effective technique that this writer can personally attest to is Progressive Muscle Relaxation, developed by Edmund Jacobson, where one tenses and releases different muscle groups while comparing feelings between each state. Another simple and effective stress management technique is exercise. There is nothing like a good kickboxing DVD or round of jumping jacks that can often shake the anxiety right out of a person! Exercise can be as simple as walking for 20 minutes and playing some cricket with the children in the garden or as elaborate as a gym membership and personal trainer. Whatever you choose, moving your body can burn through some of those stress hormones that trigger all the unhealthy symptoms above.

There are times when stress, especially related to traumas may sometimes need outside help. Women often have a hundred different reasons for not asking for help, but all of them can leave a woman trapped. Asking for help may be as simple as talking to a friend about what has been on her mind or asking a sister to watch the children while she takes a walk. Consulting with a psychologist is becoming a more widely accepted practice in Sri Lanka. The stigma of seeing a psychologist still exists more so than in the U.S., but as having an opportunity to be on the therapy couch myself as part of my training, I credit therapy for helping me get through my doctoral project and oral exams while a graduate student. Being the first person on your block to be in therapy may cause whispers, but seeing your overall peace and calm may help open minds and hearts to the practice of therapy.

Whatever technique you use, the key to long-term effectiveness against stress is regular practice, practice, practice. If you feel that other things must come first, ask yourself, If I’m not well, will the rest of my family/workplace/organization be well? You are no less important than your child, your husband, your boss, etc. Many of you may have gasped when they read that, but it is the truth! The key is knowing that you are worth the time you spend on relaxing your mind and your body. You deserve to be at peace in mind and body, too!

The writer is a Waivered Psychologist in California, U.S.A

Sri Lankan doctor felicitated by Britain’s Queen with OBE award

R L Guruge

Sri Lankan Doctor Pinnaduwage Ariyarathna De Silva has been selected for the award of OBE, by the British government. Buckingham Palace has officially announced in the 2011 New Year honours list that Dr Ariyarathna De Silva was to be ceremonially awarded the OBE on May 06, 2011.

Sri Lankans have to enjoy this rare opportunity with boundless pleasure and pride as he brings honour and credit to this country. His indefatigable dedication in the field of medicine and health has contributed immensely to the health needs of the people. Therefore he joins the chain of eminent doctors in the world in the field of health and medicine.

OBE insignia being pinned by Queen Elizabeth II

Dr Ariyarathna De Silva was born in 1944 in a remote village of Narigama in Hikkaduwa and having had his primary education in a missionary school at Patuwatha. He climbed in the ladder of education as a brilliant student. He continued his secondary education at Priyarathna Vidyalaya, Dodanduwa and Sri Sumangala Maha Vidyalaya, Hikkaduwa respectively and in 1964 entered the Faculty of Medicine in Colombo campus and passed his MBBS degree. Having excelled in Medical education, he was initially appointed to the General Hospital, Colombo as an Interim Medical Officer. He devoted himself with indefatigable effort to serve patients calling over for treatment indulging himself full time in this regard. Senior medical officers having observed his talents, inspired him to continue his higher studies in the same discipline.

This was followed by four years tenure at the General Hospital Kurunegala and one year at the Teaching Hospital, Kandy. There after Dr De Silva proceeded for Post Graduate Studies in Obstetrics and Gynecology to UK and returned to Sri Lanka in 1979 with FRCS (EDIN) FRCS (Glasgow) and MRCOG (GT:Britain) and joined the Ministry of Health as a Consultant Obstetrician and Gynecologist and was attached to Matale and Nuwara Eliya Base Hospitals. During this period (at both these hospitals) Dr Silva initiated to introduce considerable changes and improvements to the premises and quality of care at the respective hospitals and provided better medical care to the patients in the respective areas. His relationship with the general public became so effective that he was able to win the moral and financial support to effect some structural improvements and uplift the existing conditions that were prevailing there at that time.

In the year 1993 and 2005 he was endowed the fellowships of College of Obstetricians and Gynecologists, Sri Lanka (FSLCOG) and Royal Society of Medicine London (FRSM) respectively.

In 1999 Dr De Silva left to UK and opted to continue his medical career for two decades continuously in England. He was primarily appointed as a Consultant in Genito – Urinary Medicare at the Mid Yorkshire Hospitals, NHS Trust and it Heads the Chadwick Clinic Centre for sexual health in Dewsbury, U.K. in recognition of the dedicated services rendered by Dr De Silva to the British Community, he was a warded the Charter Mark Award three times consecutively for meeting the Govts Criteria of excellence in the delivery of public services. Also, Dr De Silva won the leadership award in 2008 as he displayed a role model to train his staff. He reached out to the affected patients and acceded to their health needs. Under his leadership, the health services developed and flourished into a modern service with an excellent national reputation for quality and care.

Also he educated the hospital staff, trainee doctors and also devoted time to conduct lectures at Huddersfield and Bradford Universities.

In appreciation of the services rendered by Dr De Silva to British community, the Prime Minister of UK Tony Blair commended his services for achieving the CHATER MARK STANDARD FOR EXCELLENCE for his health care services delivery. In this regard, he was handed a commendation personally by the Prime Minister having summoned him to No.10 Downing Street, London.

Minister for Home Affairs, UK M/S Hazel Blears and Minister for Cabinet Affairs, UK David Milliband have personally congratulated Dr De Silva for his excellent contributions to medicine and health care services in the United Kingdom. Mike Wood, the MP for Batlly and Spin of the House of Commons writes about Dr De Silva as follows:

”I was able to look at the work you are undertaking and to meet you and members of your staff. Chadwick clinic is obviously a jewel in the crown of Dewsbury district hospital and I’m extremely pleased that local people can look to such high quality services in sexual health.”

Dr De Silva is the firs Asian to receive the Charter Mark Awards which is the highest accolade for the delivery of the public services in the United Kingdom.

He is a doctor who is well-determined to maintain high levels and high achievements in his profession and serve the general public honestly and with integrity.

Dr De Silva along with his OBE awards has brought great honour to this motherland, Sri Lanka and joins the rare band of doctors in the world to hold fellowships in three major disciplines in Western Medicine (Medicine Surgery and Obstetrics & Gynecology) and becoming a fellow of all the four Royal Colleges of the United Kingdom FRCS (EDIN), FRCS, RCPS, (Glasgow), FRCOG (UK), and FRCP (London)

Dr De Silva is the youngest son of late Mr and Mrs P H De Silva of “Vijitha” Patuwatha, Dodanduwa.

Sri Lanka in new less costing international heart surgery trial

Edward Arambewala

Sri Lanka has recently taken part in a new less costing international heart surgery trial study. If it proves successful it is expected to replace high costing bypass heart surgery benefiting patients with serious heart conditions in the world needing bypass heart surgery at present.

This was revealed to the Healthwatch this week by Dr S Mithrakumar (Consultant Cardiologist) of Durdens Hospital Colombo who had been selected from Sri Lanka to be in the medical panel in this trial study called the ”Valentin Trial” by its US organizers. The trial study is expected to be concluded in February next year 2012 and the results analyzed and a decision is to be taken on its feasibility.

Dr Mithrakumar said from Sri Lanka two patients were subjected to this trial by him with their consent.