How can I produce more breast milk?

Dear doctor, I have a three-and-ahalf months-old baby and I returned to work a month ago. I have a low output of breast milk. Although the situation was the same with my second child, the milk was at least enough when complemented with other foods even after nine months.
My maternal relatives say they had the same problem including my grandmother who says despite being in the village with lots of food varieties, she also had a low breastmilk output.

Although my relatives insist the problem is with our genes and nothing can be done about it, I feel I can breast feed at least up to 1.5 years like I did with my first born. If not, at least one year but not just months.

I have tried various milk enhancing foods such as katunkuma (garden eggs), ebbuga (amaranthus), ebyenda (offals) as well as drinking lots of bushera (millet porridge), water and fruits as advised by friends and relatives with little success. I am instead growing fat!

When I returned to work, I got strong support from my colleagues (no work overload) and the baby’s caretakers are doing a good job so I’m not stressed.

I am free to return home to breastfeed during my lunch break because the route to home is jam-free at this time and my place of work is not far away from home. However, when I get home at lunch time, usually the milk is so low the baby just gives up suckling and instead plays with the breast!

I need advice on what to do because l am worried the milk will dry up before the baby makes six months or worse, he will get so comfortable with formula milk that we shall miss out on the bonding and might give up the breast completely!

Are there drugs to help enhance milk production and if so, what are the side effects? I am not on the pill; my husband works abroad and returns twice a year.

I will greatly appreciate any practical remedies to this issue that is causing me distress.
Nakawere

Dear Nakawere, many women think their milk supply is low when it is not, especially, if they feel their breasts are not full or as they breastfeed there is no milk at the baby’s angle of the mouth. What is true however, is that a growing baby may demand more leading to a mother thinking her breasts are dry.

One can tell the baby is getting enough if it is healthy and playing.

That said, many mothers who breastfeed less because they have started working, those with cracked painful nipples due to wrong positioning of the baby at the breast and those on wrong contraceptive pills, may get dry breasts.

Dry breasts can starve the baby and therefore the problem has to be solved instead of rushing for formula feeding as the first resort. A starving baby will lose weight apart from being perpetually irritated.

For most women, it is not producing less milk but it is actually failing to properly put the baby at breast that is the problem.

That said, there are people who are not producing enough milk and require a boost. Frequent breastfeeding stimulates more production of milk and one has to give both breasts.

Proper positioning at the breast is useful to avoid cracking of nipples. Compress the breasts if the baby seems not to be getting enough milk. It is not true that low milk production is hereditary but apart from taking lots of fluids, one requires to be stress free to produce adequate amounts of milk.

Dear doctor, I broke a collar bone six weeks ago and went to a traditional medicine man who massaged me with herbs. However, I really feel pain and when I went back, he massaged again with more herbs in vain. What else can I do?
Absolom Okot

Dear Absolom, the collar bone or clavicle is the most commonly broken bone of the body leading to pain that increases with shoulder movement, swelling and tenderness around the broken area and sometimes, inability to move the shoulder.

Treatment of a broken clavicle varies with the type and location of the fracture so that if the skin is injured by the broken bone (compound fracture), immediate and aggressive treatment helps avoid infection. If the fracture pieces are not aligned (displaced fracture) or the bone is broken into many pieces, surgery is necessary to correct the problem. Restricting the movement of the broken bone and properly aligning the broken parts are important in bone healing.

For the clavicle, wearing an arm sling or the so called figure-eight strapping and sometimes plaster (rarely used today) for about three to six weeks for children and six to 12 weeks for adults; the time taken to heal is very important. Physiotherapy may also be prescribed in addition to this.

Many people believe fractures are better treated by traditional doctors who use various antics in their treatments but most of which may result in complications. One such antic is drawing a picture in the sand of the shadow of the injury which may just delay treatment.

Massaging of broken parts apart from causing serious pain and more displacement of the fracture may cause them to injure other structures like blood vessels and nerves. Herbs are unlikely to penetrate skin and cause effect.

At six weeks with pain, it is likely that you have got complications which usually include infection of the fracture and failure or delay to unite. You need to visit a doctor especially for bones for help!

Dear doctor, I have bleeding germs. Which foods have vitamin C so that I take them?
Johash Binzira

Dear Johash, Gums are useful in holding and protecting the teeth. Since they are close to the teeth, they prevent entry of germs.

Bleeding of the gums is mainly due to injury since many people brush hard.

Infection or inflammation of the gums (gingivitis) is also another cause. Many times one may bleed once in a while but if bleeding persists, then it may be a sign of a disease like leukaemia or, bleeding disorders due to drug intake or a disease called haemophilia. It is true that nutritional conditions including lack of vitamin C and K may lead to gum bleeding problems just as pregnancy hormonal changes, and poor oral hygiene.

Many Ugandans will consume tones and tones of vitamin c supplements at the hint of bleeding gums and yet this requires a dental check so that proper treatment is given. Fruits like oranges are rich in Vitamin C.

Dear doctor, why are ulcers and cancer common today? Is it because of HIV/Aids?
Yakobo Musajjakawa

Dear Yakobo, the majority of peptic ulcers are caused by infection of the stomach by a germ, Helicobacter Pylori. The germ is acquired mainly from eating contaminated food or drink! Proper food and water hygiene is necessary to prevent it.

Painkillers like diclofenac, aspirin, indocid and brufen also cause peptic ulcers. Increasing self- prescription for pains including headaches resulting from the increasingly common stress and anxiety may also be to blame!

Eradication of Helicobacter germ from the stomach, avoiding taking unprescribed painkillers and lifestyle changes including stopping smoking can help.

It is true that cancers like cervical cancer and Kaposis sarcoma have increased with the dawn of HIV infection. However, not all cancers are related to HIV infection.

Lifestyle changes with increased consumption of fat, salt and sugars coupled with sedentary lifestyle has been associated with an increase of cancers like of the large intestine, pancrease, breast and prostate.

Smoking which is being abandoned by men but is increasingly being taken up by women is associated with cancer of the lungs. Environmental pollution affecting the air we breathe, the water we drink and the food we eat is also getting more serious risking cancers.

Exercising regularly, eating moderately and avoiding smoking can help out.

Dear doctor, I am addicted to eating lots of pepper! Which is better, red or green pepper? Is it true it causes a sore anus? However, I am fine.
Pat Bazirondere

Dear Pat, much as it is taken as a spice, pepper has its own nutritional value since it has protein, vitamins like C, and minerals.

Its burning taste has led to false belief that it causes burning in the anus which is usually caused by piles, infections and soaps used to wash the anus!The infections today are increasingly being found sexually transmitted.

Compared to green pepper, red pepper has more vitamins and nutrients and contains the antioxidant lycopene touted to prevent prostate cancer. The level of carotene in red pepper is also higher. Red pepper has twice the vitamin C content of green pepper.

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