What Every Parent Should Know about Congenital Heart Defects in Children


Consultant Paediatrician and Paediatric Cardiologist
Subang Jaya Medical Centre

The most common heart disease among children is known as congenital heart defects.

This condition occurs when the heart or the blood vessels near the heart do not develop normally before birth.


According to our Ministry of Health, the incidence of congenital heart defects among children is about 8 to 10 per 1,000 live births.

With an average of 500,000 deliveries in Malaysia each year, the number of children born with congenital heart defects is about 5,000 a year, of which two-thirds will require surgical intervention.


Most congenital heart defects have no known cause.

They may sometimes run in families.

Some congenital heart defects may be associated with genetic disorders, such as Down syndrome, Turner syndrome, Williams syndrome, etc.

Some children have a higher risk of developing congenital heart defects if the mother has diabetes or rubella, or has taken certain medications such as anti-epileptic drugs, during pregnancy.


Sometimes a heart defect can be diagnosed before a baby is born.

However, defects are usually identified days or even months after birth, when symptoms become obvious.

Less serious congenital heart defects may not show any noticeable signs or symptoms, so they may only be diagnosed later in childhood.

It is also possible to have a heart defect and show no symptoms at all.

  • Rapid breathing
  • Bluish discolouration commonly noticed around the lips, fingernails, palms of the hands, and soles of the feet
  • Shortness of breath during feeding, leading to poor weight gain
  • Poor growth
  • Recurrent lung infection

As a result of medical advancements, the outlook for congenital heart diseases is increasingly positive.

Most children with this condition reach their adulthood.

In fact, children with simple conditions may lead completely normal lives, while those with more complex conditions usually face more challenges that can nevertheless be addressed with the right measures in place.

  1. Heart medications can be very strong and dangerous if not given correctly. Parents must understand how much medicine to give and how to give it. If the child takes a blood thinner, parents must have clear instructions on how to give this medicine safely.
  2. Ensure the child eats well and receives adequate nutrition. They often tire when eating, so they eat less and may not get enough calories.
  3. Prevention of infections is crucial. Although an infection in the heart (endocarditis) is uncommon, children with heart defects have a greater risk of developing this. Good dental hygiene goes a long way toward preventing endocarditis by reducing the risk of tooth or gum infection. Parents can get more information from cardiologist about the latest guidelines on antimicrobial prophylaxis against infective endocarditis. These children must also get all the recommended vaccinations.
  4. Most children with a congenital heart defect can be physically active without restrictions. In fact, children are encouraged to be physically active to keep their hearts fit and to avoid obesity, unless they have a few specific heart conditions.
  5. Emotional support will help children who may have self-esteem issues because of how they look. They may have scars from surgery, and they may be smaller, or have limits on how active they can be.
  6. As children transition to adulthood, parents can gradually teach them about their heart defect and guide them in how to care for their own health without being overly protective.

Children More Vulnerable to Infections During These Post-Pandemic Times?


Senior Lecturer of Paediatrics
School of Medicine
Faculty of Health and Medical Sciences
Taylor’s University
Guest Lecturer of Paediatrics
School of Medicine
Faculty of Health and Medical Sciences
Taylor’s University

For the duration of the COVID-19 pandemic, children were predominantly confined to their home and as a result, were less exposed to common bacteria and viruses. This will render younger children’s immune system to develop poorly.

From March 2022 onwards, as life seemed to make its way back to normality, children started to attend school, enrichment classes, and sports activities again.

This has led to many young kids falling ill with diseases such as influenza, hand-foot-and-mouth disease, and lung infections. An elevated frequency of visits to the doctor has worried many parents that their children may have weakened immune system (we say that these children are then immunocompromised).


Currently, there is no scientific data to show that children are more prone to infections after the pandemic.


A briefing by UNICEF on the impact of COVID-19 on children has shown that the prevalence of unhealthy diets such as snacking has increased. This may be due to a lack of easy access to fresh food and financial constraints, possibly leading to childhood obesity and malnourishment.

Additionally, a sedentary lifestyle and the lack of exercise could contribute to childhood obesity, escalating vulnerability to infections.

Another major issue that arose during the MCO period was the disruption of essential health services including childhood immunisations. In a recent WHO pulse survey, 90% of countries reported disruptions to routine immunisations. Immunisations are of utmost importance for preventing certain infectious diseases.

Another important issue that needs to be taken seriously is the mental health of children and their caretakers. The Adverse Childhood experience (ACE) study showed that adverse childhood experiences in categories of abuse, household challenges, and neglect are not only associated with worse mental health outcomes, but also with chronic health conditions such as diabetes, heart disease, chronic obstructive pulmonary disease, liver disease, and cancer.

  • Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
  • Inflammation and infection of internal organs
  • Blood disorders, such as low platelet count or anaemia
  • Digestive problems, such as cramping, loss of appetite, nausea, and diarrhoea
  • Delayed growth and development
  • Autoimmune disorders, such as lupus, rheumatoid arthritis, or type 1 diabetes

Some parents go to the extreme to create a “super clean” environment to protect their children and forbid the children to play or touch anything or anyone that has not been sanitised. This isn’t necessarily a good thing, and here’s why.

In the early years, our immune system is a blank canvas. Although infectious disease is a legitimate cause for concern, and a certain level of cleanliness is necessary, children need to develop an immunity to common pathogens.

Overprotecting children from germs is detrimental to their development. Therefore, parents need to balance between a clean environment rather than a sterile environment.


Studies have shown that soap and water are better equipped to remove more germs from one’s hand than hand sanitiser does.

However, it is still recommended to use hand sanitisers when washing with soap is not an option.


Generally speaking, children with a balanced diet and outdoor activities would attain the daily requirement of nutrients.

A minimum of 400 IU (10 µg/day) of vitamin D is recommended for children and adolescents, especially among exclusively breastfed infants and all children and adolescents who are not routinely exposed to sunlight.

Vitamin D supplementation is only recommended to those who are unable to obtain an adequate amount of vitamin D from their diet or have inadequate exposure to sunlight.

Care should be taken while consuming vitamin D supplementation. A daily vitamin D intake of 2,000 IU or more puts one at risk of vitamin D toxicity. The signs and symptoms of toxicity include headache, a metallic taste in one’s mouth, pancreatitis, nausea, and vomiting.

Minister of Health Officiates New Child Health, Safety, and Well-being Programme


On September 15 2022, our Minister of Health YB Tuan Khairy Jamaluddin officiated the launch of Healthy Little Bloomers programme and the roll-out of its maiden campaign Junior Germ Busters. 

The Healthy Little Bloomers programme aims to promote child health, safety and well-being through a network more than 30,000 early childhood care and education centres nationwide, potentially benefiting more than 800,000 children.

This is an initiative led by the Malaysian Paediatric Association (MPA) in collaboration with 10 prominent early childhood care and education organisations from both private and government sectors. These organisations are Jabatan Kemajuan Masyarakat (KEMAS), ECCE Council, Malaysian Association of Professional Early Childhood Educators (MAPECE), Persatuan Tadika Malaysia (PTM), Jabatan Kebajikan Masyarakat (JKM), Persatuan Pengasuh Berdaftar Malaysia (PPBM), National Association of Special Education, Malaysia (PPKK), Majlis Kebajikan Kanak-Kanak Malaysia (MKKM), Persatuan Tadika Sabah (PTS) and Association of Kindergarten Operators Sarawak (AKO).

In his speech during the launch, YB Tuan Khairy highlighted the following:
  • Young children, especially those under the age of 5, are vulnerable to health and safety threats, such as infectious diseases, injuries, abuse and neglect
  • Children who are overweight or obese are 5 times more likely to become overweight and obese adults
  • Child abuse survivors are at higher risk of becoming abusers or getting involved in abusive relationship during adulthood
  • Unmet emotional and mental health needs during childhood will lead to difficulties and problems during adolescence and adulthood

YB Tuan Khairy is pleased with the launch of Healthy Little Bloomers because, as he puts it: “Children are the nation’s future. Therefore, addressing their health, safety and well-being needs holistically is one of the government’s key priorities. It has been part of the Malaysian government development goals since the 1960s and outlined in our latest Child Health 2021-2023 national framework”.

He applauds the campaign as an initiative that brings together MPA and partner organisations for bringing together medical professionals and early childhood care and education experts in a systematic and potentially long-term collaboration to help bring to fruition the goals of the government.

This is a vital programme as many young children spend most of their waking hours in kindergartens and children centres every week, abd studies have shown that health promotion intervention in kindergarten and childcare centres can be effective, especially if parental engagement is involved.


Professor Datuk Dr Zulkifli Ismail, Chairman of Healthy Little Bloomers, shares that the programme is meant to be cover all key domains and aspects of child health, safety and well-being in a holistic manner.

He further elaborates that the programme will take an annual thematic approach.

  • Training for early childhood care and education operators and personnel
  • Fun, exciting, and interactive lessons for children; the programme is inclusive and will cater to children from various population segments, including those that are underprivileged and with special needs
  • Information and educational materials for parents and primary caregivers; available in Bahasa Malaysia and English
  • Roadshows to cater to less advantaged children, featuring activities that will consider the needs of those with hearing or vision impairments.

Visit healthylittlebloomers.my to get more information as well as free educational materials.

Are You Worried That Your Child May Have Scoliosis?


Consultant Orthopaedic & Spine Surgeon
ALTY Orthopaedic Hospital

Scoliosis is a common, sometimes hereditary spinal medical condition, in which a person’s spine curves to the side, typically in the shape of an “S” or “C.”

A stable and mild case of scoliosis does not cause significant lifestyle issues, but severe cases with prominent curves can be harmful to a person’s health.


People often believe, erroneously, that carrying heavy bags, having poor body posture, participating in sports, or sleeping on one side will cause the spine to bend, but that isn’t quite the case.

The reality is that over 80% of all scoliosis cases have no known cause. Such cases are known as idiopathic scoliosis.

According to studies, scoliosis affects 2-3% of the Malaysian population, or between 600,000 and 900,000 persons . It’s most often detected during adolescence, but it is also known to affect adults and the elderly at a lower rate.

Scoliosis usually progresses very rapidly during the growth spurts and only slows down or stops once the child reaches bone maturity. Signs of scoliosis become more noticeable as a child grows in age or as the curve progresses, but that doesn’t mean that scoliosis is impossible to notice early.

Because the signs are not always visible in mild cases, parents should examine their children on a regular basis.

The earlier scoliosis is detected, the better the odds of preventing scoliosis from causing serious issues down the line.

As scoliosis usually starts just before the child shoots up in height, parents should begin looking for symptoms at that time. Look out for:

  1. Look for an imbalance in the height or position of shoulders, shoulder blades, or hip — for example, one shoulder appears to be consistently dropping below the other.
  2. Also look for a misalignment of the head with the rest of the body.
  3. An uneven waistline or hips, as well as whether one shoulder blade protrudes more than the other.

If you see any signs of scoliosis, regardless of how minor they are, you should schedule an appointment to see a specialist to do further observation and to also check on the severity as some hospitals may not be able to do a comprehensive check.


If you are still unsure, it is best to consult a doctor as soon as you can. Sometimes mild symptoms may not be easily spotted, and doctors can help perform more tests and X-ray scans.

An orthopaedist who specialises in pediatric conditions will be able to recommend more tests, examinations, and preventive measures upon further consultation.

If the curve identified is less than 20° degrees, the curve will be observed to ensure that it does not worsen. This is especially important for children who are still developing, although well-grown children may not require more X-rays. Such cases may require more testing like MRI which can be used in addition to the X-rays for more detail.

New imaging modality like the EOS is able to provide better images of the spine with a quarter of the radiation dose.

Introducing Spring Sheep New Zealand Gentle Sheep Step 3 Toddler Milk


Gentle Sheep Premium Sheep Milk Toddler Formula is specially formulated by experts for 1-3 year olds whose regular diet may benefit from supplementation.

Specially formulated by experts

Milk from New Zealand grass-fed sheep

Made under strictest food safety and quality protocols

Ethically and responsibly sourced

No GMOs, antibiotics, or artificial growth hormones (use of artificial growth hormones is illegal in New Zealand)

 No artificial colours or flavours

No added table sugar (sucrose)

BPA free packaging with hygienic scoop in lid

 A clean, creamy taste that kids love!

Most parents are familiar with cow’s milk and goat milk for their toddlers, but how about sheep milk? Well, sheep milk is loaded with its own unique benefits for a growing-up child’s growth and development.


✓Up to 60% more protein and calcium than milk from goats and cows.1

✓Higher amount of all 10 essential amino acids; essential amino acids can’t be produced by the body and must be obtained from diet.2


 There are 2 types of beta-casein proteins in milk: A1 and A2.

A1, present in high amounts in milk such as cow’s milk, is linked to tummy issues in some people.3

✓Sheep milk is an A2-type milk, so it’s ideal for kids sensitive to cow’s milk.1


Enriched with docosahexaenoic acid (DHA) and arachidonic acid (ARA). 

Contains beta palmitin (OPO).

  With prebiotics galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS).

Visit https://springsheepnz.com.my/ for more information on how sheep milk can be good for your kid.

This product is not for children under 1 year old. Breastfeeding is best and provides the optimal balance of nutrition and protection during growth and development. Ask your doctor for more information.


 1. Barłowska, J., Szwajkowska, M., Litwińczuk, Z., & Król, J. (2011). Nutritional value and technological suitability of milk from various animal species used for dairy Production. Comprehensive reviews in food science and food safety, 10(6), 291–30

2. https://doi.org/10.1111/j.1541-4337.2011.00163.x 2. Park, Y. W., Haenlein, G. F. W., & Wendorff, W. L. (2006). Sheep milk. In Handbook of milk of non-bovine mammals (pp.137-194). Wiley-Blackwell.

3. Jianqin, S., Leiming, X., Lu, X., Yelland, G. W., Ni, J., & Clarke, A. J. (2016). Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutrition journal, 15, 35. https://doi.org/10.1186/s12937-016-0147-z

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How & Why Organic Milk Can Be Good For Your Child

Bellamy's Organic toddler milk

Your toddler’s body is in a constant state of flux, with new tissues being built and current tissues being developed and fine-tuned.

Therefore, you don’t want to just to give your toddler just any milk. Your toddler’s milk should also be free of unwanted ‘extras’ that may hinder their optimal growth and development.

Organic milk is that milk your toddler deserves.


The unwelcome news:

  • Pesticides are 10 times more toxic to a child than an adult.1
  • High-pesticide-residue foods have been linked to chronic or long-term health complications in children, such as learning disabilities and behavioural problems (attention deficit hyperactivity disorder or ADHD, etc).2
  • Such pesticides are commonly used in conventional farming these days, including during the production of feed that will be consumed by cows.

Now, the good news:

When it comes to organic cow’s milk, care is taken to ensure that cows are fed on organic grass and hay. Absolutely no genetically modified grain, corn, or soy will be given to these cows.

That way, you can be assured that your toddler will be getting all the nutritional goodness of milk with none of the ‘extras’ that may be harmful to their growth and development.


Some nutrients are present in greater quantities in organic milk, compared to non-organic counterparts.

A good example of this is omega-3 fatty acids, which can support your toddler’s mental and eye development. Organic milk contains 40-60% more of these fatty acids compared to conventional types!3,4,5,6


Organic milk producers raise dairy cows in a more natural living environment. These cows have continuous access to organically-grown grass, and their diet is free from genetically-modified grains. They are also not subjected to antibiotics and growth hormones in order to force them to produce more milk.

As a result, these cows are healthier and happier. Such ethical raising and caring of the cows also involve sustainable practices that are kinder to the environment—less soil erosion, fewer wastage, and less air pollution.


As more parents become aware of the benefits of organic milk for their toddlers, it is important to pick the crème de la crème of organic milk brands—one that is properly certified to be indeed organic like the manufacturer claims it to be.

Were the only brand in Malaysia with double the assurances

At Bellamy’s Organic EQUISPIRE, we are pleased to share that the EQUISPIRE STEP 3 TODDLER MILK DRINK is double-certified by the Australian Certified Organic (ACO) and the National Association for Sustainable Agriculture Australia (NASAA), two leading and internationally recognized certification bodies for organic products.

√ Organic milk is produced as nature intended, so you are giving your toddler a pure start in life.

√  Less than 1% of the world’s dairy milk is certified organic, and we have two certifications! You can be assured that we are fully committed to producing authentic, genuine, and nutritious organic milk for your toddler.

√ No synthetic chemicals and processes assured.

The World Health Organisation and the Ministry of Health Malaysia recommend exclusive breastfeeding for the first year of life. After that children should receive age-appropriate complementary foods, and breastfeeding should continue up to 2 years of age. Consult your doctor if you have breastfeeding difficulties.


1. National Research Council (US) Committee on Pesticides in the Diets of Infants and Children. (1993). Pesticides in the diets of infants and children (1st ed.). National Academies Press.

2. Roberts, J. R., Karr, C. J., Paulson, J. A., Brock-Utne, A. C., Brumberg, H. L., Campbell, C. C., Lanphear, B. P., Osterhoudt, K. C., Sandel, M. T., Trasande, L., & Wright, R. O. (2012). Pesticide exposure in children. Pediatrics, 130(6), e1765–e1788. https://doi.org/10.1542/peds.2012-2758

3. Średnicka-Tober, D., Barański, M., Seal, C. J., Sanderson, R., Benbrook, C., Steinshamn, H., Gromadzka-Ostrowska, J., Rembiałkowska, E., Skwarło-Sońta, K., Eyre, M., Cozzi, G., Larsen, M. K., Jordon, T., Niggli, U., Sakowski, T., Calder, P. C., Burdge, G. C., Sotiraki, S., Stefanakis, A., Stergiadis, S., … Leifert, C. (2016). Higher PUFA and n-3 PUFA, conjugated linoleic acid, α-tocopherol and iron, but lower iodine and selenium concentrations in organic milk: a systematic literature review and meta- and redundancy analyses. The British journal of nutrition, 115(6), 1043–1060. https://doi.org/10.1017/S0007114516000349

4. Griffin, R. M. (n.d.). Omega-3 fatty acids: Fact sheet. WebMD. https://www.webmd.com/healthy-aging/omega-3-fatty-acids-fact-sheet

5. Omega-6 fatty acids. (n.d.). Mount Sinai Health System. https://www.mountsinai.org/health-library/supplement/omega-6-fatty-acids

6. Benbrook, C. M., Butler, G., Latif, M. A., Leifert, C., & Davis, D. R. (2013). Organic production enhances milk nutritional quality by shifting fatty acid composition: a United States-wide, 18-month study. PloS one, 8(12), e82429.

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“Eeeuw, My Baby Has Diaper Rashes!”

"Eeeuw, My Baby Has Diaper Rashes!"

May 8, 2022   Return

Words Pank Jit Sin and Lim Teck Choon

Dr Leong Kin Fon

Paediatric Dermatologist


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.



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.

Tip! Vaseline and zinc oxide cream can help protect a baby’s intact healthy skin from irritation. For babies who are prone to developing diaper rash, parents may consider the use of diaper rash prevention creams that contain protease enzyme inhibitors which keep the protease in a baby’s stool from irritating the skin and vitamin E which helps to support the healing of damaged skin.


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.

Tip! Make sure our baby’s diapers fit comfortably without being too snug or too loose.


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.

Tip! “Wet wipes are no replacement for water and soap,” he clarifies.



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.


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.



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7 Ways To Motivate Your Kids To Do Their Homework

7 Ways To Motivate Your Kids To Do Their Homework

May 8, 2022   Return


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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Expert Advice for Expecting Parents

Expert Advice for Expecting Parents

May 8, 2022   Return


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.



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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Your Bundle of Joy Arrives

Your Bundle of Joy Arrives

May 8, 2022   Return

Words Hannah May-Lee Wong

Dr Rama Krishna Kumar Krishnamurthy

Consultant Obstetrician & Gynaecologis

“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:


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.


True Labour: Contractions steadily get stronger and more intense.

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


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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