Children's Health

Children's Health (4)

Superfetation: Something Else to Consider, While Drafting a Surrogacy Contract

Superfetation as defined by Medicine Net, is an extremely rare situation in which a pregnant woman becomes pregnant a second time with another (younger) fetus. It is characterized by the fertilization and the implantation of a second oocyte in a uterus already containing the product of a previous conception. Superfetation is different from the process of twinning or multiple gestation and involves the conception of an additional fetus during an established pregnancy. With superfetation, the two fetuses have different gestational ages and due dates. Superfetation can occur in some animals but is so rare in humans that fewer than 10 cases have been reported in the medical literature.

As rarely as it occurs in humans, it’s a clause you probably need to consider adding somewhere in that surrogacy contract, because it did happen to Jessica Allen and quite recently too.

Jessica Allen who lives in California already had 2 children when she signed a surrogacy contract with a Chinese couple in 2016. She spoke to ABC News in 2017 after going through a battle to regain custody of her child who was conceived during the surrogacy contract.

Here is her story.

The surrogacy went off without a hitch. But it wasn’t until after delivery that things got messy, which is why Allen tells People, “I’d never do it again. I’m not the only one with a nightmare story, but I am the only one with a story like this.”

Allen followed all the rules perfectly, but something unexpected happened during the pregnancy. She worked with San Diego-based surrogacy agency – Omega Family Global, who paired her with the hopeful couple. In April 2016, Allen had the couple’s single male embryo implanted in her uterus through in-vitro fertilization.

Surrogates are required to take estrogen and progestogen in order to prepare their wombs for a successful implantation. Allen was careful to follow the IVF doctor’s instructions both before and after implantation so that the pregnancy would be a success. Six weeks into the pregnancy, however, the doctor found something that would make Allen pretty concerned.

The Doctors Couldn’t Believe What They Saw

At her six-week scan, the doctors told Allen that she was carrying two babies in her womb. The doctor explained that the chances of a splitting embryo were rare, but that it does happen. Everyone assumed that that was the case and Allen was relieved to know that the couple was excited to be getting twins.

Allen was paid $30,000 plus expenses for volunteering herself as a surrogate. When it was discovered she would be having two babies, her monthly paychecks increased by $5,000. Things were going along just fine until it was time to deliver.

After all was said and done, Allen and her husband were in for a big surprise.

Allen Noticed Something Odd About The Babies

On December 12, 2016 at 38 weeks’ gestation, Allen delivered the two babies via C-section. Because the operation was performed behind an opaque screen, Allen didn’t get the chance to see the babies as they were immediately taken from the operating room.

Later that night while she was recovering, Allen received a visit from the intended mother, who showed her a picture of the babies on her phone. “One looked full Chinese, the other didn’t look full Chinese. It was clear that they were not identical… but I didn’t ask questions,” Allen told People magazine.

The Message That Changed Everything

After the delivery, everyone went their separate ways and Allen returned home to recover. She and her husband used the money they were paid to purchase a brand-new home. Almost a month later, they were getting ready for move-in day when Allen received a text from the intended mother.

The mother sent Allen a picture of the babies and expressed doubt that one of them belonged to her. Allen told New York Post that the intended mother asked, "They are not the same, right?" and "Have you thought about why they are different?"

It’s A Rare Medical Phenomenon, But It Happens

The following week, the babies were subject to a DNA test with unexpected results. As it turned out, one of the babies wasn’t the twin of the implanted embryo. Instead, it was actually the biological son of Allen and her husband! Both embryos even had differing gestational ages.

A medical phenomenon like this is called superfetation, in which a woman continues to ovulate during pregnancy. This means that Allen conceived another child in her womb while she had the implanted embryo of the couple growing inside her. For their part, Allen and her husband were shocked that this happened.

You would think that the couple would just give Allen her baby, but of course, it wasn’t going to be easy…

They Thought They Were in The Clear

Allen and her husband were dumbfounded to discover that one of the babies she delivered was theirs. Per the IVF doctor’s instructions, they waited to get intimate again until Allen herself was confirmed pregnant with the implanted embryo for several weeks.

“As per my contract, Wardell [Allen’s husband] and I did not have intercourse until we were given permission by the IVF doctor, who recommended the use of condoms,” Allen told New York Post. In this case, it is also believed that his phenomenon happened as a result of contraceptive failure.

Allen And Her Husband Didn’t Know What to Do

Nonetheless, Allen and her husband were hit with the news that they had a third baby. They were shocked, to say the least. "I was panicking. My husband and I were panicking. We had no idea how this came about and we had no idea how we were going to prepare for a child overnight. We just moved into a new house, we didn’t have any more money," Allen told People magazine.

While they scrambled to figure out how they were going to handle their unexpected blessing, they were in for a far worse surprise.

Things Took A Turn For The Worst

With the new knowledge that one of the babies was theirs, Allen and her husband did what they could to bring him home. At this point, however, things started to get a little messy and bringing home their son wasn’t going to happen without a catch.

Shortly after they found out one of the babies wasn’t theirs, the Chinese couple allegedly wanted nothing to do with him. Allen was told someone from the surrogate agency was looking after her son and that the Chinese couple demanded up to $22,000 in compensation!

Soon Allen was placed in a situation where she thought she’d lose her own child for good.

Needless to say, All and her Husband went to a rigorous battle to gain custody of their baby, and ended up in debt. One would ask Who Was in The Wrong Here?

There was question over whether anyone was in the wrong in this situation. Some believe that Allen and her husband should have abstained completely, while others believe the IVF doctor is to blame for giving the go-ahead. Others believe the intended parents were in the wrong, but at the same time, they were forced to pay more on the notion that they were expecting twins.

After a lengthy legal battle with the Omega Family Global, Allen says they finally owed nothing. It however remains a wonder why the Agency put Allen through a painstaking process to get her son back, when all parties knew that he was biologically hers.

Allen delivered the babies on December 12, 2016, and on [February] 5, she was handed over her son.

Allen’s case is definitely a lesson, and Superfetation is definitely something to consider when preparing a surrogacy document.

The Omega Family Global issued a statement through the New York Post - “By its very nature surrogacy is a complicated journey which necessitates the support and care of agencies, parents, surrogates, psychologist, lawyers, and a host of other professionals. As with any pregnancy, issues do arise which require great care, attention to detail and respect for the process and the emotions of all involved”


Benefits of Childhood Immunization

Since the beginning of time and as long as man has existed, things have existed, which have the ability to kill man, not just from the adverse threats from harsh weather, starvation, flood, and wild animals which plagued the early man but from a unique kind of organism too small to be visualized by the human eyes, organisms which with the progress of scientific development, will become identified as microbes and the harmful categories of these microbes further identified and termed pathogens (a bacterium, virus, or other microorganism that can cause disease).

These organisms are present all around us and have the ubiquitous nature of sometimes surviving and thriving in the air, water, soil, and even in the human body where a continuous battle ranges daily between the body defenses and these pathogens. The result of these microscopic confrontations are a change in the normal functions of the body, disrupting the regular function of body systems thereby and creating what we have all come to know as DIS-EASE. (A disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms)

Human Beings have evolved through centuries and have throughout our lifetime on the planet learnt how to first conquer his environment as seen in the early men who lived in caves and learnt to control fire to prevent death from hypothermia (extreme cold) or hot conditions to prevent death from these adverse conditions. The early Man progressed to understand the difference between poisonous foods and nutritious plants in the environment. He also learnt that some plants had medicinal purposes through trial and error.

However, the modern man faces a different threat from a range of pathogens largely unseen, which have developed capabilities of infiltrating the body systems and causing diseases which can take a plethora of forms ultimately resulting in morbidity or mortality if the disease process is not prevented.

A lot of these scientists such as Louis’ Pasteur, whose discoveries led to the development of vaccination and pasteurization; Albert Sabin and Jonas Salk who worked towards the development of the polio virus vaccine; and Robert Koch who through his work created a postulate for the identification of diseases and the need for isolation of disease especially in infectious cases, dedicated their lives to the study and identification of how to stop these harmful pathogens from decimating the population of mankind. Their work remains the invisible barrier that protects mankind from the onslaught of pathogens.

The work of these great men and many others have laid the foundation for the international collaboration of countries across the world through the United Nations, and the World Health Organization has, over the years developed policies and guidelines which are accepted and domesticated by the member states to ensure that protocols regarding immunization (the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine) are effected to ensure the prevention of vaccine-preventable illnesses.

How does vaccination work?

The body has natural defenses which protect the body from invading organisms; these defenses are both nonspecific and specific. The Nonspecific defenses include the skin, nasal hairs, cilia in the windpipe, acid in the stomach, These processes ensure that a vast majority of invading organisms are destroyed by the body , However for those that escape this nonspecific process, the human body has in its design specific defenses which occur in different types quite similar to the way a country’s defense are stratified into Police force, Navy, Army, Airforce and of course of there are specific units, such as the counter terrorism squad, the SSS etc. In the body these specific defenses are uniquely created to attack a host of microorganisms with the weaponry at their disposal. Some of these cells can engulf the organism and digest them, some cells produce chemicals that destroy the invading organisms.

However during such battles, there are losses on both sides and if the body cells are severely damaged, the pathogen goes on to multiply, and destroy more of the body tissues, eventually resulting in the death of the Host.

During immunization, scientists isolate the pathogen causing a particular disease and weaken it significantly outside the body through artificial means. When the weakened version of the pathogen is introduced into the body through immunization it stimulates the process of the body immune cells to react and acquire a memory of that invasion, so that whenever it is exposed to a real threat, the response is fast enough to eradicate the threat.

At birth also the newborn’s immune system is still immature and hence young children and newborns are very susceptible to vaccine-preventable diseases. However some Antibodies are transferred to the child via breastfeeding to protect the child for some time, hence the role of Exclusive Breastfeeding cannot be underestimated.

The Benefits of Immunization Include:

  1. Immunization confers protection of that individual to prevailing diseases in that region: This is why there are concerted efforts to ensure that all children are immunized against illness that is vaccine-preventable which include BCG – Tuberculosis, OPV – Polio, HBV – Hepatitis, DPT -Diphtheria, pertussis, Tetanus Vaccine, and others which include measles, Cerebrospinal meningitis, typhoid fever, yellow fever, etc. which are widespread in the African region.

  2. Immunization has resulted in the drastic reduction in mortalities and morbidities such as wasted limbs in polio, gibbus (humpback in TB). Since the inception of the polio virus vaccine, the rate of polio cases have dropped exponentially that it is almost on the brink of extinction.

  3. Immunization protects the children from suffering fatal forms of the illness. A lot of illnesses if allowed to attack children for the very first time result in fatal outcomes because their immune systems are still immature to galvanize an appropriate response to the invading organisms.

  4. Immunization reduces the spread of epidemics: Epidemics results when the Herd immunity (a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immuneto an infection, thereby providing a measure of protection for individuals who are not immune) to a particular illness is very low. This means that a vast majority of the population do not have the immunity to resist that particular disease as we see in Ebola, Lassa which are not yet vaccine-preventable and as a result, a lot of mortalities result whenever there is an outbreak.

  5. The cost economics of immunization are cheaper for the family, society, and government, as it costs more to treat individuals who develop the illness and even more to maintain those who survive with morbidities such as flaccid limbs, mental retardation.

  6. Immunization also ensures that the health systems can channel scarce resources to focus on more non-vaccine-preventable illness such as cancer, diabetes, Malaria.

  7. Immunization drives economic development and ensures that a vast majority of a country’s citizens are able to commit their best efforts towards the development of the country as it reduces the number of sick days in hospital by that particular illness.

  8. Immunization has led to the eradication of some diseases such as smallpox in 1967 and Rinderpest in 2011.

The role of immunization in the ensuring that children born live healthy, productive lives and grew into adulthood cannot be overemphasized. In the days of HIV, Ebola, Lassa, Dengue fever and other Hemorrhagic fevers, scientists and medical practitioner pray for a vaccine to protect the vulnerable populations most of which are largely still be under testing. It is however sad that for most of the illnesses which vaccines exist, there is still a nonchalance by a few to subject their children to the above benefits because of personal ideologies or religious idiosyncrasies. This happens because they do not understand the havoc these illnesses have caused in history, the loss of lives that occurred when vaccines did not exist, if people were better informed about those times, they would better understand immunizations as a gift to humanity.

About the Author: Patrick C Ezie is a Medical Doctor, an Associate Member of the World Medical Association (WMA), the Executive Director for Africa Junior Doctors Network,
and publicity secretary of the Nigerian Medical Association. He contributes in various health journals across Africa.

Source: Amazons Watch magazine

Pediatric Obesity – Could it really be hereditary?

I spent some part of my last holiday visiting the home of my childhood friend - Aijay, who is a pediatrician and a mother of three. We relived old memories, remembering the “good old - stress-free days”, and our crazy childhood.

While catching up on old times, I mentioned bumping into a mutual friend, Kelly; who had attended the same schools we did. Kelly had always been on the big side, and as we progressed, she got even bigger, by the time we were graduating from the university, she was visibly obese, she, however, never failed to educate anyone who cared enough to listen, that the big set look, runs in her family. Fast forward twenty years on, here she was in a supermarket, with her 7-year old daughter that looks just like she did back in the day. Seeing them reminded me of her mum’s visit, during our boarding school days. Her mum back then, had looked just like our Kelly now does, and I had to ask Aijay; could it really be hereditary?

Image from GoAfricaHealth

Aijay in her usual manner smiled and said to me, Bee; read it up. And that’s exactly what I did.

Did you know that Pediatric obesity has been viewed as a growing epidemic of the past few decades that requires intervention, similar to tobacco use? Over the last decade, there have been predictions from medical and health researchers that obesity will surpass tobacco as the biggest threat to overall well-being. A 2016 report by Alaska Department of Health and Social Services stated that obesity already surpasses tobacco in estimates of annual medical costs in Alaska at $459 vs. $318 million. And this is just one of many similar statistics. In a more recent article by Kelly Heyworth the creator of Happy Healthy Kids, she cited a discussion with Dr. Ludwig the director of Optimal Weight for Life (OWL) program at Boston Children's Hospital, where he stated that Obesity has now surpassed tobacco as the biggest threat to overall well-being.

Why I’m I so worried? A January 2018 report, published by the Center for Disease Control and Prevention, stated that in the United States, the percentage of children and adolescents affected by obesity has more than tripled since the 1970s. Data from 2015-2016 show that nearly 1 in 5 school age children and young people (6 to 19 years) in the United States is obese. This report comes from a region with statistics; now think about regions with much less informatics.

As parents, we often find ourselves trying to manage our kids eating habits without making them feel less beautiful. We also find ourselves on the tricky path of identifying the difference between a child who is at risk for obesity and one who is naturally big boned or muscular. Studies have shown that parents are oftentimes poor judges of their child’s weight even when the problem is seemingly obvious. More so, being overweight has become so common that parents have come to view children having excessive weight as ‘normal’. A recent study published in Childhood Obesity stated that researchers found that more than 96 percent of parents of overweight preschoolers thought that their child was the ‘right’ size. Weight remains an incredibly touchy topic; so it’s little wonder you find a popular retort "Find a new doctor!" among parents who are advised by a pediatrician that their child's BMI is too high.

From: DrNickCampos

Whether a child is overweight, obese, or at the risk of becoming so, it's key to find a balance between encouraging healthier habits and not making them anxious about their size, because despite how common it is, studies have also shown that it “being fat” is the primary reason most kids are bullied. This may also be one reason why childhood obesity is strongly linked to low self-esteem and depression in adulthood. Oftentimes parents while trying to help their child’s with self-esteem, find themselves using phrases like, “you come from a line of heavy set people – your weight is just right – you are not overweight” etc. This will usually make the kid feel better, but will not tackle the budding weight problem. Fast forward 20 years on, and you have a Kelly, looking like her mum, holding a 7-year-old, who looks just like she did 20 years back. What I’m I saying? Build the child’s self-esteem, but do something about the budding weight issue.

While a few extra pounds do not necessarily suggest obesity, they may indicate a tendency to gain weight easily, and a call for a change in diet/exercise routine may be required. A child is not usually considered obese until the weight is at least 10 percent higher than what is recommended for their height and body type. (Read up BMI) Obesity oftentimes begins between the ages of 5 and 6, or during adolescence. Studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult. Remember, it’s never too early or too late to make a healthy change.

Experts say that the already slippery slope of managing an overweight child becomes even steeper when they approach adolescence, as research has it, 8 out of 10 overweight children will remain so as grown-ups. It is a lot easier to fix a budding weight issue than an established one, so intervening before these kids slide into a long-term problem is crucial is important. Children have a unique advantage over adults: They're still growing, so they don't have to lose weight to grow out of a minor problem; they just need to slow their rate of weight gain.

To answer the question, is it really hereditary? There’s no doubt that genetics comes in the list of causes of obesity, however, research shows that Obesity in childhood and adolescence can also be related to: poor eating habits, overeating or binging, lack of exercise (i.e., couch potato kids), family history of obesity, medical illnesses (endocrine, neurological problems), medications (steroids, some psychiatric medications), stressful life events or changes (separations, divorce, moves, deaths, abuse), family and peer problems, low self-esteem, depression or other emotional problems. This invariably means we cannot put the blame entirely on genetics, and even if there are genetic factors involved, there are ways to manage your kid’s weight. Now here are some tips from the Centre for Disease Control and Prevention about what you can do as a parent or Guardian to help prevent childhood overweight and obesity.

Balance the Calories: Help your children develop healthy eating habits - One part of balancing calories is to eat foods that provide adequate nutrition and an appropriate number of calories. You can help children learn to be aware of what they eat by developing healthy eating habits and reducing calorie-rich temptations. Remember, small changes every day can lead to a recipe for success, and look for ways to make their favorite dishes healthier. The recipes that you may prepare regularly, that your family enjoys, with just a few changes can be healthier and just as satisfying.

Remove calorie-rich temptations: Although everything can be enjoyed in moderation, reducing the calorie-rich temptations of high-fat and high-sugar, or salty snacks can also help your children develop healthy eating habits. Instead only allow your children to eat them sometimes so that they truly will be treats!

Help them Stay Active: Another part of balancing calories is to engage in an appropriate amount of physical activity and avoid too much sedentary time. In addition to being fun for children, regular physical activity has many health benefits, including Strengthening bones, decreasing blood pressure, reducing stress and anxiety, increasing self-esteem, and helping with weight management.

Children should participate in at least 60 minutes of moderate intensity physical activity most days of the week, preferably daily. Remember that children imitate adults. Start adding physical activity to your own daily routine and encourage your child to join you.

Some examples of moderate-intensity physical activity include: Brisk walking, Playing tag, jumping rope, Playing soccer, Swimming, Dancing

Reduce sedentary time:  In addition to encouraging physical activity, help children avoid too much sedentary time. Although quiet time for reading and homework is fine, limit the time your children watch television, play video games, or surf the web for no more than 2 hours per day. Additionally, the American Academy of Pediatrics (AAP) does not recommend television viewing for children age 2 or younger. Instead, encourage your children to find fun activities to do with family members or on their own that simply involve more activity.

Image from: CTV


Set time limits for video games, net surfing etc. do what you must but by all means, get your kids off the couch! They’ll thank you for it.

Boma Benjy Iwuoha
Amazons Watch Magazine


Discipline and Special Needs Children

Recently at the cinema, I had an unfortunate encounter with a parent and her special needs child, and it got me wondering; are there ways of disciplining special needs children? I bet many others have wondered same thing too.

It’s definitely not easy on the parent of the child with special needs, because they’ve got a lot to deal with. From the moment they heard the diagnosis, they probably felt that life would be more challenging for their child than it is for other children, and they are often not far from the truth. So they make excuses for their child; does he really need me to point out his limitations by trying to correct him? And when you ask him to do something and it's not done, they let it go. Slowly and gradually you let go of discipline, forgetting that Discipline — correcting kids' actions, showing them what's right and wrong, what's acceptable and what's not — is one of the most important ways that all parents can show their kids that they love and care about them.

Granted, disciplining a child with special needs is usually more challenging than disciplining a typically developing child. However, it is just as important, to discipline a special needs child if not more so, to encourage appropriate behavior for your child. It is essential to hold special needs children to the same expectations as their typically developing peers as often as possible.

Discipline is not a punishment. It is a tool to be used to promote positive behaviors and decrease negative behaviors. It should be used as a means to encourage progress of the child across all aspects of their development. And while all children are different and demonstrate different behaviors as they grow, there are a few discipline techniques that are applicable for all special needs children.

I would not go into the details of my encounter with the parent at the cinema, but I would share a few tips that I found on Northshore Pediatric Therapy about Discipline Strategies for Special Needs Children: Here they are -

  1. Praise good behaviors; ignore bad behaviors (if possible). Cause and effect is one of the earliest concepts a child learns. If he learns that you give attention (even if it is to reprimand or physically stop him) when he reacts inappropriately, he will continue the poor behavior seeking the negative attention. Rather, it is beneficial to teach him that the good behaviors will result in the attention and praise he seeks.

  2. If possible, determine the underlying cause for the behaviors and address it. It can be extremely frustrating to not be able to effectively communicate to meet wants and needs. Before you react, assess the situation and give as much assistance as you can to help him communicate with you. Then, validate his emotions and give your command. For example, “I can see that Kyle taking your toys is making you mad, but it is not okay to hit him. Hands are not for hitting.”

  3. Avoid punishments. Research supports that positive discipline and behavior management are more effective than corporal punishment.

  4. Model appropriate behaviors yourself. Children with special needs will not understand, “Do as I say, not as I do.” Children will imitate what they observe in their environments. Pay attention to when and how you raise your voice or when you demonstrate listening skills for your child.

  5. Give countdowns. It can be hard to suddenly stop a fun activity. Give warnings like, “5 more minutes before it’s time to clean up…2 more minutes…10 more seconds…” For some children with special needs, a visual or auditory aid may be more useful. For example, “You can play until the timer goes off.” or, “When the red is gone from the clock, we’ll be all done with bath time.”

  6. If you’re having trouble, give choices. If you tell your child to do something, he must complete the requested action; however, you can give him choices on how he completes the activity. If it is time to clean up and put on pajamas, he can chose where the trains can sleep for the night, whether he hops like a bunny or craws like a bear down the hall, and which pajamas he wants to wear to bed. This is a great strategy for giving some control back to the child without backing down.

  7. Consequences should be related to the behavior. Timeouts, while great for calming down, may not be effective to decrease the behavior if the child does not understand that the consequence is related to the behavior. If your child throws a toy, he must stop his activity and go retrieve the toy (with your help if necessary). If he refuses to complete an activity, he cannot complete any other activity until the original request is completed (with your help if necessary).

  8. Consistency, consistency, consistency. For many children with special needs, learning new things can be a slower, more difficult process. Remember…if you give a command, it must be followed through, with or without help from you. Having consistent expectations across environments and across caregivers is critical to ensuring effectiveness of the discipline on the behavior.

Some defiant behaviors and limit testing is a normal part of development for all children. It is a way of learning more about their roles and a way of exerting independence. It can be embarrassing and hard to deal with public meltdowns and screaming unhappy children, but remember, ALL parents have been there.

Boma Benjy - Iwuoha

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