MELOMED GYNAECOLOGISTS.
BELLVILLE
Dr N Mtimkulu
Dr MS Jacobs
021 950 8930 021 945 2970
Dr M Magopa 021 945 3483
Dr Z Dunn 021 110 5059
Dr H Nashandi 021 110 5246
TOKAI
Dr A Hendricks 021 712 2691
Dr T Motsema 021 110 5940
Dr M Tisane 021 023 2046
GATESVILLE
Dr N Allie 021 637 4323
Dr R Kader 021 638 2647
Dr S Camroodien 021 110 5930
MITCHELLS PLAIN
Dr G Khobane
Dr T Masina
Dr O Orji
021 110 5064
Dr N Maseko 021 110 5157
RICHARDS BAY
Dr J Moodley
Dr MN Nkanyane
021 391 4132/3 021 110 5945 035 772 1581 035 791 5506
Dr S Bodasing 035 791 5438
Dr K Mulomb 035 791 5446
GATESVILLE & MITCHELLS PLAIN
Dr MA Jeeva & Dr H Khamissa
GATESVILLE: 021 637 1343/4
MITCHELLS PLAIN: 021 392 8141/0516
For more information contact us at info@melomed.co.za
Caring for your newborn
My pregnancy journey
Common pregnancy discomforts
Healthy babies start with proper pregnancy planning
Breastfeeding 101 – Getting started with latching-on.
FEEDING
Breast: 8-10 times per day
Bottle: Every 2-3 hours
Nappies
One to several poopy nappies per day. More for babies that are breastfed. Change your baby's nappy every 2-3 hours.
Your baby may sleep up to 18 hours a day and wake to feed every couple of hours. Until your baby shows good weight gain, you may want to wake your baby every 3-4 hours for feeding.
BATHING
Until your newborn's umbilical cord falls off and the navel heals completely, give your baby a sponge bath. After that, a tub bath two or three times a week is fine for the first year.
MY PREGNANCY JOURNEY
your baby’s growth and development from 1st trimester to birth
FIRST TRIMESTER | 0-13 WEEKS
0-2 WEEKS
Pregnancy begins after the first day of the last menstrual period (LMP).
4 WEEKS
A home pregnancy test should display a positive result. The ball of cells formed during fertilisation have developed into an embryo in the uterus.
SIZE = POPPY SEED
SECOND TRIMESTER | 14-27 WEEKS
14 WEEKS
The foetus develops lanugo, a fine, downy hair all over its body. Lanugo helps the foetus retain body heat until it accumulates fat.
6 WEEKS
An embryo's major systems and structures, e.g. the brain and spinal cord, develop. The neural tube closes, and the heart beats at a regular rhythm.
16 WEEKS
The foetus doubles in size and weight. Fetal movements, called quickening, may be felt.
BABY SIZE = POMEGRANATE
18 WEEKS
Foetal organs and structures have been formed. An ultrasound may reveal the sex of the foetus.
THIRD TRIMESTER | 28-40 WEEKS
28 WEEKS
Breathing movements and body temperature are now controlled by the central nervous system.
30 WEEKS
Major foetal development is complete. The foetus begins rapidly gaining weight.
BABY SIZE = PUMPKIN
32 WEEKS
The foetus' bones are hardening though the skull remains soft.
34 WEEKS
The kidneys are fully developed and the liver can process some waste products.
BABY
Congratulations! You are creating a new life, even as you read this! Here’s some information to help you keep track of the changes you can expect in your body and how your baby will grow during your pregnancy. Remember, the weeks are counted not from conception but from the first day of the last menstrual period.
8 WEEKS
The embryo is now called a foetus. All key body parts are present. The brain continues to grow and the lungs begin to form.
BABY SIZE = RASPBERRY
10 WEEKS
The critical part of development is complete. Tissues, kidneys, the brain, liver, and intestines are beginning to function.
12 WEEKS
The foetus is able to swallow, the kidneys make urine, and reflexes have developed. External genitals have formed.
SIZE = KIWI FRUIT
20 WEEKS
This is the halfway point of pregnancy. The foetus is now covered in a cheeselike coating, called vernix caseosa, which protects its skin.
22 WEEKS
Foetal facial features are more distinct.
BABY SIZE = MANGO
24 WEEKS
BABY SIZE = PAPAYA
The brain is growing rapidly. Taste buds and the lungs are developing.
26 WEEKS
The lungs are developing surfactant, the substance that allows the lungs to inflate. The foetus begins to inhale and exhale – practicing breathing movements.
36 WEEKS
The foetus gains about 30g a day and fat develops under the skin.
38 WEEKS
The lanugo is mostly shed, the foetus has accumulated fat all over to keep warm after birth.
BABY SIZE = HONEYDEW
40 WEEKS
This foetus is fully developed. The due date arrives but is just an estimate; it is normal to give birth before or after this date.
BABY SIZE = WATERMELON
BABY
Common Pregnancy
and how to deal with it
By Dr Ncamsile Maseko
Congratulations on your pregnancy! Pregnancy is a normal physiological state and there are certain physical and hormonal changes. It is important to differentiate between minor ailments of pregnancy from serious complications in pregnancy.
This is an overview of the common minor complaints of pregnancy and tips of how they can be managed.
Headaches
Usually caused by many factors including hormonal changes, blood pressure changes, recurrent sinus infections, straining of the eyes.
Try relaxation of warm compressors around the neck muscles. Stay hydrated and avoid triggers. Paracetamol may be prescribed for simple or minor headaches. Tell your doctor if the headaches persists, associated with flashing lights and does not resolve with Paracetamol.
TIP
Leg Swelling
Also known as oedema.
Remember to rest and elevate your legs, avoid prolonged standing or sitting. Reduce salt intake. Take short breaks at work and sit with your feet raised. If the swelling is sudden, severe and affects face, hands and legs – urgently contact your doctor to check your blood pressure and exclude pre-eclampsia.
TIP
Discomforts
Haemorrhoids / Piles
Increasing pressure in the pelvic cause haemorrhoids.
TIP
Heart Burn
This will happen as the uterus starts pushing up the stomach and can lead to acid reflux.
Avoid overeating, eat small regular meals to prevent acid build up. Avoid lying down immediately after eating. Contact your doctor for antireflux medication like Gaviscon.
Muscle Cramps
Muscle cramps are common at night, during sleep on the lower legs.
TIP
Have leg massages daily to improve blood circulation, eat food rich in magnesium e.g.: Bananas, potatoes. Flex your toes towards the knees. Avoid prolonged sitting or standing. Elevate the legs when you get home after a long day. If the calf muscles are suddenly painful, contact your doctor immediately to rule out deep vein thrombosis (DVT) of the lower limbs.
TIP
Treat constipation, increase your fibre intake, if painful and itchy piles. Sitz baths and topical products maybe used in pregnancy.
Breast tenderness
This is one of the 1st signs that you are pregnant and your breast may remain sensitive throughout the 1st trimester. The glands in the breast enlarge and your breasts may feel firmer and full and nipples may be more sensitive.
TIP
Keep your breast well supported, invest in soft and comfortable bras, however, if you notice a breast lump, report to your doctor for breast examination.
Morning sickness or Nausea and Vomiting
It is an unpleasant feeling that can happen anytime of the day not necessarily in the mornings. It typically worsens at 8-9 weeks of pregnancy and is usually over around 12 weeks. The experience of nausea or vomiting does not predict the gender of your baby.
TIP
Drink ginger tea, eat bland food like toast. Avoid fatty and spicy foods, dairy products, fried eggs and cheese. Keep drinking small amounts of water to avoid dehydration however if you are not able to keep even fluids, contact your doctor for antiemetic medication. Treat it early to avoid Hyperemesis gravidarum. >>
Constipation
TIP
Stay well hydrated and increase your fluid intake. Increase your fibre by eating wholegrain foods, vegetables and fruits and a small cup of prune juice. Contact your doctor for fibre supplementation and mild laxatives if all fails.
Bleeding Gums
This commonly happens when you brush or floss your teeth.
TIP
Use a soft-bristled tooth brush. Rinse your mouth and brush gently. Always inform your dentist that you are pregnant. Use salty water or plaque controlling antibacterial rinse before bed. Ensure that your gums and teeth are clean and healthy during your pregnancy.
Lower back pain
Aches and pains are common as your ligaments are loose.
TIP
Improve posture and walk tall, use pregnancy support belts, use firm bed mattress, have low heat back massages, acupuncture and physiotherapy. Paracetamol may be prescribed by your doctor if deemed necessary.
MEET THE DOCTOR
DR. NCAMSILE MASEKO
MBBCh(Wits), Dip Obs (SA), Mmed (UP), FCOG (SA)
Dr. Ncamsile Maseko is an Obstetrician/Gynaecologist and currently practices at Melomed Mitchells Plain.
Tel: 021 1105 157
Email: admin@drmasekoinc.co.za
Healthy babies start with PROPER PREGNANCY
PLANNING
By Dr Jayeshnee Moodley
Pregnancy is a beautiful journey, but it begins long before the first positive test. The mother’s health before conception and in the early weeks of pregnancy plays a powerful role in determining pregnancy outcomes for both mother and baby. Whether you are actively trying to conceive or have just discovered you are pregnant, thoughtful preparation and early care can significantly reduce risks and improve outcomes.
PRE-PREGNANCY GYNAECOLOGICAL EVALUATION: WHY IT MATTERS
A pre-pregnancy consultation is one of the most valuable steps a woman can take before trying to conceive. This visit allows your gynaecologist to:
1. Identify medical conditions that may affect pregnancy
Certain conditions can influence fertility, pregnancy progression, and delivery, including:
• High blood pressure
• Diabetes
• Thyroid disorders
• Anaemia
• Polycystic ovarian syndrome (PCOS)
• Endometriosis
• Fibroids
• Autoimmune conditions
• Previous pregnancy complications
Early identification allows us to stabilise and treat these conditions before pregnancy begins.
2. Review past gynaecological and obstetric history
This helps determine whether your pregnancy may be considered high-risk and what additional monitoring may be needed. Your doctor will assess:
• Menstrual regularity and ovulation
• Previous pregnancies or miscarriages
• Previous caesarean sections or complications
• Infections or abnormal Pap smears
• Fertility concerns
3. Review and optimise medication
Some medications are unsafe in pregnancy, while others need dose adjustments. We ensure that:
• Current medications are pregnancy-safe
• Chronic conditions are well-controlled
• Supplements are appropriate >>
LIFESTYLE FACTORS THAT INFLUENCE
FERTILITY AND PREGNANCY
Nutrition
A balanced diet supports hormone regulation, egg quality, and early foetal development. Key principles include:
• Plenty of fruits and vegetables
• Whole grains
• Lean protein
• Healthy fats (avocado, olive oil, nuts)
• Adequate hydration
• Iron, calcium, iodine, vitamin D, and omega-3 fatty acids are especially important.
Exercise
Walking, swimming, yoga, and light strength training are excellent options. Regular moderate exercise:
• Improves circulation
• Helps maintain a healthy weight
• Reduces stress
• Improves insulin sensitivity
• Prepares the body for pregnancy and labour
Smoking, alcohol and substance use
Alcohol and recreational drugs should be avoided entirely when trying to conceive and during pregnancy. Smoking significantly increases the risk of:
• Infertility
• Miscarriage
• Premature birth
• Low birth weight
• Placental complications
The importance of multivitamins
A good prenatal multivitamin should ideally be started at least 1-3 months before conception. Key components include:
• Folic acid (400-800 mcg): Reduces the risk of neural tube defects
• Iron
• Iodine
• Vitamin D
• Vitamin B12
Women with certain medical conditions may require higher doses of folic acid.
OPTIMISING EARLY PREGNANCY
The first trimester is a critical period of organ development.
Early booking visit
As soon as pregnancy is confirmed, schedule a consultation to:
• Confirm the location and viability of the pregnancy
• Accurately date the pregnancy
• Screen for ectopic pregnancy
• Review medical history
• Initiate appropriate blood tests
• Assess early pregnancy risks
Managing common early pregnancy symptoms
The first trimester brings significant hormonal changes that can affect both physical and emotional wellbeing. With proper guidance, most symptoms can be managed safely and effectively.
Nausea and vomiting
(Morning sickness)
Nausea is one of the most common early pregnancy symptoms and may occur at any time of day. Helpful strategies include:
• Eating small, frequent meals rather than large meals
• Avoiding an empty stomach
• Choosing dry foods such as crackers or toast in the morning
• Limiting fatty, spicy, or strongly scented foods
• Drinking fluids between meals rather than with meals
• Ginger (tea, biscuits, or capsules) may reduce nausea
• Vitamin B6 supplementation can be beneficial
• Adequate rest and stress reduction
• In more severe cases, safe anti-nausea medications can be prescribed.
Persistent vomiting, dehydration, or weight loss should be assessed promptly to exclude hyperemesis gravidarum.
Fatigue
Extreme tiredness is very common in early pregnancy due to rising progesterone levels, increased blood production, and the body's energy being directed toward placental development. Ways to manage fatigue:
• Prioritise sleep and rest when possible
• Take short daytime naps if needed
• Maintain regular, gentle exercise such as walking
• Eat iron-rich foods (spinach, legumes, lean red meat) Stay hydrated
• Avoid over-scheduling and allow flexibility in daily routines
• Blood tests may be required to exclude anaemia or thyroid dysfunction if fatigue is excessive.
Emotional changes and mood fluctuations
Hormonal changes, physical symptoms, lifestyle adjustments, and anxiety about pregnancy can lead to emotional sensitivity, tearfulness, irritability, or mood swings. Supportive measures include:
• Open communication with your partner or support system
• Reassurance that emotional changes are common and normal
• Practising relaxation techniques such as deep breathing or mindfulness
• Maintaining light physical activity
• Adequate sleep and nutrition
• Limiting unnecessary stressors
Women with a history of anxiety or depression should inform their doctor early, as mental health is an essential part of prenatal care. Early support and treatment can significantly improve both maternal and pregnancy outcomes. If emotional distress becomes overwhelming, persistent, or interferes with daily functioning, professional support should be sought promptly.
ABOUT THE AUTHOR
ONGOING RISK ASSESSMENT
Some pregnancies require closer monitoring due to maternal age, chronic medical conditions, previous pregnancy complications, multiple pregnancy or structural uterine abnormalities. Early identification allows us to implement preventative strategies such as:
• Low-dose aspirin
• Blood sugar monitoring
• Cervical length surveillance
• Specialist referrals when necessary
Healthy pregnancies begin with informed preparation and early professional care. Pre-pregnancy counselling and early antenatal management empower women to enter pregnancy with confidence and optimise outcomes for both mother and baby. If you are planning a pregnancy or have recently conceived, consult your gynaecologist early. A personalised approach makes all the difference.
DR. JAYESHNEE MOODLEY MBChB, FCOG (SA), MMed (O&G), AHMP (YALE)
Dr. Moodley is an Obstetrician/Gynaecologist and currently practices at Melomed Richards Bay.
Tel: 035 772 1581
Email: jmoodleypractice@gmail.com
BREASTFEEDING
GETTING STARTED WITH LATCHING-ON.
Like most things in life, getting off on the right foot (or boob) is half the battle. Here are your need-to-know pointers on settling into breastfeeding.
Prior to having your baby, you might have imagined that it would be a case of latching mini-me onto a nipple, and then letting your new boobs do their thing. Unfortunately, it is often not this straight forward - it's very common for breastfeeding to be difficult in the early weeks, and plenty of help is available. First though, here's a run-through of the basics. Also, we all know babies come in two flavours (better known as 'boys' and 'girls'), but for consistency here, we'll refer to your baby as 'she' throughout.
Read up and reach out before B-day
Consider pregnancy your time to swot up on feeding. Read more about infant feeding online, where thousands of women have, over the years, asked for advice or offered support. You could also consider taking a class and look into where and when your local breastfeeding clinics are.
Get plenty of skin-to-skin time
Skin-to-skin contact is crucial in making your baby feel safe and comfortable, and has been shown to help enormously in encouraging them to breastfeed. Try to feed them as soon after birth as you can - within the hour is best.
Bring them to the breast, even when there's no milk
Your milk won't come in for a few days, but you should still bring your baby to the breast in order for them to learn how to feed. This will also stimulate the production of your milk.
Get comfy before a feed
Make sure your back is well-supported and you have everything you need (phone, water, TV remote, pack of digestives etc) close to hand. Both you and the baby need to be nice and comfortable for the greatest chance of success.
Find the right position
On that note, what are the best positions for a brilliant breastfeed? Try one (or all) of these:
Laid back
Support yourself with pillows, and have your baby lying on top of you in a tummy-totummy position.
Cradle hold
Cradle your baby across your lap, supporting her using the arm on the side that she's feeding from. Rest her head in the crook of your elbow, and let the rest of her lie on your hand. Bring her towards your breast, rather than leaning forward.
Rugby hold
Put a pillow next to you on the side you want her to feed from, and tuck her body beside you (her hip to yours) under your arm. Support the head with your hand and guide her to the nipple.
The koala hold
For babies that can support their own heads. She should be held sitting upright with her legs wrapped around you, like a koala.
Lying down
Lie on your side and place her body parallel with yours, tucking a pillow behind her for extra support.
How to tell if your baby is latching on Once your baby has latched on, she'll be able to suck in a strong, rhythmic way that will stimulate your milk to flow freely and you will feel a deep pulling in your breast. Your baby’s bottom jaw will move rhythmically as her tongue stimulates the breast ducts to release milk, while the top jaw will remain still.
An incorrect latch
It's never fun - potentially causing you pain and stopping your baby from getting milk. If you're experiencing difficulty, try facing your baby's body towards you so that she doesn't have to turn her head, and tuck her in as close as possible so that her chin touches your chest and her nose is above your nipple. If that doesn't help, ask your lactation specialist or paediatrician for advice. An inability to latch may mean that something is wrong - for instance, your baby might have tongue-tie so it's always a good idea to get it checked out.
Breastfeeding support – where to go
Your lactation specialist or midwife
When breastfeeding isn't going well If sorting out your latch and positioning wasn’t enough, you may also have to contend with breastfeeding thrush, mastitis, cracked nipples, engorgement and then getting through growth spurts. While you're waiting for it to all come together, here are a few things to remember:
It's worth having a go -Even if you're pretty sure breastfeeding isn't for you, consider giving the first feed or two. This is because your colostrum will be jampacked with antibodies and all sorts of goodies that help to stabilise your baby's blood sugars, line her gut and generally ease her introduction to the world.
It gets easier- So don't worry too much. Breastfeeding can be hard, especially in the early weeks, but many women who've done it say that if you can manage the first six weeks of breastfeeding, the following weeks/months/years are a comparative doddle.
Breastfeeding support
Local breastfeeding support group
Handy hints from mums who've been there
"Air your nipples as much as possible.
"Change feeding positions. Lying on my side was a godsend –the latch didn't hurt so much then."
Whatsapp groups - (especially if it's 1 am - there's always someone online who's been there)
“Learn f rom your own body and milk supply, and fr om the babythey'll give you visual clues. With mine, if their hand was very close to their mouth, you knew they were hungry."
“Start with low expectations. I think people have unrealistic expectations - then, when they're not met, they assume something is wrong”. ."
Melomed
Hospitals
have specialist doctors to treat all your baby’s sickness and ailments.
From our specialised Paediatricians, Neonatologist, Ear, Nose & Throat (ENT) specialists to Baby Clinics.
Paediatricians
Melomed Gatesville & Tokai
Dr S Raban 021 023 0604 021 637 2358
Melomed Richards Bay
Dr KP Seake 035 791 5428
Melomed Gatesville
Dr R Khan 021 637 3811/3817
Melomed Bellville
Dr M Bassier 021 950 8980
Melomed Mitchells Plain
Dr O Adam 021 391 4967/8
Melomed Tokai
Dr R Moore 021 110 5941
Melomed Mitchells Plain Dr V Singata 021 392 8255/8
Melomed Tokai
Dr M Meyer 021 712 1643
Melomed Gatesville Dr M Ismail 021 633 0332
Melomed Bellville Dr Rhode 021 945 1898
Melomed Mitchells Plain
Dr MW Mathure 021 110 5145
Melomed Gatesville & Tokai
Dr B Nondela Paediatric Surgeon 021 637 8100
Melomed Richards Bay Dr S Chetty 035 791 5535
Melomed Bellville
Dr M Ledger 021 946 1347
Melomed Mitchells Plain Dr O Dreyer 021 110 5805
Melomed
Gatesville & Tokai
Dr. J Stulinski 021 764 7208
Melomed Bellville
Dr. A Behr 021 945 1502
Melomed Gatesville & Tokai
Dr. S Ebrahim 021 637 20263
Melomed Bellville
Dr. Z Doolarkhan 021 946 2191
Baby clinics
RHO Clinic
Melomed Bellville Hospital 021 950 8960
The following services are rendered:
• Follow up on newborn babies f rom the age of 2 weeks.
• Immunisations of babies
• Family planning
• Asthma education
• Responsible for doing lung functions for the pulmonologist.
• Breastfeeding Education
Clinic Hours:
Mondays to Thursdays: 9:00 - 16:00, Open some Saturdays as per request and by appointment only.
Melomed Mitchells Plain
Dr. W Makhaye 021 110 5950
Melomed Bellville
Dr. Raphael Mlauzi 021 110 5217
Melomed
Richards Bay
Dr. L Setoaba 035 791 5440
Dr Raban
Melomed Tokai 021 023 0604
The following services are rendered:
• Vaccinations
• Breastfeeding consultation
• Circumcision
• Family Planning
• Paediatric Consultation
Pre-eclampsia
Pre-eclampsia is when hypertension, usually accompanied by protein in the urine, develops in the second half of pregnancy (after 20 weeks of pregnancy). It is a common, but serious, complication of pregnancy.
When left undiagnosed or untreated, pre-eclampsia can cause harm to both the pregnant mother and the baby. Even though the diagnosis and treatment of pre-eclampsia has improved over the years, and the best possible treatment is given, it still often leads to early delivery of the baby and harm to the mother.
Screening
First trimester screening for pre-eclampsia is now available at PathCare. This screening entails a blood test of the pregnant mother during her early pregnancy (11 weeks to 14 weeks gestation), before pre-eclampsia develops. The information of the blood test is used, together with the mother’s blood pressure results, clinical details and ultrasound findings, to calculate the risk of developing pre-eclampsia later in pregnancy.
Mothers found to be at high risk of developing pre-eclampsia, can then be put on aspirin to help prevent pre-eclampsia from occurring. The test result will also help the doctor to decide how regularly follow-up visits should be scheduled.
Many studies have shown that determining the risk of pre-eclampsia with early screening, and then treating with aspirin, can prevent pre-eclampsia from developing in many cases, which then improves the outcome for both the mother and the baby.
Across the world, early pregnancy pre-eclampsia screening is strongly encouraged.
Even though screening and prevention is ideal, it is helpful to know some of the key findings of pre-eclampsia. Please remember that antenatal visits, and blood pressure measurement, is very important during pregnancy.
Please see below some additional information on pre-eclampsia.
Symptoms
The defining feature of pre-eclampsia is high blood pressure, proteinuria, or other signs of damage to the kidneys, liver or other organs. You may have no noticeable symptoms. The first signs of pre-eclampsia are often detected during routine prenatal visits with a health care provider.
Along with high blood pressure, pre-eclampsia signs and symptoms may include:
• Excess protein in urine (proteinuria) or other signs of kidney problems
• Decreased levels of platelets in blood (thrombocytopenia)
• Increased liver enzymes that indicate liver problems
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
• Shortness of breath, caused by fluid in the lungs
• Pain in the upper belly, usually under the ribs on the right side
• Nausea or vomiting
Risk factors
Conditions that are linked to a higher risk of pre-eclampsia include (but are not limited to):
• Pre-eclampsia in a previous pregnancy
• Being pregnant with more than one baby
• Chronic high blood pressure (hypertension)
• Type 1 or type 2 diabetes before pregnancy
• Kidney disease
• Autoimmune disorders
PathCare offers testing for 1st Trimester Pre-eclampsia Risk. Please contact your doctor for more information.