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Question: What are the proper steps for bathing a newborn?

It’s mandatory in Irish hospitals for midwives to go through the routine of washing a new baby with parents just before they leave, so most of us will have a good idea of what is involved. However, if you were overcome with the excitement of getting your little one back home for the first time, or if you’ve suddenly drawn a blank on just what part follows the other, here is a handy step by step list for making sure that everything goes as smoothly as possible for both baby and parents.

Did you know that for the first few weeks of a baby's life it is advisable to just give them a warm sponge bath with a gentle damp washcloth? However, once the umbilical area heals, you can proceed with giving your newborn a bath in the sink or a small plastic tub designed for bathing babies.

Babies are usually quite uncomfortable with the change in temperature that bathing involves, but you might find that he or she will sleep better afterward. If for this reason you want to give baby a bath on most evenings, it is best not to use gel, shampoo, or lotion more than once a week, as this will dry out their sensitive skin.

1. Spend a few moments to get together all of the necessary bath supplies.  Then, place a soft towel, a fresh nappy, and clean baby clothes or pyjamas on a nearby flat surface.  Tip:  You can make things easier on baby by turning up the central heating a bit and taking the chill out the air if you’re bathing in winter.
2. Add warm water to the tub or sink to about a depth of 3 inches.  Be sure it is not too hot. About 32 degrees Celsius is perfect, and you can test it by dipping your elbow, which is more sensitive than your hand, into the water.
3. Carry your baby over to the bath area and undress them completely. Tip:  If you find your baby cries through every bath, then leave their nappy on the next few times. It seems to give them an added sense of security during an unfamiliar and no doubt alarming process.
4. Slowly place your baby into the tub feet first.  Use one hand to support the baby's back, neck and head.
5. If you’re right handed, use your left to form a ring around your baby’s upper arm near the shoulder with your thumb and middle finger. This will hold them perfectly in place and prevent them from slipping. Using your other hand, wet down your baby's body with your cupped hand or even use a small plastic cup.  Tip:  Pouring the warm bathwater over your baby steadily throughout the bathing process will ensure they don't get too chilled.
6. Be sure that you use a mild soap.  With a soft facecloth, start at the top and work your way down the baby's body.  Gently lean the baby back and then apply water to their hair and scalp in the same manner as their body. Then slowly pour clean water over the baby's head, being very careful not to alarm them or get water or soap in their eyes.  Tip: Did you know babies are born with all the natural oils needed to keep the scalp healthy, so it is not strictly necessary to use shampoo on their hair at this stage?  
7. Rinse your cloth well and then gently cleanse the baby's eyes and face.  Sleep or hardened mucus may have collected in the corners of your baby's eyes or nostrils. Get the cloth nice and wet and then dab at this softly. The water will soften the deposits, and you can wipe them away without any undue irritation or upset.  
8. Ensure you are thorough by paying particular attention to small creases, and behind the ears and under the neck.  These are areas that retain moisture.  Be sure that these areas are clean and dry.
9. It is imperative that you clean the baby's genitals last.  Use a little bit of baby soap and be sure to rinse the area well. Tip: If you are washing a baby girl always wash from front to back to prevent any sort of infection.
10. Rinse your baby thoroughly with lots of warm clean water.
11. Very carefully lift your clean baby out of the tub or sink.  Use one hand to support their little neck and head and the other hand to support their bottom end.  Tip:  Babies are very slippery when they are wet, so it is a good idea to keep your fingers wrapped around one thigh or the upper arm to ensure they don't slip out of your grasp.
12. Now you can wrap your clean beautiful baby in a hooded towel and pat them dry.   

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy

Question: What are the causes of erectile dysfunction?

Answer: This is one of those subjects that everybody has a joke about, and truth be told, some of them are pretty funny. The elephant in the room, however, is that erectile dysfunction is no laughing matter in reality. The answer to today’s question then is not just a list of the causes of the condition, but also a quick tutorial on how it can be avoided.

Knowing What the Problem Is

Difficulty achieving and maintaining an erection for adequate sexual performance involves both physical and psychological processes. As such, pinpointing exactly where the problem begins and whether it is physical or mental or even both can be troublesome. If the problem is ongoing and persistent, or if there are any underlying health problems, it is usually best to arrange a consultation with your doctor. 

Some of the increasingly common medical conditions linked with erectile dysfunction are heart disease, diabetes, high blood pressure. In some cases, erectile dysfunction can also be caused by prostate problems, including prostate cancer, which is another reason not to put off having a check-up, particularly if you are over 30. Post-surgery erectile dysfunction can also occur, and in the majority of these cases, it will cease as the healing process continues. Sometimes, the problem of erectile dysfunction will be brought on by the medication prescribed to treat these conditions. It’s possible in this case that bringing the subject up may bring some embarrassment to the patient, but it’s only by informing your doctor that any possible help can be forthcoming.

Lifestyle Factors

In some cases diet and lifestyle may contribute to the problem. Smoking, for example, can harden the arteries and restrict blood flow around the body, making for a serious, yet completely needless impediment. By the same token, alcohol and illegal drug use can have hinder the process in the short term, particularly on or after a heavy night. This will become more pronounced over time if the abuse of drugs continues, gradually making the ability to have full penetrative sex more and more difficult, even leading to full blown impotence if unchecked. 

A sedentary lifestyle will have a similar effect, though the symptoms may seem less severe and gradual in the short term here. The “couch potato” lifestyle of moving from bed to car to a job that is primarily seated and back again, without taking adequate exercise during free time can be just as harmful to a person’s sex life as drug and alcohol abuse.

Couple either or both of these habits with a less than balanced diet, especially if it is high in fat and cholesterol and the chances of developing some form of erectile dysfunction increase further. These will clog and narrow arteries also, restricting the amount of blood that can reach the penis. If you have been diagnosed with high cholesterol, chances are that you will need some form of medication to control it, obtainable from your local pharmacist, who will also be able to advise on other treatments that may be available.

Beyond Physical Causes

If there are still existing problems with erectile dysfunction even after changes have been made to diet, lifestyle, and exercise regimens, and there are no underlying medical problems of which the condition could be a side effect, then it is likely that there is some other, perhaps psychological, cause. These can usually be put down to stress or anxiety (which will be discussed in a later post). In this case, a professional consultation is the safest and quickest route to take.

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy

Question: Are Vitamin Drinks a Good Idea?

Answer: Getting extra vitamins into our diet is always a good idea, especially when many of us struggle to fit our five a day into our meals. Taking vitamins in liquid form is a great way to make things easier and ensure that we keep topped up all the time. In the short term, vitamin drinks are a great pick-me-up on the move, and over the course of a longer day, a full complement of iron, calcium, and vitamin C etc. will make sure that we’re not run down and alert enough to get the most out of the hours in the day. Finally, by keeping our systems strong, it’s less likely that we’ll come down with any of the usual seasonal ailments like colds and flu, which can make an already gloomy time of year even worse.

Accept no alternatives…

It’s important to make sure that the vitamin drinks we’re taking in are actually healthy and not simply crammed full of sugar. That will keep us pepped for an hour, but the inevitable crash will leave us feeling even worse than we were before. The ingredients on the label here are the key. If you see something along the lines of “Carbonated Water, Sugar…” or “Carbonated Water, Glucose”, then it’s best to put that brand back and try something else.  A high amount of caffeine is not what you’re looking for either, as this will have the same effect. 

Instead, keep an eye out for the drinks with actual fresh fruit (or even concentrate), along with other natural ingredients like nuts or pumpkin seeds. Natural yoghurt is also great for energy also. 

Why not make your own?

It makes sense to try your hand at coming up with your own energy shakes and drinks by investing perhaps in a smoothie maker that includes a transportable container. Not only does this make economic sense in the long term, but it also means that you can sure that everything you’re taking in is completely natural.

Here a quick overview of what you could think about including-

Vitamin A- Strengthens immunity and keeps the eyes sharp, Vitamin A also repairs damage tissue (particularly after strenuous exercise) and helps with growth. It’s found in mangos and apricots, as well as milk and eggs. Shredded carrot is also a nice addition to a shake and full of Vitamin A.

Iron- The root of our red blood cell count and as such responsible for the dispersal of oxygen all around the body, a low iron count means that we lose focus and become sluggish. Avoid becoming dull by adding some diced dried fruit or even a few flakes of a bran cereal to your shake.

Vitamin C- The antioxidant to beat them all, Vitamin C works out the contaminants from our systems and even protects us from serious illnesses like heart disease and cancer. As well keeping our colds and flus less severe it also helps the bones and the rest of the body to digest iron. It’s found in all the fun fruits like oranges, kiwis, and strawberries, and will give you a long lasting pick me up that sugar and caffeine that can only dream of.

To really get the fruit bar or Jamba Juice effect, try adding chilled natural yoghurt or ice to give a revitalising kick, or even experiment with freezing fruit overnight to keep things cool.  

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy

Migraine Treatment

Question: What are the steps to take when a migraine strikes?

“You’re giving me a migraine,” has entered our colloquial vocabulary as a phrase synonymous with ultimate discomfort. It’s no wonder that people who have literal migraines are truly suffering – even more than those with the figurative sort. Migraines may be awful, but that does not mean there is nothing to be done. 

What is a migraine?

A migraine is like a headache, but much worse. Migraine pain is usually located at the front, or on one side, of the head. In some cases, the pain may also occur on both sides of the head and can even affect the face or neck. Migraines can also cause nausea and vomiting. The pain throbs and intensifies if you move. Migraines also increase sensitivity to light. This makes going about your day quite difficult. Instead, when migraines strike, most people tend to hide out in their quiet and darkened bedroom. 

What are the signs a migraine is about to strike?

If you regularly experience migraines you may have noticed subtle changes that indicate that a migraine may be on the way. These can include constipation, depression, food cravings, hyperactivity, irritability, neck stiffness, and uncontrollable yawning. You may also experience visual phenomena such as flashes of bright light, bright spots, seeing various shapes, vision loss, or dizziness. These are sometimes associated with pins and needles sensations in an arm or leg as well as speech or language problems. Of course it is also possible for a migraine to come on suddenly without warning. 

How to improve self-management of migraines 

Because many of the signs of an on-coming migraine are shared with other ailments it can be difficult to notice patterns. You might consider keeping a symptoms log to help you predict when your migraines will strike. Knowing that it is coming is one of the best ways to minimize the effects. 

When migraines strike

The first rule is to take care of yourself. Listen to your body, create the space you need and communicate with loved ones. Communication about what you need when a migraine strikes might make things go smoother before it arrives in full force. 

Muscle relaxation techniques can help ease migraines. You might try a yoga class of the meditative (non-athletic) sort. Look for classes, DVDs, and books on restorative, therapeutic, kundalini and yin yoga. If you take a class, tell the instructor that you experience migraines; he or she may have additional suggestions for you. It is also important to get enough, but not too much, sleep each night. Is there a new pillow or mattress that might improve the quality of your sleep? Try to calm yourself and clear your thoughts before going to bed at night. 

Other options

There are a number of therapies that might be useful to you including acupuncture, biofeedback, massage, and vitamins such as B2 and COQ10, which are available at your local pharmacy. You might also learn helpful techniques through cognitive behavioral therapy, which is offered through mental health professionals.


When to seek medical advice 

If your migraines are frequent yet controlled, you should still your G.P. If you find that you are having migraines five or more times a month then you should consult your G.P. The other reason to consult a physician is the uncontrollable migraine. If you cannot manage your migraines with over-the-counter medication, it’s time to call your G.P. 

When to call an ambulance 

If you or someone else experiences paralysis or weakness in one or both arms and/or one side of the face, slurred or garbled speech, blinding pain unlike anything experienced before, a fever, stiff neck, mental confusion, seizures, double vision, or a rash, you should take immediate action. These symptoms may feign as a migraine but can actually be indications of more serious conditions such as a stroke or meningitis. 

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy

Menopause Treatment

Question: What are the treatments available for menopause?

No one every said menopause was easy, but help is on the way. Changing hormones can cause a number of unpleasant symptoms. Your G.P. or pharmacist can prescribe medications that address the physical effects of these hormone changes as well as the physiological effects. 

Hormone Replacement Therapy (HRT)

Most women have heard of HRT, but not everyone fully understands it.  There is not a silver bullet for menopause symptoms, but HRT may be the closest that chemists have come. The name “hormone replacement therapy,” is a good indication of what the drug does: it replaces the hormone estrogen, which is the female hormone that decreases during the course of menopause. The reduction of estrogen is a normal part of aging, but normal does not always mean pleasant. 

Because HRT treats the source of the symptoms – the hormone change - rather than responding to one symptom at a time, it can be quite effective in reducing the overall troubles of menopause. HRT can relieve hot flashes, night sweats, vaginal symptoms and urinary tract infections. The pharmacist may give you a cream or gel, tablet, or skin patch. HRT is also available as an implant. 

Talk to your pharmacist to understand the possible side effects. These include weight gain, tender breasts, nausea, headaches, and mood changes. If you are experiencing these side effects, your G.P. and pharmacist may help you reduce your dose or suggest that you change the kind of HRT you are taking. Or, depending on the severity of your symptoms and risk factors, perhaps the best answer for you is to avoid HRT altogether. 

HRT medicines can increase a woman’s risk of health problems such as breast cancer, heart disease and stroke. But then again, some women - those with early onset menopause and those who have had their ovaries removed - may be prone to other health problems, if they do not take HRT. These conditions include osteoporosis, coronary heart disease, and dementia. 

As you can see, the logic puzzle of whether or not to take HRT can become complex rather quickly. This is why it is best to consult your G.P. who can take all these factors into account given your personal health history and lifestyle. If you still have periods, your G.P. may suggest a combined HRT that includes both estrogen and progesterone. If you are past menopause, your G.P. might prescribe continued HRT.

Alternatives to HRT

Women under the age of 60 might be interested in Tibolone, a hormone that is similar to HRT. It still has some risks, but generally the risks less than the risks associated with HRT. In addition to addressing hot flashes and night sweats, Tibolone may improve sex drive and can also help to prevent spinal fractures. 

Another medication that is now commonly prescribed for menopause is Clondine. This medication was originally created for hypertension (high blood pressure), but has been found to reduce hot flashes and night sweats. For women who have trouble regulating their temperature, this can feel like a lifesaver. If you start taking this medication, plan to check in with your pharmacist at two weeks and four weeks to report back as to whether your symptoms are improving. 

Other alternatives to HRT include antidepressants, lubricants, and the usual: healthy eating and regular exercise. Some women have also found it helpful to carry a small fan in their purse for when the hot flashes arise. If anyone asks, don’t be ashamed, just tell the person you’re having a “power surge” and continue whatever you were talking about before the hot flash came on.  

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy

Menopause – Symptoms and Onset

Question: What are the common symptoms of the onset of menopause?

The Perimenopausal Stage

Changes to the monthly cycle are usually the first indication that menopause has begun. The start of menopause is called the perimenopausal stage; this is usually marked by lighter or heavier periods, and changes to the frequency of time between periods. There may be more than three weeks between periods or even months. The perimenopausal stage is considered complete when a woman has gone twelve months without a period. 

Menopause Symptoms

Women experience different sets of symptoms and these symptoms can change during menopause. Menopause usually lasts about four years, but can last anywhere from two to ten years. Menopause can cause hot flashes and headaches. During menopause, it is not uncommon to experience vaginal dryness, pain or itching, bladder irritability, or urinary tract infections (UTIs). Women in menopause may have decreased sex drives, or might experience itching or discomfort during sex. Mood changes, such as irritability, depression or anxiety are also common. Women might also find that their sleep is disturbed by insomnia or night sweats. Women who experience menopause suddenly may find that their symptoms are worse than women who have a more gradual onset. 

Onset and Early Onset

Most women experience menopause from their mid-forties to mid-fifties. The average age is somewhere around 51, but statistics vary. Some women may not experience menopause until they are in their sixties. Other women may suffer from early onset, also called perimenopause, before their fortieth birthdays. 

Early onset menopause happens naturally, but can also be attributed to certain conditions, illnesses and medical procedures. In rare cases, some infections, such as tuberculosis, malaria, mumps, chicken pox and shingles might cause early onset. Conditions such as Down’s Syndrome, Turner Syndrome, Addison’s Disease and hypothyroidism (an underactive thyroid gland) may also be related to early onset. Possible causes from medical procedures include hysterectomy (removal of the ovaries or womb), and cancer treatment such as radiotherapy and chemotherapy. 

During menopause, at any stage, the ovaries slow and eventually stop their production of estrogen. Estrogen can help protect women from conditions such as osteoporosis and ovarian cancer. This means that women with early onset menopause will spend more years without this protective factor, thus increasing their overall risk. 

Taking Care of Yourself

In mild cases, women will be able to cope with and sooth symptoms without seeing their G.P. One of the best things a woman can do during menopause is to maintain a proper diet and exercise regimen. During and after menopause women should prioritize fiber-rich fruits and vegetables and small amount of calcium-rich dairy products. Women should avoid saturated fats, fatty meats, fatty dairy (chose 1% or skim), and too much salt. Women should engage in at least 30 minutes of exercise a day; more is better. Your pharmacist can help you create a plan for your diet and exercise. If itching and dryness gives you an excuse not to exercise, you might also ask your pharmacist to provide a cream to help clear that up. Hopefully you’ll be in your running shoes in no time! 

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John Keane is a full time pharmacist and owner of Keanes Pharmacy. Why not discuss this topic confidentially with John anytime in person at Keanes Pharmacy, Austin Friars or 0449342884 ©Keanes Pharmacy