Monsoon brings a host of mosquito-borne diseases like dengue, malaria, chikungunya, zika virus. Stagnant water becomes breeding ground of mosquitoes which can transmit infection to humans. Children, elderly people, pregnant women, people with low immunity must take extra precaution during monsoon as they become easily prone to these diseases.
Dengue is one of the most dangerous monsoon diseases. The high-grade viral fever is caused by the Aedes aegypti mosquito. Pregnant women must be precautious of falling prey to dengue because the platelet counts of infected person drops sharply and make immune system week.
According to the World Health Organization, there are 190 million cases of dengue reported worldwide, of which 96 million cases require treatment. In India, there is 25 percent increase each year, mainly due to lack of awareness and preventive steps to check breeding of mosquitoes.
It is important to keep your neighbourhood clean, avoid accumulation of water, thereby keeping onself, pregnant women and newborns safe from being bitten by mosquitoes and falling prey to dengue.
Effect on to-be mother
If a pregnant woman falls prey to dengue fever, immediately increase intake of fluids, as hyderation is essential for maintaining embryonic fluid level. Apart from fever, other symptoms of dengue include severe headache, retro-orbital pain, abdominal pain, vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement and increasing haematocrit with decreasing platelets. If dengue gets severe it can be associated with excess plasma leakage, haemorrhage, or organ failure.
Dengue fever during pregnancy requires proper hydration, antipyretics and constant and careful monitoring by medical experts. There is a possibility of pre-term delivery, low birth weight babies and pre-eclampsia.
Treatment of dengue fever during pregnancy
Pregnant woman diagnosed with dengue can take paracetamol after six hours but only under doctor's prescription. The dose should not exceed 4 gms in 24 hours. Avoid taking NSAID like ibuprofen, aspirin and diclofenac sodium. Sponging for fever can help bring respite from high fever during dengue. Intake of fluids like coconut water, ORS, juice and home cooked food along with clean drinking water, at least 3 litres a day should be followed.
Early detection and access to proper medical care decreases fatality from 20 percent to below 1 percent. Warning symptoms and signs for capillary leak are to be taken care of, especially when the fever starts to subside. Such patients are considered for IV fluid therapy. Symptoms to be checked are abdominal pain and tenderness, vomiting with lethargy and restlessness.
Babies with mothers who have been diagnosed with dengue just before or at delivery should be closely monitored after birth to restrict the risk of vertical transmission.
Breastfeeding during dengue
According to experts, breastfeeding is safe if the mother is infected with dengue. The risk of transmission of dengue virus from mother to the baby through breast milk is next to negligible. Evidence shows that the colostrum, the first breast milk, and breast milk have anti-dengue antibodies which make the baby immune from the infection.
According to the guidelines by WHO, it is important to breastfeed the newborn during maternal dengue infection as breast milk has lot of nutrients and antibodies which helps protect the baby, prevent dehydration and maintain emotional well-being in the baby. If a mother is moderate to severely ill, then the doctor can put the newborn on formula or top feed.
Tips for breastfeeding mother who have dengue:
Consult a doctor to find out if breastfeeding during or immediately after dengue is safe or not.
Mothers should avoid breastfeeding their newborns if they have high fever and are not physically well.
Breastfeeding mothers should discuss the options of formula feed with their doctor.
Discuss breast milk storage and breast milk pumping options with doctors and health practitioners.
If situation worsens, try to be open to use breast milk of other mothers as breast milk is of utmost importance for your newborn’s health.