Aline: 10 months, 22kgs and doctors mull cause

Ten months ago, Aline Mutuyimana brought joy to a family of four. Theodosie Nyirangirimana and her husband had two other children. The third born came weighing a healthy 3.4 kilogrammes. Both antenatal and post-natal check-ups had gone normally and all seemed okay until two months later.First, Aline started putting on weight. This worried her parents, but the worries would soon turn into distress when she clocked five months. The world seemed to turn on its axis at 120mph as Nyirangirimana would have seen it.“Aline had me worried, when she had five months with 20 kilogrammes and it was at this time that my husband abandoned us,” Nyirangirimana said.The 25-year-old mother, from Kanyinya Sector, Nyarugenge District, said with the alarming weight gain, she decided to take her baby back to Nyiranuma’s clinic whence she was delivered from. At the clinic, she was advised to feed the baby on vegetables and water regularly to fight the weight gain. At the time, Aline was seven months old.However, two months later, the hand of the scale shook at 22 kilogrammes. The vegetable diet Aline was on was not helping. One would think she was born in the same medical circumstances as the likes of Baby Jasleen, born last week in Leipzig, Germany, weighing six kilogrammes, or Akbar Risuddin, born in October 2009, in Jarkata, Indonesia, weighing 8.5 kilogrammes, or the world record baby birth weight.According to the Guinness Book of World Records, Giantess Anna Bates, from Canada, gave birth to a boy weighing 10.8 kilogrammes on January 19, 1879.However, in the three latter cases, doctors discovered that the mothers were suffering from undiagnosed gestational diabetes which can cause abnormally big babies. The condition, known as gestational diabetes, can cause unborn baby to receive too much glucose in the womb, accounting for massive size upon delivery.Gestational diabetes is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy, especially during their third trimester. According to the Wikipedia, gestational diabetes is most commonly diagnosed by screening during pregnancy. Diagnostic tests detect inappropriately high levels of glucose in blood samples. Doctors speculate on Aline caseHowever, in Aline’s case, health service providers at Nyiranuma’s clinic told Nyirangirimana that her daughter had a problem of obesity, adding that Aline would be okay. But this has not calmed the worried mother, who has to take care of her three children alone today. She has been told she needs to seek medical help so that the baby can be further checked for obesity and other health problems, but Nyirangirimana says she cannot afford medical bills at the moment.“My family depends on me, there is no one in my family who can help me with my baby as they all ignore her. I cannot leave her with someone else, I have to carry her everywhere I go and she is too heavy,” she said,With the despair and dejection she in, Nyirangirimana now sees Aline’s weight as a burden, saying she can no longer do anything as the baby demands her attention at all times.“This has pushed me to town to beg, which was not my habit,” she said, adding that the baby’s weight is increasing by the day.“I’m losing hope in my baby ever getting better since nothing has changed over the last two months that I have been going for a check-up, only God will heal my daughter,” Nyirangirimana said.Aline has an insatiable appetite and can gobble food until her mother stops feeding her. Even then, she gets hungry shortly afterwards, Nyirangirimana said. “Suddenly, my child likes eating a lot. While feeding her, I am forced to take away the food because she wants to continue eating,” she said.Some of the doctors in Kigali Healthy Times talked to ruled out gestational diabetes as the cause of Aline’s health condition. According to Dr Stephenson Musiime, a paediatrician at King Faisal Hospital,Rwanda, Aline has obesity. Dr Musiime said obesity in infants may started before birth or after birth. He advised that Nyirangirimana takes the baby to see a paediatrician for proper diagnosis and treatment.“Nutritional history is important and physical examination is very crucial in making the diagnosis and the type of treatment,” Dr Musiime said. “I want to be the one to diagnosis this child.”The paediatrician ruled out gestational diabetes in Nyirangirimana’s case because if it was such, Aline would have been born with more than four Kilogrammes; she weighed 3.4 kilogrammes at birth.Nyirangirimana, too, said she is not aware of any diabetes in her family’s history and that her other two children are normal.Dr Musiime said Aline has a special problem that should be handled in particular way since her mother agreed she attended both antennal and post-natal care. He said with proper diagnosis and management, Aline has a chance for a better life. These words will surely give a glimmer of hope to Nyirangirimana, but also leave her with big questions: “How do I finance Baby Aline’s medical bills?”-------------------------------------Understanding gestational diabetesGestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) — your bodys main fuel. Gestational diabetes causes high blood sugar that can affect your pregnancy and your babys health.Any pregnancy complication is concerning, but there is good news. Expectant mothers can help control gestational diabetes by eating healthy foods, exercising and, if necessary, using medication. Taking good care of yourself can ensure a healthy pregnancy for you and a healthy start for your baby.In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if youve had gestational diabetes, youre at risk for future type 2 diabetes. Youll continue working with your health care team to monitor and manage your blood sugar.Between two and 10 per cent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy. How it occursWhen you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn’t produce enough insulin – or your cells have a problem responding to the insulin – too much glucose remains in your blood instead of moving into the cells and getting converted to energy.When you’re pregnant, hormonal changes can make your cells less responsive to insulin. For most moms-to-be, this isn’t a problem: When the body needs additional insulin, the pancreas dutifully secretes more of it. But if your pancreas can’t keep up with the increased insulin demand during pregnancy, your blood glucose levels rise too high, resulting in gestational diabetes.Most women with gestational diabetes don’t remain diabetic after the baby is born. Once you’ve had gestational diabetes, though, you’re at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.Source: Mayo Clinic, babycentre.com