Doctors & Midwives On The Go…

On The 27 October 2015 North Shore Private Hospital hosted a symposium for Sydney GPs. The Drs at MC&M were the main presenters.  Approximately 40 GPs attended for the education update. The presentations were on Miscarriage, Endometriosis & First Trimester Screening.  Following each presentation there was the opportunity for interactive discussion and answering of any questions. It was a very informative evening and it was great to put a name to a face as we often only know the GPs on paper!

AGES Focus Meeting- Hobart

Dr Neil Campbell has been travelling overseas again well across the Tasman that is! Neil recently visited Hobart for a 2 day Focus meeting -‘Taking Control’ presented by the Australian Gynaecological  Endoscopy & Surgery (AGES) Group.

Neil particularly enjoyed the presentation by Dr Frank Clark ‘The Difficult Caesarean Section’. Caesarean section is the most common operation attended by Obstetricians and Gynaecologists and although common it can be a very challenging and difficult procedure in some cases.  The presentation dealt with some of the difficult issues including the teaching of trainee doctors.

Women’s Health Care Australasia Meeting (WHA)-Melbourne

Dr Adam Mackie travelled to Melbourne in mid November 2015. The meeting was titled ‘Towards Consensus on Best Practice for Women Giving Birth for the First Time’. The Chief Aim of the meeting was to develop a consensus among practitioners on what should be the key elements of best practice care for women having their first baby. The groups aim was to review & discuss the current variations in obstetric practice across the WHA community regarding the induction of labour and caesarean section for first time mothers & to identify the ‘drivers’ behind this variation.

At the two day meeting, there were a number of presentations. The sessions were then followed by roundtable discussions to discover what areas required further work & or research & those areas that did not require further input. Presenters included doctors and midwives from hospitals all around Australia. Dr Mackie presented with Prof Sally Tracy- ‘Induction of labour & the risk of caesarean section-is it that simple?  What the data tells us about current practice re caesarean sections for first time mothers?’ A question & answer session followed. A Consumer from Sydney also presented on the importance of ‘language.’ She concluded, for best practice to occur in all facilities, any consensus statements developed in optimizing the care of women should utilize woman -friendly language and be consistent. The meeting ended with a summary and a plan for the next steps including safe implementation of potential changes to current practice.

Tresillian Conference

Belinda attended a Tresillian Update in North Sydney in late November 2015. The Program was entitled ‘Educating Todays Parents’. The presentations covered Health Literacy, Infant feeding with a focus on over feeding in the formula fed baby. The focus here was for practitioners to help parents recognize unsettled signs in their infants. Many formula fed babies are just given more milk to calm them which can lead to over nutrition with the long term result then being obesity. There was a very interesting review of the literature about babies and sleep!

Human Reproduction Update. Jan/Feb 2016.

A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes.

Leone, U, et al.

I frequently get asked about the impact of endometriosis on future pregnancy and especially rates of miscarriage.

This review concludes: “Complications of endometriosis during pregnancy are rare and there is no evidence that the disease has a major detrimental effect on pregnancy outcome. Therefore, pregnant women with endometriosis can be reassured on the course of their pregnancy.”

The effects of chemical and physical factors on mammalian embryo culture and their importance for the practice of assisted human reproduction.

Wale, PL, et al.

This is one for the CREI Fellows.

Various chemical and physical factors have adverse effects on the viability of embryos. The effects can be long-term. Therefore, optimising the in vitro environment is essential.

 

WATER

An essential to all of us is water! Tap water in the majority of Australia is extremely safe to drink, accessible and inexpensive! Tap water contains fluoride, which concerns some but this is an essential element required for developing strong bones and teeth.

Unfortunately when we are unable to access a tap you can be paying a premium for bottled water. This may mean that people opt for another less healthy drink option, usually a soft drink or juice. Water is of course free of sugar and therefor, there is an absence of the acidity found in soft drinks and juices. It is the acidity in these drinks, when drunk regularly that can destroy tooth enamel which results in tooth decay. In some parts of the world children under 10 years of age are having their teeth surgically removed due to the teeth rotting down to the roots!! Soft drink and juice consumption has been blamed for this in a lot of cases. Water should always be the drink of choice. The sugar in soft drinks can sometimes contribute to weight gain.  Water of course is free from calories!

INFANTS

Infants should only be given breast milk and or formula, exclusively until 6 months of age. Cooled boiled water can be given in a bottle or cup from 6 months.  Up until 12 months of age the milk should only be breast milk  & or formula. After 12 months cow’s milk can be introduced to their diet. Babies should not be put to bed with a milk bottle as this also encourages dental caries. At no time, should babies be given a bottle with soft drink or juice in it. It is also advised that a baby should only be drinking from “sippy” cups from 12 months of age and no longer using a bottle at any time of the day.

PREGNANCY

Water is an essential to health & well being. In pregnancy, being well hydrated helps particularly with fluid retention, it can also reduce the risk of urinary tract infections and makes you feel better. Dehydration can make you feel tired  and cause the bowel to become sluggish. So if you are feeling tired ensure you are drinking enough and ensure your iron level is adequate.

In pregnancy 2-3 litres of water is encouraged dependent on activity level and the weather. Some elderly and children should be encouraged to drink before they become thirsty.

www.eatforhealth.gov.au

Next Month

The Food Pyramid and what has changed.

https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55a_australian_dietary_guidelines_summary_131014.p