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This pregnancy was confusing! Chike wondered what would make a pregnant woman want to eat paper. His wife, Louis had developed an insatiable desire for books, but not in a good way.

Speaking to their family doctor, Chike complained his wife eats the paper. Ripping away pages, one by one, putting them in her mouth and chewing greedily on them.

Apart from her voracious appetite for books, his wife Louis was otherwise normal. In fact, she’d just given birth to their first daughter.

During the pregnancy, everything was normal; there was no complication or usual discomfort. Everything about her diet remained regular (except the paper consumption, of course).

He had no idea when it began nor how to stop it. He had first noticed it when she was consuming just bits of paper, loose pages, cutouts of newspapers, small flyers, and the likes. At that time, he thought it was just a phase that would soon pass away. However, Chike gradually watched his wife progress from bits of paper to whole books!

At this point, he decided to seek help

“What is happening?”, Chike asked the doctor. “Is this going to hurt her?”, “Is she depressed?”, “Should I be worried?”.

The questions kept on coming.

The desire to eat non-food items or things not normally considered to be food is known as PICA.

It is an eating disorder that makes people to eat things with no nutritional value such as paper, cloth, dirt, ashes, string, wool, starch, matches, cardboard, hair, laundry detergent, chalk and soap, talcum powder, gum, metal, pebbles, charcoal, paint chips, ice, among other things.

DIAGNOSIS

There are no laboratory tests to detect PICA. Instead, diagnosis is made through a patient’s medical history.

For efficiency, this diagnosis should be followed by lab tests for anemia and digestive tract blockages which may arise from the substances consumed.

AFRICAN WOMEN AND PICA

In Nigeria, most cases of PICA are usually unnoticed.

Therefore, it is unclear about how many people are affected by pica. However, one study reported that pica was a normal occurrence for pregnant women in Malawi, as this is how they know they are pregnant. Similar studies also reported a high prevalence of pica in Tanzania (63.7%), Kenya (73%) and Nigeria (50%).

SIGNS & SYMPTOMS OF PICA

Some of them include:

• Stomach upset
• Stomach pain.
• Bloody stool
• Constipation
• Diarrhea
• Bowel problems

HEALTH IMPLICATIONS

Repeated consumption of non-food items for a long period of time could prove dangerous. This is because some of these items have toxic, poisonous and bacterial content. Some health implications include;

• Lead poisoning
• Intestinal blockage or tearing
• Teeth injuries
• Infections
• Iron defi

RISK FACTORS

Some risk factors of pica include;

• Mental health disorders like autism, schizophrenia, e.t.c
• Iron-deficiency anemia
• Malnutrition
• Pregnancy

TREATMENT

The first course of treatment for pica is checking for nutritional deficiencies.

At times, the development of pica is an indication that your body is trying to compensate for a mineral or vitamin lack. Thus, using vitamins or nutritional supplements to treat such deficiencies usually helps resolve the pica. 

However, if pica is not caused by malnutrition or does not stop after nutritional supplementation, other forms of management need to be considered. There are a variety of behavioral therapies available.

Your health care providers will be in the best position to recommend one.

In Conclusion

A majority of pica cases go unreported in Africa, because most people who have this disorder tend to be secretive about it. The onus thus is in the court of health-care providers to pay key attention to any tell tale signs or even inquire specifically about any abnormal eating habits. Find out about foods to avoid during pregnancy

Malaria is one of the most common health challenges for pregnant women in Nigeria. Although malaria can be life-threatening, it is preventable. During pregnancy, the prevention and treatment of malaria in pregnancy is done with simple behavior changes and medication.

Let’s consider the causes, treatment and prevention of malaria in pregnancy.

What Causes Malaria?

Malaria is caused by a parasite carried by the female anopheles mosquito. These mosquitoes transmit the parasite to humans when they bite us. They prefer to bite at dusk and dawn.

So far, the strains of malaria parasites identified include Plasmodium Malariae, Plasmodium Ovale, Plasmodium Vivax and Plasmodium Falciparum. Even though Plasmodium Falciparum is the most lethal strain, Plasmodium Vivax, on the other hand, is the most common, and has a tendency to remain latent in the liver and placenta causing relapses of malaria.

During pregnancy, women have a decreased immunity that places them at a higher risk of contracting malaria. In addition to this, the weather condition in Nigeria also plays a major part. During the rainy season, mosquitoes grow faster and the spread of malaria increases.

Pregnancy and Malaria

Malaria is common in pregnant women. Their immune system during pregnancy does a poor job of protecting mums from malaria infection during pregnancy. Once they get into the bloodstream, the parasites love to hide and multiply in the placenta. ⠀

Immunity is lowest during pregnancy in the second and third trimesters. As a result, it is really important to be extra careful in this period.

Signs and Symptoms of Malaria

The basic signs and symptoms of malaria include:

• Headache
• Nausea
• Vomiting
• Fever
• Diarrhoea
• Muscle aches
• Sweats
• Tummy aches
• Weakness / Fatigue
• Chills

Note that some mums may have the parasites and not experience symptoms. They can still pass malaria to their growing babies.

Risk factors of malaria in pregnant women

• Living in a region where malaria is common
• Living in a dirty environment: A dirty environment provides a good breeding space for mosquitoes. If a pregnant woman is living in an area that is dirty and/or there are collections of stagnant water around, she has a very high risk of contracting malaria. Mosquitoes breed in stagnant water collected in disused containers, vehicle tires, clogged-up gutters, and so on.
• Blood transfusion: Receiving blood from someone who has malaria or has just been treated for malaria puts the pregnant woman at risk for malaria. The baby also has a chance of contracting the malaria from the mother’s blood in severe cases.

Malaria Drugs For Pregnant Women

For malaria in pregnancy, prevention and treatment must follow proper medical guidance. Your treatment depends on your age, pregnancy stage, and severity of symptoms.

Your doctor is in the best position to tell you what drug to use at that particular time. This is because certain malaria medications are unsafe in the first trimester. So be sure you are not pregnant or in the early stages before taking them. Others, if taken too close to delivery can cause jaundice in the newborn. However, the WHO recommends sulfadoxin- pyrimethamine as a drug of choice for prevention and artemisinin based combination for treatment of pregnant women with malaria.

Please, avoid over-the-counter drugs at all times. Ensure that your doctor is well informed regarding all matters pertaining to your health during your pregnancy .

Prevention

• Stay in a clean environment. Eliminate stagnant water completely and make sure that your garbage is properly disposed.

• Use of long acting insecticide treated mosquito nets while sleeping and mosquito repellent is encouraged.

• When you’re using mosquito repellents, ensure you use in the appropriate quantity specified by the manufacturer. An excess use of repellent does not equal an extra kill effect on the mosquitoes, rather, you are placing your health at a higher risk.

• Wear light-coloured clothes as much as possible. This is because mosquitoes are more attracted to dark colours. Ensure your dresses are full-length and long-sleeved especially at night.
• The World Health Organisation recommends intermittent preventive treatment in pregnancy (IPTp) for all pregnant women. This is with a medication called sulfadoxine and pyrimethamine(SP) (Fansidar) for mums who don’t react to sulfur. From the second trimester, this is to be taken twice in pregnancy for regular mums and 3 times for HIV positive mothers. This treatment reduces the number of episodes of malaria. It reduces the chances of anaemia in mum and baby as well as infant death. Your doctor will advise on the dosage and timing.

Effects of Malaria on Pregnancy

• Anaemia : The parasite makes us ill by destroying the oxygen carrying red blood cells starving the tissues of the fuel they need to function and thrive. This explains the weakness and fatigue associated with malaria
• Miscarriages ⠀⠀⠀
• Low birth weight: Malaria can cause poor growth and malformations in the baby
• Still birth
• Malaria in the newborn: The new born also has a risk of coming down with malaria after getting infected through the placenta.

Finally,

Take care of your surroundings and ensure that your environment is clean at all times. Please try and get your doses of preventive anti-malaria medication during your antenatal care period. Not all fevers are malaria. Remember, it is important for every sick mum to take a test before getting malaria drugs.

Call or visit the clinic whenever you feel unwell. Please avoid the use of over-the-counter drugs at all costs.

COVID-19 AND PREGNANCY: WHAT YOU NEED TO KNOW

Pregnancy can be stressful, we know this.

Of course, being pregnant during the spread of a global pandemic can definitely be overwhelming. If you are currently pregnant, we understand how worried you may feel.

Your mind has most likely been tossing and turning with questions about how COVID-19 would affect you and your baby.

As usual, we are here for you. Here are some vital things about COVID-19 and your pregnancy that you need to know.

What Is COVID-19?

Pandemic… Coronavirus… COVID-19.

We have heard these terms almost a zillion times these past few months. But what exactly is the COVID-19?

Simply put, it is an infectious disease caused by a newly discovered coronavirus called SARS COV-2

And yes, it is very, very real.

No, it is not a “white man’s disease”. Neither does it affect only “rich people”.

Anybody can get infected because it spreads through human interaction. One can get infected by staying close to an infected person who is coughing or sneezing. The virus can even be contracted by touching an infected person or surface, then touching one’s eyes, mouth or nose.

What do you feel if you get it?

Most signs usually appear within 2 – 14 days after exposure. The common symptoms of covid-19 include;

• Fever
• Cough and/or sore throat
• Shortness of breath
• Chills
• Body pain
• Headache
• Loss of taste or smell
• Diarrhoea

If you or anyone around you has any of these symptoms, please stay at home and contact the NCDC (Nigerian Center for Disease Control) as soon as possible.

Note that some people may be infected and not show symptoms. These people can still spread the virus.

COVID-19 and Pregnancy

A lot is still unknown about the new coronavirus, although a lot of research is ongoing.

It is already known that people with underlying health conditions are more likely to have complications. However, no evidence suggests that pregnant women without underlying health conditions face such risks.

Furthermore, there are a lot of unknowns about how COVID-19 affects pregnancy. As an expecting mom, you are strongly advised to adhere strictly to the social distancing guidelines. Also take extra care to follow proper hygiene by regular hand washing and sanitizing.

COVID-19 And Your Birth Plan

Yes, we know. You already have a lot of plans in place, from your hospital, to your doctor, to your birthing partner, to your birthing videos and pictures, and many more.

Unfortunately, some of these plans may have to change. The level of change may be different for each hospital or birthing center, but here are a few things that you should prepare you mind for;

• Change of birthing location or center.
• Unavailability of your preferred doctor or nurse
• Compulsory screening for COVID-19
• Your birthing partner being restricted from entering the delivery room.
• Your doctors, nurses and you may be required to wear protective gear. `
• Restrictions on your movement
• Restrictions on the amount of visitors you can have

COVID -19 and Your Unborn Baby

It is still uncertain whether or not coronavirus can be transferred from mother to child.

Current research however suggests that it is very unlikely. In some countries it is advised though that babies born to mothers who have COVID-19 be separated from their moms for 14 days. This may have negative effects on breastfeeding. If you are well enough and choose to have skin to skin and/or breastfeed and your baby is stable, nothing stops you from doing so following these precautions.

Wash your hands before touching your baby, breast pumps or bottles

Try to avoid coughing or sneezing on your baby

Wearing a mask or face covering when carrying baby

Follow recommendations for pump or bottle cleaning before and after use

Express your breastmilk and consider asking someone who is well to feed your baby

RCOG. Corona Virus Infection and Pregnancy: Information For Pregnant Women and Their Families. Uhttps://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/#suspected Accessed 13/8/2020

The benefits of breastfeeding outweigh the risks.

We know, we know. This is a very distressing thought. However, it is only for a short period of time, and it is for the ultimate benefit of you and your baby. 

How Can You Protect Yourself?

The best way to do this is to practice social distancing, especially if you are pregnant. Even if there is no confirmed case in your area, please stay at home as much as possible.

Stock up on essential items if you can. If you must go out in public, always wear your face mask and never forget your hand sanitizer at home.

The COVID-19 pandemic has left the world at large in a state of shock and uncertainty.

These are stressful times, and we wish the pandemic would just go away. However, for as long as it is here, we need to do our part to live through it. This is only possible if we follow all guidelines that have been laid down for us.

Wash your hands regularly. Sanitize frequently touched surfaces like door handles, tables, stairways, etc. regularly. Practice social distancing, avoid physical touch as much as possible. Doing this would not only protect you, but would protect everyone around you, including your unborn child.

It is our honest hope that you stay safe during these trying times. Once again, please remember to wash your hands and sanitize!