Oral Contraceptive Pill

Oral Contraceptive Pill (OCP) is a popular contraceptive birth spacing method among women.

Intrauterine Devise or IUD as it is commonly called is a long acting contraceptive method which is free from hormones and once inserted and settled can provide hassle free protection for up to 10 years. There are two types of IUD: Copper T which protects for 10 years and Multiload which is effective for five years. IUDs can only be given by providers especially trained on its insertion. They are available at government clinics, hospitals and FP centers, NGOs and in the private sector through g

Diarrhoea is the passage of loose or watery stools, usually at least three times in a 24-hour period. However, it is the consistency of the stools rather than the number that is most important.

Iron is an essential micronutrient for the body. It is a component of body systems that are involved in the utilization of oxygen. It forms part of hemoglobin, the red pigment in blood, which allows oxygen to be carried from the lungs to the tissues.

Use a calendar to keep track of your menstrual cycle. Mark each day of your period with an X. Calculate the length of your cycle by counting the days from the first day of bleeding in one period to the first day of bleeding in the next period. In addition to noting the days of your period, it is helpful to make notes about the flow, any pain that is felt, and changes in mood or behavior.

Zinc is classified as an essential mineral. It is essential to over 180 biologic functions. Many foods rich in trace minerals contain zinc, with the highest amounts in meat products. Lesser amounts are found in milk, spinach, nuts, oats, rice and beans.

Condoms last for a long time but you should always check the expiration date printed on the wrapper or box. Open condoms carefully so you don’t damage them, don’t use your teeth or scissors.

An IUD or intrauterine device is a long-acting reversible form of birth control that is highly effective (over 99%). It is a small “T” shaped device that is placed in uterus to help prevent pregnancy. It is hassle-free as no daily attention is required.

Smile baby diapers are made from ingredients that are thoroughly tested and proven to be safe. The ingredients we use are common in most diapers and are used safely by millions of babies around the world every day.

Use a calendar to keep track of your menstrual cycle. Mark each of the days of your period with an X. Calculate the length of your cycle by counting the days from the first day of bleeding in one period to the first day of bleeding in the next period. In addition to noting the days of your period, it is helpful to make notes about the flow, any pain that is felt, and changes in mood or behavior.

Injectable contraceptive is for women and it can can protect couples from pregnancy for upto three months. It is a progestin-based (DMPA) short term reversible contraceptive known as Depo-Provera. It is widely available in Bangladesh both from the public and the private sector. Another type of subcutaneous DMPA is also available in the private sector which is known as ‘Sayana Press.’ It is currently under clinical trial to be offered from the public sector. Norethisterone enanthate or NET-EN (also known as Noristerate) provides two month protection, but it is not available in Bangladesh.

Yes. Condoms are very effective in preventing HIV and many other STDs when used the right way every time. Condoms may prevent the spread of other STDs like Human Papillomavirus (HPV, genital or venereal warts) or genital herpes, only when the condom covers the infected areas or sores.

Oral Contraceptive Pill (OCP) which contains a combination of estrogen and progestogen hormones is known as the Combined Oral Contraceptives (COC) pill.

Any women of reproductive age can take a COC to space between children. A number of COC pills can be found in the market. In order to select the right COC pill, one should consult a doctor.

IUD provides long term protection so they are ideal for women who do not want or are not sure about having any more children. In that sense they can be an alternative to a permanent method. IUDs are also popular among women who are breast feeding; contraindicated to the use of estrogen and progestin hormones; or who want immediate return to fertility upon removal.

Four clinical types of diarrhoea can be recognized:

Acute watery diarrhoea (including cholera): This lasts several hours or days, the main danger is dehydration, weight loss also occurs if feeding is not continued.

Acute bloody diarrhoea: This is also called dysentery, the main dangers are intestinal damage, sepsis and malnutrition; other complications, including dehydration, may also occur.

Persistent diarrhoea: This lasts 14 days or longer, the main danger is malnutrition and serious non-intestinal infection; dehydration may also occur.

Diarrhoea with severe malnutrition: the main dangers are severe systemic infection, dehydration, heart failure and vitamin and mineral deficiency.

- Iron transports and stores oxygen in human body.
- Supports proper physical and mental growth of children.
- Aids in energy production and cell diffusion in human body.
- Helps the immune and central nervous systems.

The presence of menstrual irregularities can be a sign of other health problems such as Primary ovarian insufficiency (POI), endometriosis, Polycystic ovary syndrome (PCOS), polyps, and uterine fibroids. If left untreated, menstrual irregularities can lead to other conditions. These possible conditions vary depending on the type of menstrual irregularity and include endometrial hyperplasia (thickening of the endometrium), low bone density, and iron-deficient anemia. It is important for a woman with a menstrual irregularity to speak to a health care provider to determine the cause of the irregularity and to receive appropriate treatment as necessary.

‘Relax’ is an SMC branded intrauterine device (IUD) that can provide long-term birth control. Relax is a small, T-shaped, copper-based device of the type IUD TCu 380A which is safe, effective for 10 years and completely reversible upon removal.

Many experts say that zinc deficiency is widespread. People living in poverty with diets low in zinc, especially children below five years of age, need zinc the most. Deficiencies result in poor wound healing because of zinc's role in cellular repair. Zinc deficiency also leads to slower growth. Most importantly, children with low levels of zinc are at increased risk for infection, severe infections and death.

Unfortunately, diaper rash is quite common. More than half of babies between the ages of 4 months and 15 months develop diaper rash, and nearly all babies will get at least one diaper rash before they are potty trained. Changing the diaper promptly after it becomes wet or soiled is the best way to prevent diaper rash.

The presence of menstrual irregularities can be a sign of other health problems such as Primary ovarian insufficiency (POI), Endometriosis, Polycystic ovary syndrome (PCOS), Polyps, and Uterine fibroids. If left untreated, menstrual irregularities can lead to other conditions. These possible conditions vary depending on the type of menstrual irregularity and include endometrial hyperplasia (thickening of the endometrium), low bone density, and iron-deficient anemia. It is important for a woman with a menstrual irregularity to consult to a doctor to determine the cause of the irregularity and to receive appropriate treatment as necessary.

Contraceptive Injections (DMPA) has many advantages. Being a progestin only method, it can be safely used by lactating mothers and also by estrogen contra indicated women. It can be used immediately after delivery and within seven days after miscarriage or abortion. The injection prevents the risk of developing uterine tumors. It is reversible and protects pregnancy for up to three months.

All SMC’s condoms adhere to quality assurance. These include electronic testing, water leak test, air burst test and strength test.

COCs are the most popular contraceptive method in Bangladesh. It is safe, hassle-free and easily reversible, which means after stopping dose of COC pill, a woman can quickly get pregnant.

In addition to preventing pregnancies, COCs are also prescribed by doctors/health providers to treat acne, extreme menstrual cramps and a few other female health issues.

COC pills consist of iron tablets which helps prevent iron deficiency anemia among women due to excessive blood loss during the period.

There are many low-dose brands of COC available in the market such as Femicon, Femipil, Noret-28, Ovacon Gold, Mypill, etc.

A woman can start this method at any time during her menstrual cycle if she is sure that she is not pregnant at that time. If she is starting within 12 days after the start of her monthly cycle, then there is no need for a back up method. If starting more than 12 days after the start of her cycle, she can have the IUD inserted anytime it is reasonably sure she is not pregnant. IUDs are also very popular as a post partum contraceptive method and can be safely inserted within 48 hours after delive

During diarrhoea there is an increased loss of water and electrolytes (sodium, chloride, potassium, and bicarbonate) in the liquid stool. Water and electrolytes are also lost through vomit, sweat, urine and breathing. Dehydration occurs when these losses are not replaced adequately and a deficit of water and electrolytes develops.

The volume of fluid lost through the stools in 24 hours can vary from 5 ml/kg (near normal) to 200 ml/kg, or more. The concentrations and amounts of electrolytes lost also vary. The total body sodium deficit in young children with severe dehydration due to diarrhoea is usually about 70-110 millimoles per litre of water deficit. Potassium and chloride losses are in a similar range. Deficits of this magnitude can occur with acute diarrhoea of any aetiology.

Iron absorption refers to the amount of dietary iron one obtains from the food s/he eats. Healthy adults absorb about 15% of the iron in their diet.

Vitamin C helps the body to absorb iron. The actual amount of iron a body absorbs depends on the amount of iron already stored in the body. When the body has low amounts of iron stored, it will absorb more iron from the foods eaten. When the body has a large amount of iron stored, the amount of iron it absorbs will decrease.

According to studies conducted by the World Health Organization, the hygiene of female sanitary products is especially important to a woman, as the pelvis, uterus, vagina of a women’s body are all inter-connected, thus it increases the chances of bacterial infection if sanitary napkins of low hygiene standards were used during the menstruation period.

Relax IUD is not available in market or pharmacies; it is only available with trained doctors and some selected hospitals under SMC’s Pink Star program. Pink Star is a network of privately practicing graduate doctors who promote and provide long acting reversible contraceptives from their private facility. In addition, they are also offering family planning injectables (SOMA JECT and Sayana Press – 3 months protection). One can call 16387 (SMC tele-counseling center) to find any doctor.

IUDs are also available at government hospitals, FP centers and some NGO clinics.

Zinc is prescribed to treat and prevent diarrhea for children < 5 years of age.

Because babies come in all different shapes and sizes, diapers fit babies differently. Our diaper system was designed to achieve the highest level of leak protection. We measure thousands of babies' legs, bottoms, and waists to try to get a good fit that helps contain leaks. Sometimes leaks happen because the leg cuff or waist is a bit folded. Running your finger around the waist band and cuffs sometimes helps to ensure a better fit. Another reason for leaks is if there isn't enough absorbent material for baby’s urine output. If your baby is close to the upper end of the weight range of the diaper you are currently using, you may want to try the next size up diaper as there is more absorbent material in the larger diapers.

According to studies conducted by the World Health Organization, the hygiene of female sanitary products is especially important to a woman, as the pelvis, uterus, vagina of a women’s body are all inter-connected, thus it increases the chances of bacterial infection if sanitary napkins of low hygiene standards or unhygienic clothes were used during the menstruation period.

SOMA-JECT is an SMC brand injectable contraceptive. It is Depo Medroxy Progesterone Acetate (DMPA) and it contains 150 mg progesterone in a 1 ml vial. It is administered through intramuscular route. It is 99.7% effective if taken properly (right dose and right schedule).

No, reuse of any condom is not recommended. A new condom should be used every time you have intercourse.

A woman can start taking a COC pill any time she wants as long as she is not pregnant and not having any health issue or restriction to take additional hormones. She should start using a COC from the first day of her menstrual bleeding. (For details, please see the product insert inside of the pack).   

For women who want to switch to COC from other methods like IUD, Implant, and condom or a Progestin-Only Pill (POP) method can start COCs immediately after stopping the previous method.

IUDs don’t have the side effects that are so commonly associated with hormonal methods. However some women may go through irregular or heavy bleeding or abdominal cramps after its insertion but these generally go away over time and regular follow up with the provider. A woman must ensure proper hygiene of her genital area to protect from infections.

Two main dangers of diarrhoea are death and malnutrition. Death from acute diarrhoea is most often caused by loss of a large amount of water and salt from the body. This loss is called dehydration. Dysentery is another important cause of death related to diarrhoea. Diarrhoea is worse in children with malnutrition. Diarrhoea can cause malnutrition and can make it worse because:

- Nutrients are lost from the body in diarrhoea,
- It may develop loss of appetite
- Mothers may not feed children during diarrhoea, or even for some days after the diarrhoea is better.

To reduce this malnutrition, additional foods should be given to children as soon as dehydration has been corrected.

 

Iron Deficiency Anemia is a common condition that occurs when there is not enough iron in the body. It is the most common type of anemia. A lack of iron in the body can come from not eating enough foods that contain iron, bleeding, or not absorbing enough iron from food that is eaten.

The term anemia is used for a group of conditions in which the number of red blood cells in the blood is lower than normal, or the red blood cells do not have enough hemoglobin. Hemoglobin — an iron-rich protein that gives the red color to blood — carries the oxygen from the lungs to the rest of the body.

Children need to absorb an average of 1 mg per day of iron to keep up with the needs of their growing bodies. Since children only absorb about 10% of the iron they eat, most children need to ingest 8-10 mg of iron per day. Breast-fed babies need less, because iron is absorbed 3 times better when it is in breast milk.

A common time for iron deficiency is between 6 and 24 months of age. The adolescent growth spurt is another high-risk period.

Menstruation flow and secretion are highly prone to growth of bacteria; therefore sanitary napkins should be replaced on a regular basis. Under normal circumstances, bacteria start to grow 15 minutes after a new napkin is used. In two hours, the napkin can be filled with bacteria. It is strongly advised that a new napkin is used every 3-4 hours during the menstruation period.

• Offers long-term contraception up to 10 years after insertion
• Effective immediately after insertion
• Fertility returns just after removal
• Non-hormonal so no chance of hormonal side effects
• Safe for lactating mothers
• Can be inserted in post partum (NVD and CS) period
• Can be used more than once and inserted following removal of the previous one (if desired)

Yes, zinc and ORS can be given at the same time when a child has diarrhea. Zinc is given once a day. Give the zinc at a time of day that is easy for you to remember and repeat every day for 10-14 days. ORS needs to be given throughout the day only as long as your child has loose or watery stools, but zinc should be given for the entire 10 to 14 days.

Newborns: Newborn babies require changing often, especially if they are breastfed. Our recommendation is every 3-4 hours during the day. 

Older Babies: As babies get older, they gain in bladder control. They tend to wet less often, in higher volume. We recommend that you change your baby's diaper every 6-8 hours.

However, Smile baby diaper can give a complete protection for 12 hours which will give the baby a good night’s sleep.

Menstruation flow and secretion are highly prone to growth of bacteria; therefore sanitary napkins should be changed on a regular basis. It is strongly advised that a new napkin is used every 3-4 hours during the menstruation period.

Sayana Press is a progesterone based subcutaneous family planning contraceptive. It provides protection for three months. It contains 104 mg progesterone in a 0.65ml uniject. All other features of this product are similar with SOMA-JECT

No. When used as directed, condoms are effective in preventing pregnancy and are the only form of contraception that also can prevent STIs. This is why it is important to follow directions for correct use.

A woman needs to take one pill every day until the pack is empty. When she finishes the pack, she should take the first pill from the next pack from the next day.

She should take the pills at the same time every day for better effectiveness. Before starting a COC pill brand, one must read the instructions given in the packet.

A woman should consult her provider who inserted the IUD if she is having irregular and overdue periods, severe abdominal pain or signs of infection. She also needs to see the doctor if she feels that the IUD has shifted position, or the strings are missing or if just feeling weak following the insertion.

The body normally takes in the water and salts it needs (input) through drinks and food. It normally loses water and salts (output) through stool, urine and sweat.

When the bowel is healthy, water and salts pass from the bowel into the blood. When there is diarrhoea, the bowel does not work normally. Less water and salts pass into the blood, and more pass from the blood into the bowel. Thus, more than the normal amount of water and salts are passed to the stool.

This larger than normal loss of water and salts from the body results in dehydration. It occurs when the output of water and salts is greater than the input. The more diarrhoea stools a child passes, the more water and salts he/she loses. Dehydration can also be caused by a lot of vomiting, which often accompanies diarrhoea.

A person can have low iron levels mainly for four reasons:

- Not getting enough iron in the diet.
- Not being able to absorb the iron in the diet.
- Blood loss, either from disease or injury
- Parasitic infections, malaria, worm.

Iron deficiency anemia also can develop when the body needs higher levels of iron, such as during pregnancy and lactation period

First of all, SMC is truly committed to manufacturing health products under stringent quality control standards and bringing better health, better value and an unprecedented level of comfort for women. Joya Sanitary Napkins are light, odourless, and can be used with assurance of no side effects. Unlike many of the brands, who have devoted their resources in doing commercials and hiring celebrities in their promotions, we have devoted all resources in our product development, in pursuit of a real quality and benefits for women.

Almost all women of reproductive age with one living child can use Relax IUD safely and effectively. However, it is most recommended for women who:
 

> Do not want any more children but are not interested in using a permanent method of contraception

> Are not sure whether they would like to have any more children in future

> Have not had a history of pelvic infection or sexually transmitted infections in the last three months

> Contraindicated for hormonal contraceptive methods

During diarrhea ORS should be given first and followed by zinc. If it is the first time the child has received zinc, it is best to wait 30 minutes after the ORS is given.

The size diaper you need is determined by the weight of your baby

Small:  3-6 kg

Medium: 4-9 kg

Large: 8-14 kg

XL: 11-18 kg

SMC is truly committed to manufacturing health products under stringent quality control standards and bringing better health, an unprecedented level of comfort for women at a value for money. Joya Sanitary Napkins are light, odorless, and can be used with assurance of no side effects.

It is available at trained providers under SMC Blue Star Program. One can find their private chamber by looking at the branded Blue Star signboard in front of their shop

COCs are the most popular methods compared to other contraceptive methods. At the beginning of starting the pill (for first 2/3 months), a woman may face some changes in the menstrual pattern, headache, dizziness, nausea, breast tenderness, weight change, mood changes, etc. However, in the majority of the cases, these initial side effects or discomforts go away within two or three months of regular use.

Contraceptive Implants are long acting progestin only preparation which can protect a woman from an unwanted pregnancy for up to 5 years. They are inserted underneath the skin of a woman desiring contraception. There is more than one type of Implants available in Bangladesh. The most widely available now are Jadelle which contains two flexible rod like implants each containing 75 Mg of synthetic levonorgestrel hormone and protects for 5 years. Implants can only be given by providers especially

The most important parts of treatment of diarrhoea are:
- Prevent dehydration from occurring if possible
- Treat dehydration quickly if it does occur
- Give zinc supplements for 10/14 days, depending on the availability of supplies and national policy to reduce the severity of the episode and to reduce the incidence of diarrhoea episodes in the following 2 to 3 months, and
- Feed the child.

Prevention of dehydration:

In the home, dehydration can usually be prevented by drinking more fluids as soon as the diarrhoea starts. To do this, give the recommended home fluids or give available food-based fluids, such as gruel, soup or rice-water. Also increase the frequency of breastfeeding, or give milk feeds prepared with twice the usual amount of water. The types of fluid or solutions used in your area for preventing dehydration in the home will depend on:

- local traditions for treatment of diarrhoea,
- availability of a suitable food-based solution,
- availability of salt and sugar,
- access of people to health services, and
- availability of oral rehydration salts (ORS)

Treatment of dehydration:

If dehydration occurs, the child should be brought to a community health worker or health centre for treatment. The best treatment for dehydration is oral therapy with a solution made with ORS. This treatment for children is also good for adults with diarrhoea. For treating dehydration, ORS should always be used, if possible.

Zinc supplementation:

It has been shown that zinc supplements given during an episode of diarrhoea reduce the duration and severity of the episode, and lower the incidence of diarrhoea in the following 2–3 months. For these reasons, all patients with diarrhoea should be given zinc supplements as soon as possible after the diarrhoea has started.

Feeding:

The child should be offered small amounts of nutritious, easily digestible food frequently. If the child is breastfed, try to increase the frequency and duration of feeds. Feeding during the diarrhoea episode provides nutrients the child needs to be strong and grow, and prevents weight loss during diarrhoea. Fluids given to the child do not replace the need for food. After the diarrhoea has stopped, an extra meal each day for a week will help the child regain weight loss during the illness.

An important development has been the discovery that dehydration from acute diarrhoea of any etiology and at any age, except when it is severe, can be safely and effectively treated by the simple method of oral rehydration using a single fluid. Glucose and several salts in a mixture known as Oral Rehydration Salts (ORS) are dissolved in water to form ORS solution. After 20 years of research, an improved ORS solution has been developed.

Following are the most common symptoms of iron deficiency anemia. However, each individual may experience symptoms differently. Symptoms may include:

- Feeling tired and weak.
- Decreased work and school performance.
- Slow cognitive and psychosocial development during childhood.
- Difficulty maintaining body temperature.
- Abnormal paleness or lack of color of the skin.
- Irritability.
- Decreased immune function, which increases susceptibility to infection.
- Increased heart rate (tachycardia).
- Sore or swollen tongue.
- Enlarged spleen.
- A desire to eat peculiar substances such as dirt or ice (a condition called pica).

Most customers tend to store sanitary pads in the bathroom, which is rather unhygienic. Under the moist environment, pads will be prone to growth of bacteria. We have adopted the highest standards in packaging which are comparable to those used for food packaging. This ensures that every piece of Joya Sanitary Napkin remains dry and more resistant to growth of bacteria.

No. The thickness of the condom doesn't necessarily correspond to safety. Please make sure to read the instruction manual.

IUDs work immediately after insertion

Usually children with severe dehydration are given intravenous fluids first. After the intravenous fluid is no longer needed and the child is not vomiting, ORS and zinc should be started.

> Not washing hands before and after a napkin change: Changing napkin by dirty hands can cause a considerable quantity of microbes to be brought onto its surface. 

> Storing napkins in humid conditions: Humidity is an ideal environment for reproduction of bacteria, which can easily get into napkins. For example: Bathroom.

> Disregarding expiry date: Date expired napkins can cause health hazards. 

> Not changing a napkin for a long period: After a longer period of use, bacteria increases promptly and may cause health hazards.

> Eligible couples (15-49 years) who have one living child

> Do not want any more children

> Do not want another child currently.

> Women contra-indicated for Estrogen hormone  

> Lactating mother – after 6 weeks of delivery

> Non lactating mother – Immediately after delivery 

If a woman misses a hormonal pill (white pills), she should take the missed hormonal pill as soon as she remembers and should continue taking the other pills as usual, one each day (see product insert for details).

Jadelle provides long term protection so they are ideal for women who want spacing intervals for between 3 and 5 years. They are popular among women who are breast feeding; contraindicated to the use of estrogen and also newly married women who want to delay their first child since return to fertility is fairly quick upon removal.

ORT is the giving of fluid by mouth to prevent and/or correct the dehydration that is a result of diarrhoea. As soon as diarrhoea begins, treatment using home remedies to prevent dehydration must be started with Oral Rehydration Salts (ORS).

Iron Deficiency Anemia has serious health consequences, which are:

- Impaired physical growth.
- Impaired brain development and cognitive performance.
- Decreased concentration and attention.
- Impaired learning capacity and memory functions.
- Decreased resistance to diseases.
- Increased morbidity and mortality from infections.

Joya Sanitary Napkin is scented first time in Bangladesh and hygienic. It helps to prevent bacterial multiplication, eliminates odour and promotes comfort during menstrual period.

All SMC’s condoms come with adequate lubrication. However, you can always add more as long as the lubricant is either water-based or silicone-based. Oil-based lubricants, like baby oil or petroleum jelly, can weaken latex, and therefore, should not be used. Please make sure to always check the instructions for use when choosing a lubricant for use with a condom.

• Any time during the menstrual cycle if pregnancy is excluded
• Within first seven days of menstruation
• During lactation period, IUD can be given four weeks after delivery, if she exclusively breastfeeds her baby and her menstruation has not returned
• Within 48 hours of normal vaginal delivery
• During caesarean operation
• After MR/abortion

The zinc tablet is meant to be dissolved in water, breast milk, or ORS. Other fluids are not recommended.

> After using the pad, wrap it with paper or tissue and throw it into the bin.

> Do not flush the pad in toilet pan or in commode.

> Within five days from the onset of menstrual bleeding

> If the injectables are administered at any other time, pregnancy must be reliably excluded before; and an additional non-hormonal contraceptive method used for at least seven days after the insertion

> Immediately after complete abortion and MR

> In postpartum period; after 6 weeks for lactating mothers

> In immediate postpartum period if mother is not lactating

> Can be used anytime within effective use of other contraceptives

She should take a hormonal pill as soon as she remembers and should continue taking the other pills as usual, one each day. There would be little or no risk of pregnancy. It is also advisable that her partner should use a barrier method (condom) till the start of next pill cycle. (see product insert for details). 

A woman can start this method at any time within seven days of her menstrual cycle without taking any back up contraceptive method. If insertion is done later than 7 days, the provider must ensure that the patient is not pregnant at the time of insertion and the woman must use a non hormonal contraceptive such as condoms for the next seven days. If a woman has had a miscarriage or abortion, she can have Implants inserted immediately.

ORT does not stop the diarrhoea, but it replaces the lost fluids and essential salts thus preventing or treating dehydration and reducing the danger. The glucose contained in ORS solution enables the intestine to absorb the fluid and the salts more efficiently

Special care and attention should be given to children from birth to age 5. This is the most critical period for physical and mental development of human child. This is also the most critical age for children to be affected by Iron Deficiency Anemia. Children with IDA should be treated with Iron Supplementation (i.e. MoniMix) along with iron-riched foods.

- Not washing hands before a napkin change: Changing napkin by dirty hands can cause a considerable quantity of microbes to be brought onto its surface.
- Storing napkins in a bathroom: In a bathroom, there is humidity. This is an ideal environment for reproduction of bacteria, which can easily get into napkins.
- Disregarding expiry date: Date expired napkins can cause health hazards.
- Not changing a napkin for a long period: After a longer period of use, bacteria increases promptly and may cause health hazards.

IUDs do not have side effects that are so commonly associated with hormonal methods. However, some women may go through -

  • Mild cramping pain in the lower abdomen in the first few days after insertion
  • Increased duration and/or amount of menstrual bleeding or spotting, cramps, inter-menstrual bleeding for first few months after insertion

Most side effects usually subside spontaneously within 2-3 months after insertion or with symptomatic treatment. There is no need to take any special intervention.

No, you should continue to give plenty of ORS, as recommended, even though you are giving zinc. ORS will help to replace fluids lost during diarrhea. Zinc will speed up recovery but does not replace fluids.

Injectable contraceptives are to be taken in three months interval. It can also be given in special situation within 28 days following due dose and within 14 days before due dose (Window period).

She should take a hormonal pill as soon as she remembers and ask her husband to use a condom or avoid sex for the next 7 days. And if she had sex in the past 5 days, she should consider taking an Emergency Contraceptive Pill.

Irregular menstrual bleedings are most common side effects of Jadelle implants. The periods may be prolonged, scanty or sometimes heavy. In some women periods may stop altogether. Bleeding irregularities however diminish with continuing use. In over 10% of the cases women have also reported vaginal discharge, pelvic pain, breast tenderness, headache, weight gain and nausea.

The benefits of fluid replacement in diarrhoea far outweigh the risks of using contaminated water to make oral rehydration solution. In situations where it is difficult to boil water, mothers are advised to use the cleanest water possible.

1. Food-based approaches

Dietary Improvement: Food-based approaches represent the most desirable and sustainable method of preventing micronutrient malnutrition. Food Fortification: Food fortification is the process by which nutrient is added to commonly eaten foods to improve the quality of the diet.

2. Iron supplementation:

Treating iron deficiency anemia with iron supplementation is a common practice especially in the developing countries. Iron supplementation is quite often prescribed/recommended by medical professionals for children most of who suffer from anemia.

The IUD inserted into the uterine cavity does not move to other parts of the body.

The earlier that zinc is administered, the sooner the child will benefit. However, it can be started at any time during the illness.

If a woman taking the pill vomits within 2 hours after taking a pill, she should take another pill from her pack as soon as possible and then keep taking the pills as usual.

• Implants should be removed immediately after the end of five years since they lose their efficacy soon afterwards. • They can also be removed any time before 5 years. However they must be removed by a trained provider. • Breast feeding mothers can use Jadelle Implant from the 6th week after child birth.

ORS is safe and can be used to treat anyone suffering from diarrhoea, without having to make a detailed diagnosis before the solution is given. Adult need rehydration treatment as much as children, although children must always be treated immediately because they become dehydrated more quickly.

MoniMix contains a number of vitamins and minerals including Iron, Zinc, Folic Acid, Vitamin A and Vitamin C.

The contraceptive effect of the IUD is readily reversible. This means that a woman can become pregnant as soon as the IUD is removed. 

Zinc treatment is recommended for the complete dosing regimen of 10 to 14 days because zinc not only decreases the number of days with diarrhea and the severity of diarrhea, it helps the child fight off new episodes of diarrhea and pneumonia for the next 3 months following a full treatment.

A woman can take the pill without a break as long as she wants unless she has any medical issues.

Mothers must be taught to persist in giving ORS solution, even though this requires time and patience. They should give regular, small sips of fluid. Giving ORT reduces nausea and vomiting and restores the appetite through correction of acidosis and potassium losses.

MoniMix can be used in any food products, but because the iron is coated with lipid (to mask the metallic taste), it will float to the top of liquids and tend to stick to the side of the cup or glass. So, to avoid the wastage, it is better to mix MoniMix with solid food.

Yes, you can, as long as the possibility of pregnancy and infections is ruled out.

Studies have included 10 or 14 days of treatment. Both have been proven to be equally effective.

Progestin-only Pills or POPs as they are commonly known are contraceptive pills containing progestin hormone only. Unlike COCs, they do not contain estrogen hormone and therefore can be used safely by estrogen contraindicated women.

Once the diarrhoea episode has passed, the child should be given more food than usual to make up for losses during diarrhoea. Breastfeeding is particularly beneficial because breast milk is easily digestible. It also contains protective substances which help to overcome the infection causing the diarrhoea.

Yes. The amount of micronutrients in the MoniMix sachets is high enough to meet the needs of infants with micronutrient deficiencies (e.g. iron deficiency anemia) but not too high for those who do not have deficiencies.

The IUD is a safe method for women with diabetes.

Yes, all episodes of diarrhea should be treated with zinc. Even if a child has recently completed a full course of zinc treatment, it is still safe to give a second course. Children with persistent, repeated episodes of diarrhea should be taken to a clinic or hospital.

The most significant advantage of POP is that they can be used by lactating women at least 6 weeks after childbirth. In addition, it can also be used safely by women who want to delay their first child and those who cannot take estrogen because of various health reasons. A woman should consult a doctor for starting and continuing a POP.

High energy foods such as fats, yogurt and cereals are quite well absorbed during diarrhoea. Small, frequent feeds of energy-rich local foods familiar to the child should be given.

- Foods high in potassium are important to restore the body's essential stores depleted during diarrhoea. Such foods include lentils, bananas, mangoes, pineapples, pawpaw, coconut milk and citrus fruits.
-It is very important to continue feeding a person with diarrhoea. Give soft, easy-to-digest foods, like khichuri, watery dal, curd, bananas etc.
-You should also give plenty of other fluids, like lebu pani, lassi, coconut water etc. If the baby is being breast-fed, continue to give her mother's milk.
- Give an extra meal a day, after the diarrhoea stops, to help the body get strong again.

Certain foods should be avoided during diarrhoea, for example those containing a lot of fibre such as coarse fruits and vegetables, whole grain cereals and spicy foods.

Yes, they can be safely used for any age group, although they were developed for infants and young children. Infants and young children cannot safely ingest tablets or pills. Syrups and drops have been used for many years, but compliance has been documented to be poor (for iron). For other age groups, there are more choices for supplementation, including the use of fortified foods, pills and capsules. Nevertheless, MoniMix can be used in these other age groups without fear of toxicity. To date, research emphasis has focused on infants and children under aged 5 years, however there are other ongoing research involving pregnant women.

Implant is a contraceptive and made up of two small rods the size of a matchstick. These rods are silicone based, sterile and flexible. It contains slow releasing progesterone hormone. Depending upon the type, it provides 3-5 years protection from pregnancy. This method is to be inserted just under the skin of the non-dominant upper arm in the shape of a narrow V to prevent pregnancy.

It is clear that zinc is vital for a wide range of biological functions. In diarrhea we have come to know that zinc helps in the following ways:

- It boosts the immune system  - It helps in healing the intestinal lining  - It improves absorption of fluids

A breastfeeding mother can start the pill anytime after 6 weeks of childbirth if her period has not returned. One pill must be taken at the same time every day. Because of a single hormone and very low dose, it is important to maintain regular timing to ensure maximum efficacy. (See product insert for details).  

In most cases, no. The diarrhoea will get all right by itself in a day or two. If there is any blood or mucous in the stools, any fever or vomiting, you must see the doctor immediately. Don't take any medicines yourself, It is important to follow the doctor's advice.

ORT on its own is usually enough to rehydrate the child. Unnecessary antibiotic therapy upsets the normal bacteriological balance of the intestine.

In order to mask the strong metallic taste of the iron, the iron in the MoniMix is coated or encapsulated with a thin coat of a soy lipid. The melting temperature for the lipid is around 60°C. If MoniMix are added to food that is hotter than 60°C, the lipid coating around the iron will melt and the food will be exposed to the iron. The result will be that the iron can change the color of the food and will have a taste that may not be liked by children. To prevent changes in the taste and the color of food to which MoniMix is added, it is recommended that MoniMix be added to the food after it is cooled to a temperature below 60°C.

SMC introduces Implant (Jadelle – 2 rods) with the brand name of I-Plant. I-Plant is a progestin-only contraceptive. It is safe, effective and provides protection for a period of five years. It consists of two rods which are 43 mm long, 2.5 mm in diameter and contains 75 mg of levonorgestrel.

The zinc treatment is given according to age, not weight. Irrespective of the child's weight, the recommended dose of zinc for children 6 months to 5 years is 20 mg zinc once daily for 10 consecutive days. Children 2 to 6 months are prescribed 10 mg/day.

Yes, it can be chewed. Chewing is not the recommended mode of delivery, but is acceptable.

No significant side effects has been observed. A woman may face some changes in the menstrual bleeding patterns like spotting and irregular and scanty bleeding. Other common side effects include: headaches, nausea, dizziness, mood changes and breast tenderness. These minor discomforts usually subside with regular use and there is no need to worry.

No. They are not the same thing at all. The complete formula ORS contains potassium and a base - either bicarbonate or citrate - which corrects acidosis which small infants in particular suffer when they are dehydrated. If a child is rehydrated with a solution containing no potassium, each successive attack of diarrhoea leaves the child more and more depleted of potassium - this results in fatigue, apathy and muscular weakness and finally such a child may die.

MoniMix is most suited for all children from the age of 6 months to 24 months. It is also suitable for children under the age of 5 years. A single sachet of MoniMix provides the daily dose of 12.5mg Iron recommended by WHO for infants of 6-24 months.

I-plant implant is not available in market or pharmacies. It is only available with trained doctors and some selected hospitals under SMC’s Pink Star program. Pink Star is network of privately practicing doctors who promote and provide long acting reversible contraceptives from their private facility. In addition, they also offer family planning injectables (SOMA-JECT and Sayana Press – three months protection). One can call 16387 (SMC tele-counseling center) to find a doctor.

Implants are also available at government hospitals, FP centers and some NGO clinics.

Give the zinc tablet the next day and continue for the full course of 10 days.

Emergency contraceptive pills prevent pregnancy when taken within 72 hours (3 days) to 120 (5 days) of having unprotected intercourse.

An ECP is made of synthetic progestin hormone only at a high dose. A sexual act may be unprotected meaning it could lead to pregnancy for various reasons such as breakage or slippage of condoms, missing of pills, rape, failure of the man to withdraw his penis before ejaculation if not using a condom, and others. There are a number ECPs sold through pharmacies such as Norix (protects within 72 hours).

Fortunately to some extent yes. However, mothers need to be taught and motivated how to modify a child's normal diet to include these foods for several weeks after an attack of diarrhoea or more or less permanently in fact in order to have much of an effect.

Infants should be exclusively breastfed until 6 months of age. MoniMix should be given once complementary foods are started.

• Very effective, long acting, provides contraceptive protection for up to 5 years
• Fertility returns right after removal
• Newly married couples can use
• No interference during sexual intercourse
• Can be used by lactating mothers

The current recommendation is to provide zinc treatment to all children < 5 years of age. However, diarrhea among newborns is rare and may be a sign of sepsis or severe disease so care should be sought.

ECPs provide couples with a second chance at preventing pregnancy if they are not ready and therefore protect them from seeking out abortion which may be highly risky and costly as well as brutal as an option to eliminate pregnancy.

Firstly, prevention including the following measures should be taken:

- breastfeeding
- environmental sanitation
- personal hygiene
- clean drinking water
- clean preparation and storage of food
- insect and fly control

Secondly, maintaining or increasing food and fluid intake during and after an attack of diarrhoea should be ensured.

- MoniMix is recommended one packet per day for a child.
- MoniMix is food based rather than a medical intervention, suggesting a daily dose, but unlike conventional medicine, it is not so important if a dose or two are forgotten.

For MoniMix to be efficacious, research findings suggest that a child must be given a minimum of 60 packets over a period of 60-120 days to prevent anemia for at least the next 6 months. A dose of 60 packets should be repeated at every 6 months interval.

• Within five (5) days from the onset of menstrual bleeding
• If the implants are inserted at any other time, pregnancy must be reliably excluded before insertion and an additional non-hormonal contraceptive method used for at least seven days after the insertion
• Immediately after MR or abortion
• In immediate postpartum period (NVD and CS)
• Can be used any time within effective use of other contraceptives

Zinc can be given to anybody, but WHO/UNICEF recommendations are limited to children under five years of age.

There are two different packaging of ECPs available in the market: a higher dose single tablet version and a milder two tablet version such as SMC’s Norix. The single dose must be taken within 72 hours of unprotected sex. In the case of the two tablets, the first tablet must be taken within 72 hours of unprotected sex and the second tablet after 12 hours of taking the first tablet. Monthly menstruation may start a few days earlier or later than the usual date. If the next monthly periods do not return within 7 days from the usual time, then the woman should go for a pregnancy checkup. 

Zinc is classified as an essential mineral. It is essential to over 180 biologic functions. Many foods rich in trace minerals contain zinc, with the highest amounts in meat products. Lesser amounts are found in milk, spinach, nuts, oats, rice and beans.

According to the WHO recommendation infants should be exclusively breastfed until 6 months of age. We do not recommend using MoniMix before 6 months of age.

Almost any fertile woman without contraindications who wants to avoid pregnancy may use I-Plant.This method is suitable for women who:

> Seek continuous, yet reversible contraception

> Want to space their children

> Cannot use methods that contain estrogen

> Live a busy life with a lot of other things to think about besides contraception

> Have recently started their studies or career and want to concentrate on these for the next few years

> Do not want to be sterilized; and/or who desire a method that is convenient

No. Parents should be advised to only purchase zinc products that you know to be safe and of high quality.

There are no long-term side effects has been observed so far after using an ECP. Some women may face initial discomforts after taking ECPs such as nausea, vomiting, headache, dizziness, abdominal pain, vaginal bleeding, etc. These are very temporary.

Many experts say that zinc deficiency is widespread. People living in poverty with diets low in zinc, especially children below five years of age, need zinc the most. Deficiencies result in poor wound healing because of zinc's role in cellular repair. Zinc deficiency also leads to slower growth. Most importantly, children with low levels of zinc are at increased risk for infection, severe infections and death.

There are no major side effects of MoniMix. Color of stool may become dark which happens because of 'unabsorbed1 iron being excreted in the stool. Iron itself is dark in color, thus unabsorbed iron will darken as a result of the iron content of MoniMix.

Yes, the implant can be removed at any time. However, it must be removed by a well-trained healthcare provider at the end of three or five years depending on the type or, they can be removed at any time before that, for either personal or medical reasons.

Yes, children should continue to be fed. Allow the child to take as much as they want. If vomiting occurs, the smaller, more frequent feeds are recommended.

Zinc is prescribed to treat and prevent diarrhoea for children < 5 years of age.

Content of one whole sachet should be mixed with one meal to achieve the desired result. It is recommended not to split one sachet into portions and administered several times. Since many children do not like to eat too much at one meal, it is recommended that MoniMix be mixed with a small amount of food so that the child finishes the MoniMix mixed food in the first few morsel.

There are some common misconceptions regarding pill. For example:

• Misconception-1: A woman only needs to take the pill if she has had an unprotected sex/intercourse that day.

• Correct answer-1: She must take the pill every day whether or not she had sex that day. She should complete the entire cycle pack as instructed.

• Misconception-2: Taking the pill for a long period makes a woman infertile. 

• Correct answer-2: Pills do not cause infertility no matter how long it been is used.

The Implant which is inserted just under the skin of the non-dominant upper arm does not move to other parts of the body

Yes, zinc can be given with other medications. However, if a child is receiving iron supplement, it is recommended this be stopped while on the zinc treatment because the iron will decrease the effect of zinc.

Yes, zinc and ORS can be given at the same time when a child has diarrhoea. Zinc is given once a day. Give the zinc at a time of day that is easy for you to remember and repeat every day for 10-14 days. ORS needs to be given throughout the day only as long as your child has loose or watery stools, but zinc should be given for the entire 10 to 14 days.

Yes, MoniMix is available in all pharmacies.

A few other important things to remember that:

•OCPs, POPs or ECPs do not protect from HIV/AIDs or STIs.
•ECPs are not recommended as a regular contraception.
•Breastfeeding women should breastfeed her child immediately before taking ECP and wait for a few hours each time after taking the table before starting to breastfeed again.

Yes, you will be able to get pregnant as soon as the implant is taken out.

Yes, multivitamins without iron can be continued. If the multivitamin contains iron, it should be stopped until the 10-14 days of zinc is finished.

During diarrhoea ORS should be given first and followed by zinc. If it is the first time the child has received zinc, it is best to wait 30 minutes after the ORS is given.

I-Plant is well tolerated, safe and convenient. Bleeding changes are likely to occur, although the nature of the change in any individual woman is not predictable, changes may include prolonged, frequent, irregular bleeding and amenorrhoea.

During the 10-day period of zinc treatment, the child should stop taking the iron supplements. If the child is being treated for severe anemia, he/she should be seen by a doctor (or nurse where no doctor is available) before deciding to continue or stop iron supplementation.

Usually children with severe dehydration are given intravenous fluids first. After the intravenous fluid is no longer needed and the child is not vomiting, ORS and zinc should be started.

Zinc fortified foods contain low amounts of zinc in line with recommended daily requirements. Adding the zinc treatment is safe and highly recommended. There is no risk of overdosing.

The zinc tablet is meant to be dissolved in water, breast milk, or ORS.. Other fluids are not recommended.

Do not stop the zinc. The child should be taken to a local clinic or a community health worker for further assessment.

No, you should continue to give plenty of ORS, as recommended, even though you are giving zinc. ORS will help to replace fluids lost during diarrhoea. Zinc will speed up recovery but does not replace fluids.

Zinc tablets are preferred over syrup for the following reasons:

- Easier distribution and storage 

- Lower cost 

- Easier for caretakers to administer properly as well as count the number of days given 

- Longer shelf-life

The earlier that zinc is administered, the sooner the child will benefit. However, it can be started at any time during the illness.

The ingredients in zinc tablet include zinc sulphate, glucose and flavoring.

Zinc treatment is recommended for the complete dosing regimen of 10 to 14 days because zinc not only decreases the number of days with diarrhoea and the severity of diarrhoea, it helps the child fight off new episodes of diarrhoea and pneumonia for the next 3 months following a full treatment.

At the dose being provided in the zinc tablet, there is a small increased chance of transient nausea or vomiting. If the child is vomiting, we recommend settling the child first before administering zinc.

Studies have included 10 or 14 days of treatment. Both have been proven to be equally effective.

You should keep the tablets away from all children in the home to prevent this from happening. If more than one tablet is taken, wait until the next day a resume to course of one tablet per day until the blister pack is finished

Yes, all episodes of diarrhoea should be treated with zinc. Even if a child has recently completed a full course of zinc treatment, it is still safe to give a second course. Children with persistant, repeated episodes of diarrhoea should be taken to a clinic or hospital.

When a child is vomiting with diarrhea, wait for the child to settle before giving zinc. If the child vomits repeatedly withhold zinc for that day and start from the next day.

It is clear that zinc is vital for a wide range of biological functions. In diarrhoea we have come to know that zinc helps in the following ways:

- It boosts the immune system
- It helps in healing the intestinal lining
- It improves absorption of fluids

The zinc treatment is given according to age, not weight. Irrespective of the child's weight, the recommended dose of zinc for children 6 months to 5 years is 20 mg zinc once daily for 10 consecutive days. Children 2 to 6 months are prescribed 10 mg/day.

Yes, it can be chewed. Chewing is not the recommended mode of delivery, but is acceptable.

Give the zinc tablet the next day and continue for the full course of 10 days.

The current recommendation is to provide zinc treatment to all children < 5 years of age. However, diarrhoea among newborns is rare and may be a sign of sepsis or severe disease so care should be sought.

Zinc can be given to anybody, but WHO/UNICEF recommendations are limited to children under five years of age.

No. Parents should be advised to only purchase zinc products that you know to be safe and of high quality.

Yes, children should continue to be fed. Allow the child to take as much as they want. If vomiting occurs, the smaller, more frequent feeds are recommended.

Yes, zinc can be given with other medications. However, if a child is receiving iron supplement, it is recommended this be stopped while on the zinc treatment because the iron will decrease the effect of zinc.

Yes, multivitamins without iron can be continued. If the multivitamin contains iron, it should be stopped until the 10-14 days of zinc is finished.

During the 10-day period of zinc treatment, the child should stop taking the iron supplements. If the child is being treated for severe anemia, he/she should be seen by a doctor (or nurse where no doctor is available) before deciding to continue or stop iron supplementation.

Zinc fortified foods contain low amounts of zinc in line with recommended daily requirements. Adding the zinc treatment is safe and highly recommended. There is no risk of overdosing.

Do not stop the zinc. The child should be taken to a local clinic or a community health worker for further assessment.

Zinc tablets are preferred over syrup for the following reasons: -
- Easier distribution and storage
- Lower cost
- Easier for caretakers to administer properly as well as count the number of days given
-Longer shelf-life

The ingredients in zinc tablet include zinc sulphate, glucose and flavoring.

At the dose being provided in the zinc tablet, there is a small increased chance of transient nausea or vomiting. If the child is vomiting, we recommend settling the child first before administering zinc.

You should keep the tablets away from all children in the home to prevent this from happening. If more than one tablet is taken, wait until the next day a resume to course of one tablet per day until the blister pack is finished.

When a child is vomiting with diarrhoea, wait for the child to settle before giving zinc. If the child vomits repeatedly withhold zinc for that day and start from the next day.