Category: Developmental Milestones

Words Pank Jit Sin and Lim Teck Choon

Patches of bright red skin on the buttocks, thighs and genitals… many parents will be familiar with such a sight in their babies as diaper rash is a common condition among babies that regularly wear diapers. Also called perianal dermatitis, diaper rash can cause a baby to fuss and cry (especially when someone touches the diaper area) and alarm the parents.

This month, paediatric dermatologist Dr Leong Kin Fon offers a look into what causes diaper rash and how we can keep our little ones free from this annoying condition.

WHAT CAUSES DIAPER RASHES, ANYWAY?

There are a few possible causes that parents should take note of.

The baby’s own stool. Dr Leong shares that a baby’s stool contains high amounts of protease, an enzyme that helps in the digestion of protein. Protease can also irritate a baby’s skin, which is thinner and more sensitive than an adult’s. This is why diaper rash is more prone to break out when a baby experiences frequent bowel movement or has diarrhoea.

Diapers that are too tight. When a baby’s diapers are too tight, the diaper material can rub against the skin each time the baby moves. This constant rubbing can lead to rashes forming on the affected areas of the skin. Also, tight diapers reduce the airflow into the diaper region, causing that area to stay moist. A moist environment will encourage bacteria and yeast to grow and irritate our baby’s skin.

Constant use of wet wipes. Babies do as they please, and much to many parents’ exasperation, this behaviour also applies to doing a number one or two at the most inconvenient moments. In such a moment, wet wipes can come in handy. However, Dr Leong cautions against overusing them, as wet wipes tend to contain preservatives that can cause allergic reaction on a baby’s skin.

OTHER GENERAL TIPS TO KEEP DIAPER RASH AWAY FROM OUR BABY

Change our baby’s diapers often. Soiled diapers should be removed promptly. If your baby is cared for by a nanny or a daycare centre, remind them to do this in your absence.

Clean our baby’s bottom gently but thoroughly during diaper change. We can do this using a moist washcloth. As Dr Leong mentioned earlier, avoid the use of wet wipes as much as possible.

It’s okay for baby to go without diapers. Exposing our baby’s skin to air is a gentle but effective way to let the diaper region dry. Therefore, after a diaper change, we can lay our baby down on a large towel (just in case our baby decides to do another round) and play with him or her for a while.

Wash our hands before and after a diaper change. Our hands may carry germs that can be passed on to the baby’s diaper region and cause an infection.

MY BABY HAS DIAPER RASHES… WHAT SHOULD I DO?

Diaper rashes are rarely life threatening and can often be addressed without having to bring the baby to a paediatrician.

Dr Leong advises the following:

1. Keep the baby’s skin dry as much as possible.
2. Wash soiled areas with tap water. Then, use a clean cloth or towel and gently pat to dry.
3. Change the baby’s diapers as often as possible.

However, we should bring our baby to a paediatrician if we observe any of the following:

• The rashes look severe.
• The rashes remain or get worse despite our efforts to keep our baby’s skin dry and clean.
• There is also bleeding and/or pus formation.
• Our baby also has a fever.

KEEP THE BABY’S SKIN CLEAN AND DRY, AND CHANGE DIAPERS AS OFTEN AS POSSIBLE. HT

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WORDS LEE WAN TENG

All children go through a phase where they just don’t feel like doing their homework, sometimes. So, what can you do to motivate them and make studying a fun experience? 

Tip#1: Keep calm and don’t nag

Don’t nag, no matter how much you are tempted to. Some kids are natural rebels, so the more you nag them, the more they will refuse! 

Just like how you would like a break after a long day at work, your kids need to wind down too after a long day at school. Allow them to spend a little time (about 20 minutes) to unwind such as playing football or watch a bit of TV. Get your children to set the time when they have to work on their homework and make sure that they stick to it. 

Tip#2: “Study time” sounds more fun than “homework time”

Instead of guilt-tripping your kids by saying “it’s homework time”, why not say “it’s study time”? “Study time” is broader and can reflect on either studying and/or doing homework. It also gives the impression that they can also use that time to study while doing homework.  

Tip#3: Make study time a part of their daily schedule

Studying will become a habit once you get your kids to study around the same time. Isn’t it just wonderful to see your kids studying on their own without you telling them to? Have a chat with them and establish a study schedule through which they can determine the time they would like to spend studying. Ensure your child is doing this on a daily basis, and all other activities such as meeting up with friends are listed out too, so that there will be a healthy balance between study and life. Most importantly, ensure that they stick to their schedules as much as possible.

Tip#4: A little support and encouragement goes a long way

As much as you would like to help your children with their homework, remember this, it is their homework. So, let them be responsible for it. The purpose of having homework, in the first place is to test their understanding of the subject while making use of the knowledge and skills they have learnt. Be a supportive parent and don’t criticize or punish your child. Encourage your child to be independent in getting the homework done.  Understand the problems they face (if there are any) and provide rational solutions.   

Tip#5: Praise and appreciate

Let your kids know that you appreciate the efforts they make to tackle their homework independently, even if they do not get it all right. Use encouraging words such as “You have done an amazing job, keep it up!” to induce positivity while providing them the confidence to accept future challenges.  

Tip#6: Motivate with goals and rewards

You can motivate your kids to study by giving out a reward when a goal is achieved. The goal set must, of course, be achievable by your child. It should reflect on their ability to make improvements for the desired goal. The form of reward given can be varied, for instance, it can be a movie trip, an ice-cream, a sleepover, etc. 

Tip#7: No distractions, please!

The TV, mobile phone, computer and hand-held games can be distracting. Limit and control their use. For example, they can only watch the TV when they are done with their homework. If your child likes to listen to music while doing homework, make sure that the music he or she is listening to is not too distracting.

References: 1.http://parenting-ed.org/ 2.www.today.com/parents/secrets-getting-kids-do-their-homework-8C11080329

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WORDS HANNAH MAY-LEE WONG

We all know that expecting a new born is never easy, even if it isn’t your first time. On January 27th 2019, M&B marketing held their fourth Parentcraft Workshop titled “Nourishing Parents, Nurturing Little One”, a practical and informative crash course on what to expect when expecting. HealthToday was right there to bring you some interesting topics discussed during the event.

“IF YOU ARE CALM AND IF YOU ARE HAPPY, IT AFFECTS YOUR BABY POSITIVELY.”

In this day and age, the slew of opinions and information shared with us from various sources is sometimes more than we can handle. With an endless supply of online videos, websites, blogs, magazines and mobile apps, how do we sieve through the information? Which is true? Which is false? As an expecting parent, we often wonder: what are the latest updates on caring for the little ones? Well, all that may be too much for Dr Cheah to cover in merely an hour. However, he brings up some pertinent updates found in recent studies and debunks a few common myths as he goes along.

Dr Cheah opens by saying, “Nothing truly prepares you, when it comes to becoming a parent, but there are certain tweaks you can make to your mindset, to help you discern every piece of information you receive.” You should always check whether the information comes from a reputable source, and whether it is evidence-based. Also, get ready for a long journey of learning. “I’m a paediatrician and my kids are already teenagers, but I’m still always learning,” Dr Cheah reveals.

Caring for your baby starts when the baby is conceived. On top of that, Dr Cheah shares that environment factors during pregnancy, birth and after-birth can affect your baby’s health in the long run.

Be a Happy Mummy

Pregnancy is a wonderful time. Your body is going through changes hormonally, immunologically, metabolically, and even psychologically. That said, it can also be a stressful time if you don’t journey it well. “Personally, I think that if you are calm and if you are happy, it affects your baby positively. During pregnancy, your baby can detect your heartbeat, your happiness, but also your fears and anxiety,” Dr Cheah says. He advises expecting mothers to keep calm and think positive. It’s good for the baby and nine months is a very short time compared to the rest of the baby’s life.

Maternal Microbiome and Baby’s Health

Our microbiome refers to all the microorganisms in our body. There are tons of good and bad bacteria in us, and a balance of these bacteria ensures us a healthy body. When you have an imbalance of good and bad bacteria in the body during pregnancy, it affects the baby. One of the factors that can set-off an imbalance is the use of antibiotics. The use of antibiotics during a Caesarean section is linked to increased prevalence of childhood obesity, allergies, eczema, asthma and so on.

“Almost 80% of newborn babies I see in my clinic have some form of allergy to cow’s milk protein. The number of children with allergies has doubled in the last three years,” Dr Cheah says. However, you should follow your obstetrician and gynaecologist’s advice on this. If the baby or your health is in jeopardy and antibiotics are needed, you should follow your doctor’s advice.

Get Plenty of Fruit and Veggies

A healthy and balanced diet, rich in fibre, fruit and vegetables is good for you and your baby overall. A high-fibre diet containing lots of fresh fruit and vegetables is associated with a lowered risk of the baby developing allergies. “That doesn’t mean you should become a vegetarian,” Dr Cheah chuckles. “You still need your good quality protein to ensure your baby grows healthily. Certain proteins can pass through the amniotic fluid, and your baby, without being born, will get a taste of the food you eat.”

In the Chinese culture, after delivery, serving alcohol to the mother in herbal soups is a popular and common practice. But Dr Cheah warns that alcohol can pass through breast milk and is not safe for the baby.

Smoking is a Big No-no (and Dad’s not off-the-hook)

It is well documented that women should not smoke when they are pregnant, it affects the mother and baby negatively. Smoking increases the risk of low birth weight, premature birth, stillbirth, respiratory complications, heart defects, central nervous system defects and infant death. That’s not all, recent studies show that if a father smokes during or before his wife’s pregnancy, it also jeopardizes the baby’s health. Having a father who smokes increases chances of chromosomal breakage, which leads to an increased risk of the baby developing genetic defects.

Mode of Delivery Matters

Dr Cheah explains, “In the past 10 years, there is strong evidence to show that vaginal delivery is associated with the reduction of risk in developing allergies and asthma in babies.” As the baby comes out of the birth canal, the baby gets exposed slowly to all the good bacteria around the birth canal. “Somehow when this happens, it improves the baby’s immune system.” He continues, “Having a caesarean birth is also associated with an increased risk of the baby developing childhood obesity, autoimmune diseases and allergies. That said, you should follow the advice from your obstetrician and gynaecologist. Your doctor will advise you if you need a Caesarean section.”

Does a clean environment lead to a healthier baby?

Contrary to popular belief and according to a study done by Johns Hopkins Medicine, newborns exposed to dirt, household germs and pollen during the first year of life, appeared less likely to develop allergies, wheezing and asthma later in life.

What is the best milk for my baby?

“This is the number one question I get asked as a paediatrician. I always tell them that human milk is best for human babies.” Dr Cheah also says, “A human mother’s breast milk contains the right amount and the quality of nutrition that is needed for her baby.”

Dr Cheah explains, “Your breast milk and the amount that you produce changes as the baby grows older. Your breast milk carries certain hormones, and even these hormone levels change throughout the day.” That’s how dynamic breast milk is. He concludes, “We are taking more and more processed food now. But in order for us to be fit and healthy, we have to have a balanced diet with good nutrition, especially in the early years. This will build up the immune system, along with vaccinations.” HT

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Words Hannah May-Lee Wong

“Labour, by the English definition, is manual hard work, and that’s what you’re going to be doing when you deliver your baby; either by operation (Caesarean section) or naturally.” Dr Rama begins. “Of course, mums delivering through the normal labour process are going to be burning much more calories. During the whole process of labour, a mother burns 2500 to 3000 calories in one hour! Just imagine those in labour for more than 15 hours. It’s indeed a very laborious process.”

Your doctor will probably provide you an estimated date of delivery, but that’s just an estimation. According to Dr Rama, most women (approximately 70%) deliver at more than 9 and a half months (more than 38 weeks).

Preparing for Labour

Before the miraculous event of birth, some preparation is needed to welcome the little one into this world. Besides preparing baby napkins, outfits and your hospital bag, one of the most important form of preparation is the preparation of the mind. “The best way you can assure yourself is to tell yourself: ‘my grandmothers did it, my mother did it, so I can do it’,” Dr Rama says. Fill yourself with positive thinking, tell yourself that you will do your best, meditate and exercise to calm yourself.

Every pregnancy is unique, and you can’t predict when you will go into labour. That said, some of the things you can do to prepare yourself for the big day include: making a checklist for yourself and your baby, packing a hospital bag, planning the fastest route to the hospital, getting a babysitter for your other children, and checking whether to call your doctor or nurse first or go straight to the hospital when you go into labour.

The Hospital Bag

When you are about 36 weeks pregnant, it is advisable that you start packing what you need at the hospital for delivery day (and after). This is to ensure you have plenty of time to pack and you don’t leave out anything essential.

Things to pack for Mum:

• Identity Card
• Check-up record
• Smartphone
• Shirts that button-up in front (preferably of cotton material) and sarong
• Going home outfits
• Slippers
• Toiletries
• Socks
• Cereal bars, snacks and drinks
• Underwear and sanitary pads

Things to pack for baby:

• Going home outfit
• Mittens and booties
• Hat
• Blanket
• Car safety seat to bring your baby home

Am I in Labour?

“Not every time you feel pain in your stomach means you’re in labour,” Dr Rama clarifies. The symptoms of labour can be divided into true labour and false labour. So how do you know you’re in labour? In the last weeks of pregnancy, your uterus may start to cramp. These cramps are often uncomfortable or painful, especially as you get closer to your due date. However, these irregular cramps you experience may not be labour, but Braxton-Hicks contractions, also known as false labour. Here is how to differentiate them:

Contractions

True Labour: Contractions come at regular intervals and these intervals get closer together as time goes on. They typically last for 30 to 90 seconds each time. The contractions will keep coming no matter what you do.

False Labour: Contractions are irregular and do not get closer together with time. False labour contractions may stop when you walk, rest or change position.

Intensity

True Labour: Contractions steadily get stronger and more intense.

False Labour: Contractions are most often weak or strong contractions are followed by weaker ones.

Pain

True Labour: Pain starts in the back and moves to the front.

False Labour: Pain is most commonly felt only in front.

Other signs of labour:

Dr Rama says that 50% of women may experience some bleeding when they go into labour. This happens because once you go into labour, your cervix opens. An early sign of labour is when a drop of blood with mucous is being discharged— this is the mucous plug that has been keeping your cervix sealed and protecting your baby from infections.

Your amniotic sac ruptures (your water breaks). If fluid flows out without strain or force, it’s likely your amniotic sac has ruptured. Write down what time it happened.

The Three Stages of Labour:

Knowing what to expect when going into labour may put your mind at ease a little. On average, labour lasts 12 to 14 hours if you are delivering your first baby. In subsequent births, labour may be shortened by approximately half the time.

First Stage: The latent phase is the longest phase of labour. It is when your cervix dilates slowly to 4 cm. It lasts around 12 hours on average for first-time mothers. From 4 cm to 10 cm, you enter the active phase where dilation happens at a rate of approximately 1 cm per hour.

Second Stage: This stage entails full dilation at 10 cm until delivery of baby. It typically lasts 1 hour, but it could go up to 2 to 3 hours.

Third Stage: The easiest stage. It lasts from the birth of the baby to the expulsion of the placenta. It is completed in 30 minutes.

Interventions and Pain Management in Labour

“This is probably the best part of this talk that all mothers have been waiting for,” Dr Rama jokes. The good news is, there are options available to make the labour and delivery process less painful. Medical intervention options include: inhalation of nitrous oxide (laughing gas), opioid injections and regional anaesthesia by epidural. You should discuss with your doctors when deciding which option to go for. Alternatively, natural pain management options include relaxation therapy, warm showers and aromatherapy.

Additionally, at 32 to 34 weeks of pregnancy until labour, mothers can opt to do perineal massages either on their own, or with the help of their spouse. These massages help relax and increase the elasticity of the vaginal and perineal muscles. It will ease the delivery process and reduce tear and cutting during labour. A cut is usually made between the vagina and anus in a procedure known as episiotomy. The massage also stimulates the muscles which betters the blood supply to it. Thus, it helps speed up wound healing after delivery. Dr Rama says, “All these benefits are medically proven; however, they are not easy to do. But once you’ve done it a few times, you’ll be more sure of yourself.” HT

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