Questions

• I just turned 40, and I am already noticing that my memory skills are slipping. What can I do to improve my memory?
• Can a diabetic mother breastfeed her infant, and are there any special considerations?
• My child is headed to camp this summer. What measures should I take to be sure he is safe while he is at camp?

Jonathan M. Richman, M.D.
Neurology
Pinehurst Neurology
(910) 295-6868

Although we cannot halt the aging process, there are many things that we can all do to help improve our memory. Interestingly, our memory skills begin to decline as early as age 30. Most of these lapses, however, are quite benign, such as misplacing an object at home or forgetting someone’s name at a party. While they can be frustrating, these types of mild memory loss are part of normal aging.

There are three things that I emphasize to my patients in terms of what they can do to keep themselves mentally sharp.

First, remain physically active. Moderate exercise will lessen the common problems that people have as they get older, including weakness, stiffness of the joints and problems with balance. It also helps with more serious medical problems such as hypertension and diabetes. The benefits of physical fitness go beyond this, however, and research shows that exercise can help sharpen cognitive skills, prevent depression and ward off the changes in memory associated with age.

Second, remain mentally active. There is good reason to believe that the phrase “use it or lose it” applies to the brain. There is no particular mental activity that I emphasize, but anything that keeps the mind engaged—reading books, doing crossword puzzles, using a computer, or going to lectures or concerts—is beneficial. It is also worth noting that people who spend their time doing these kinds of activities are less likely to spend time in the passive mode of watching television.

Third, maintain relationships and participate in activities that allow you to feel good about yourself. Support from friends, family, support groups and religious affiliations can be a strong defense against disease. It appears that people with good relationships have lower stress levels as well as better overall health.

Other tips include eating foods rich in antioxidants, such as blueberries and dark-leafy vegetables; foods that are rich in omega-3, as well as other dark beans; and vitamins such as vitamin C, vitamin E and folate. It is important to visit a doctor if you or a loved one begins to notice memory loss outside of what most people would consider normal. Problems of disorientation, personality change or significant confusion performing familiar tasks may indicate a more serious condition.

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Robin Kennedy, R.N.
Certified Lactation
Consultant
FirstHealth Moore
Regional Hospital
(910) 715-2068

In most cases, a diabetic mother is encouraged to breastfeed and should, with close blood sugar monitoring, be able to breastfeed successfully. She can provide pumped breast milk for bottle-feeding, too.

When a mother breastfeeds, her insulin requirements are decreased because the milk-producing hormone prolactin provides improved diabetic control.

It is very important for the diabetic mother to monitor her blood sugar routinely. She will also need extra calories while breastfeeding. Even if she requires insulin, her milk is considered safe for her infant because insulin does not pass into her milk.

Because insulin is required for milk production, the diabetic mother may experience a 24-hour delay in lactogenesis II, the time period during which the milk comes in. In addition, her infant may need close monitoring of his/her blood sugar in the Neonatal Intensive Care Unit, which can also cause a delay in breastfeeding.

For these reasons, if the mother is unable to breastfeed within the first hour after birth, she should begin to pump her breasts as soon as possible to stimulate milk production. When she decides to wean her child, she will need to alter her insulin intake and her diet to compensate for the decrease in milk production. Gradual weaning is recommended.

(Note: The milk supply of a diabetic mother can decrease after a hypoglycemic episode, but it will usually rebuild over a few days.)

Breastfeeding has many advantages. Studies continue to suggest that breastfeeding protects a child against the onset of diabetes in childhood. Among many other advantages, it also often gives the mother a sense of well-being.

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Joleen Moore, C-FNP
Family Medicine
FirstHealth Family Care
Center-Biscoe
(910) 428-3720

One of the most important steps that you can take is to know what medical and safety services are available at the camp your child will attend. According to recommendations from the American Academy of Pediatrics, most camps should have written health policies and protocols. Ask to see the policies and protocols of your child’s camp.

Before camp starts, be sure that camp leaders have a detailed health history of your child. This should include any significant illnesses, operations, injuries, allergies and any current medical problems. The camp may ask you to provide this information as part of the application process.

If your child has a special medical condition, ask your medical provider what precautions you should take. If your child is on medication, you will also want to check with camp leaders on the process for handling medications.

Most camps will keep first aid items on hand, and some may even have a nurse on site or close by to help deal with minor emergencies. This means that you likely won’t have to worry about packing first aid items, but check with camp leaders to be sure.

Finally, not all problems kids might experience at camp are physical. Some children may experience homesickness, especially if this is the first time away from home for an extended period. Prepare your child by talking to him beforehand, and let him know what steps he should take if he is homesick. Most camps will have a procedure for dealing with homesickness as well.

Most importantly, though, remind your child to have fun and enjoy being at camp. It is a wonderful learning experience for your child … and for you.

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