Go for the Eyes!

Go for the Eyes!

May 8, 2022   Return


As parents, we surely do not want our children to be forced to wear glasses from an early age. Fortunately, there are simple little things that you can do to protect the vision of your little ones.



  • Eye examination:  Send your kids for an eye examination to detect potential eye problems early and while they are treatable. Your child should be receiving their first comprehensive eye test at 6-months old, an additional eye exam at age 3 and just before they enter primary 1 – around 6 or 7 years of age. An eye examination is recommended every 2 years if your school-aged child need no vision correction. Children who require glasses, however, should be examined yearly or as required by the optometrist or ophthalmologist. 
  • Feed your children right. Yes, a well-balanced diet that consists of the right minerals, vitamins and proteins seems to play a role in good eye health. Deficiency in vitamin A, for instance, may result in night vision problems. Not only that, it can also cause severe dry eyes, which may possibly lead to eye infections or worse; vision loss.  Consume foods such as green, leafy vegetables, salmon, tuna, nuts, eggs, beans and citrus fruits such as oranges regularly to maintain good eye health.
  • Take a break from electronic devices. Staring at harsh lights from electronic devices such as phone and computer for long periods is damaging to the eyes. This is especially true as kids nowadays are so intrigued to technology that they can stare at it forever! Staring at such devices for long can result in eyestrain, headaches, blurry vision and even dry eyes.  Encourage your kid to blink often and look away from the screen after every 20 minutes to rest the eye. Adjust the brightness of the device so that it is not too bright to see.
  • Adjust the viewing distance. First of all, ensure the place for reading and watching is properly lit. Discourage your kids from sitting too close to the TV or reading while lying on their back. The reading material should be about 30cm in distance away from the eyes.  Glares from electronic screens should be minimized to prevent eye strains. The distance between the monitor screen and your children’s eyes should be within 45cm-71cm and the top of the screen should be at eye level   
  • Limit the amount of time spent on electronic devices. And, encourage your kids to do a mix of tasks throughout the day. Support your kids to participate in activities that involve postural changes and physical activity such as swimming and playing sports. Limit the time your kids spend on electronic media to less than 2 hours per day.
  • Keep your ears out for complaints. If your kid has been complaining about blurred vision or having trouble viewing the blackboard, take him to an optometrist.



All About Vision. Available at www.allaboutvision.com

International Myopia Prevention Association. Available at www.preventmyopia.org

Kids Health. Available at www.kidshealth.org

Mayo Clinic. Available at www.mayoclinic.org

University of Utah Health Care. Available at www.healthcare.utah.edu

WebMD. Available at www.webmd.com

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Your Child’s First Fast

Your Child’s First Fast

May 7, 2022   Return


Jamilah Binti Abdul Jamil   Dietitian

Watching a child grows up brings bittersweet joy to every parent: sweet joy as the child is spreading his wings and finding his way in this world, with a touch of bitter – just a little! – because it is always hard to watch a child grow up and need you a little bit less each day.

Fasting, and discovering the spiritual joy in the abstinence, is one of the milestones that a Muslim parent would want her child to experience. HealthToday asked dietitian Jamilah Binti Abdul Jamil on how a parent can best introduce the act of fasting into a child’s life.

HT: Ms Jamilah, when is the best age for a child to begin fasting?

JAJ: The parents need to consider several things when introducing fasting to their children. Some children may find it easier to fast, while others, such as those with hyperactivity, may find it more difficult. The parents will be the best people to evaluate if their children are ready to fast or not.

Parents can introduce the idea of fasting and its purpose to their children from as early as 3-4 years old. This is the time when their children will ask many questions such as why the moon is following them when they are in the car, and, no doubt, they will ask their parents why they are not eating. This is a good opportunity to share why, as Muslims, they are required to fast.

Parents can start encouraging their children to fast at age 7, but they should not be too strict about it. Depending on a child’s attitude, general health and nutrition, the child may or may not have an easy time fasting. It is fine if they fast for only half a day – the Malays call this “puasa yang yok”. The whole idea here is to give the child a “taste” of fasting and to instil in them the desire to fast during Ramadan.

If the child has health conditions such as type 1 diabetes and asthma, the parents should consult a doctor or dietitian before encouraging the child to fast.

HT: When is the right time for a child to try fasting for the full month?

JAJ: Children should be introduced to fasting in stages.

They can start by fasting for 2 hours a day. Once they have become used to this, the hours can be increased to 4 hours, half a day, and eventually a full day.

If the child is 9 years old (almost reaching puberty) and has successfully practised fasting in previous years, then parents can encourage the child to try fasting for the entire month. However, do not force the child if he cannot do it. Let him try again next Ramadan.

For younger children, let them break their fast early when they show signs of tiredness.

The bottom line here is, parents need to be alert to signs such as the child looking rather tired during the day and be considerate in not forcing the child to do something he is not ready for. The most important thing at the end of the day is the take-home message and values the parents are trying to instil in their children.

HT: How about children who are sickly? What considerations should the parents have in mind while preparing and supporting the child to fast for the first time?

JAJ: Chapter 2 of Al-Quran verse no. 184 makes it explicitly clear that those who have illness or medical condition, and if fasting can be detrimental to their health, are exempted from fasting.

Depending on the type of medical condition and its seriousness, parents should not be demanding about getting their children to fast. They may postpone introducing fasting until a time when the children’s condition is more ready (mentally and physically).

Type 1 diabetes (T1DM):

Children with T1DM are not encouraged to fast. However, a study called EPIDIAR which involved 13 countries showed that 43% of T1DM patients fasted at least for half of the Ramadan month (15 days). Fasting should only be encouraged in children with good glycaemic control and regular blood glucose monitoring at home.

A few studies have shown that it is safe to fast among adolescents with T1DM. Thus, Ramadan fasting is achievable in older children and for those who have had T1DM for a long time.

It is especially important for parents to talk to a doctor, dietitian and diabetes educator before they introduce a child with T1DM to fasting. There are important considerations, such as insulin adjustment, the right eating habits during Ramadan and how to monitor sugar levels and what to do should hypoglycaemia happen.


While fasting, a lack of fluid intake may cause dehydration and dryness of the inner lining of the respiratory airways. In children with asthma, this can worsen the constriction of the airways in the lungs (bronchoconstriction), causing the child to cough, wheeze and experience shortness of breath. Therefore, parents with asthmatic children should discuss with a doctor on whether or not it is safe for their child to fast, as well as to equip themselves with the knowledge on what to do should any complications arise.

HT: How can parents support their children’s effort to fast?

JAJ: First of all, parents need to get the child to understand the purpose of fasting and why Islam wants its “ummah” to fast for a month. Let the child know why fasting is compulsory, and how the child’s daily routine would change during Ramadan. For example, the child would need to sleep earlier than usual to wake up in time for sahur, school may finish earlier too, and they probably will not be able to go to the park or enjoy other activities affected by fasting as often as before.

Also, parents should realise that their children look up to them as role models. Thus, it is important that parents are setting a good example for their children. They should practice sahur, pray on time, drink plenty of plain water between iftar and sahur, eat balanced meals with fruits and vegetable, go for Tarawih prayers, bestowed alms upon the poor, and more.  


HT: For children who are fasting for the first full month, what are the good buka puasa habits that the parents can inculcate in the child?

JAJ: Well, parents can do the following.

  • Have iftar with the entire family. This will promote greater bonding among the family members.
  • Recite doa and break the fast with dates (tamar/rutab) and plain water to follow the sunnah.
  • Eat in moderation. Make sure meals are balanced.
  • Limit intake of sweetened foods and beverages and high fat foods.
  • Teach the children about gratitude.

The following are tips for healthy eating during Ramadan:

  • Prepare sahur and iftar meals that promote more satiety (rich in complex carbohydrates such as fruits, vegetables, whole grains and other food high in dietary fibre).
  • These meals should be balanced (containing food from all food groups in the right amounts) and nutrient-dense.
  • Eat slowly to avoid indigestion especially at iftar.
  • Encourage drinking more water to maintain hydration.
  • Limit intake of food that is high in salt or sodium.

Here are some ideas for a healthy Ramadan meal for children, courtesy of Jamilah:


  • White rice with grilled chicken/fish and vegetables
  • Chicken kebab
  • Fish/ chicken porridge
  • Vegetable soup with pasta
  • Grilled fish with sweet potatoes and vegetables


  • Baked beans/ eggs with whole meal toast
  • Fruit yoghurt or smoothies
  • Oat porridge
  • Cereals with milk
  • Pancakes

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“Mummy, I’m Bleeding!”

“Mummy, I’m Bleeding!”

May 7, 2022   Return

For your little child, the world is full of new and joyful discoveries. Unfortunately, it is only a matter of time when he experiences his first wound.

If your child comes to you with tears, the first thing you should do is to keep your cool. Getting worked up would only terrify your child further. Here are some things you can do to help your child calm down while seeing to his wound: 

  • Keep calm. You may feel tempted to scold him, especially when you have been warning him so many times to stop climbing up the tree. Instead, take a deep breath and comfort him with a hug and some reassuring words.
  • Wash your hands. Despite the urgency you may be feeling at that moment, take some time to wash your hands with soap and water first. This way, your hands are free from germs that may infect the wound. (Don’t forget to wash them again after treating your child’s wound!)
  • For little cuts such as scrapes and abrasions, you can first rinse the wound with water to clean off any dirt or debris (be prepared for tears when you do this). You can then apply an antiseptic ointment or solution to the wound before covering it with an adhesive gauze or plaster.
  • For more serious wounds such as large cuts or larcerations, especially on the face and neck, your child may need stitches. It is best to bring your child to a doctor for proper medical care.
  • Throughout the whole experience, your child may continue to cry. Say comforting things such as: “Mummy is going to apply some medicine now, it will hurt a little bit, but you will be fine afterwards!” You can also promise to give him a treat after the treatment, such as ice cream, so that he has something pleasant to keep his mind on.

A word on “plasters”

Like most children, your child may be up and running again, his tears forgotten, once you have seen to his wound. Antiseptic plasters, or simply “plasters” to many of us, are a good way to keep his cuts clean from dirt and germs that may cause infection. If you have a problem keeping them on your child for more than a few minutes, try these tips:

  • Paste a first aid tape over the plaster to make it “stick” better.
  • Cut along the middle ofthe plaster strip’s adhesive part into two smaller strips. Wrap the lower strips as usual, but arrange the upper strips so that they cross in an “X”.


About Kids’ Health. Available at www.aboutkidshealth.ca

KidsHealth. Available at www.kidshealth.org 

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Learning to Learn

Learning to Learn

May 7, 2022   Return


Dr Selina Ding Wai Eng   Clinical & Educational Psychologist, Ding Child Psychology Centre

When a child shows signs of having problems at catching up in school, parents get understandably worried. Failure to learn can affect a child’s ability to secure a good future.Furthermore, it can affect the child’s self esteem. However, when extra help in the form of tuition classes and such fail to show improvements in the child, what can the parents do?

According to Dr Selina Ding, a clinical and educational psychologist, there are many reasons why a child could have learning difficulties.

“Perhaps the child simply lacks exposure and needs time to adapt,” she suggests. “Or perhaps the child is suffering from specific learning disabilities, such as dyslexia.”

Learning Dysfunctions

  • Dyslexia. This condition affects not only one’s ability to read – it also affects the way the brain processes, stores and retrieves information.
  • Dyspraxia or developmental coordination disorder (DCD). This condition affects a person’s motor skills. There are varying degrees of dyspraxia – some may have mild forms of this condition, while others are more affected. Learning skills such as writing are negatively impacted by it.
  • Dyscalculia. People with dyscalculia have problems understanding the concept of numbers or solving even basic sums. They may also have problems trying to tell the time.
  • ADD/ADHD. People with attention deficit (hyperactivity) disorder (ADHD) are typically restless, erratic, impulsive and inattentive. Their behaviour can be unpredictable and even inappropriate (such as saying rude comments or behaving too aggressively). People with attention deficit disorder (ADD), without any hyperactivity, are a little less aggressive, but they too suffer from being easily distracted, unable to pay attention to details and losing track of what they are doing. Note that ADD/ADHD can only be diagnosed by a qualified healthcare professional – you cannot simply assume your child has ADD/ADHD! 

Dr Selina also points out that not every child’s learning disability has to stem from a biological condition. It is also possible that the child simply does not enjoy the schoolroom environment, or perhaps he or she is unable to get along with his teachers or other students and therefore, cannot fully pay attention in class.

Getting back on track

“Unfortunately, there are only a few schools in Malaysia that are equipped to manage the many different types of learning difficulties that exist,” says Dr Selina. “There are classes for students with autism or below average intelligence, but slow learners with other causes for their problem will not find such classes beneficial.”

For the parents of those students, a better solution would be to consult a child psychology centre. Here, the child would be assessed to determine the possible causes behind his or her inability to catch up in school, and a suitable programme would be developed just for that child.

For example, many children are found to be dyslexic only after they are screened and assessed by an educational psychologist. Children with dyslexia need special programs tailored for their condition to help them learn; if undiagnosed, most children languish in ordinary classes, unable to keep up. Some are even regarded as “stupid” by their peers and teachers, and sadly, many end up believing this.

Who says dyslexics can’t be brilliant people? Just take a look at the more successful dyslexics out there. Famous dyslexics include:

  • The late Fred Epstein, a neurosurgeon who developed many new technologies to operate on cancer.
  • Scott Adams, cartoonist and creator of Dilbert, who describes himself as “mildly dyslexic”.
  • Steven Spielberg, arguably the most famous director in the world.

In such a programme, the child can learn at his or her own pace, in a manner that the child will enjoy. Dr Selina herself uses various fun learning methods such as play therapy for her young charges. Counselling would be given to help the child cope with emotional issues that may be getting in the way of learning. Parents would also be given guidance and advice on how to continue to support and guide the child at home.

“Given the complex and varied reasons behind a child’s learning difficulty, there is no one-size-fits-all solution,” says Dr Selina. “But with the help of a team of qualified child psychologists, parents can help their child catch up and cope with her studies – and even get her to enjoy learning in the same time!”

[1] http://www.nytimes.com/2006/07/12/nyregion/12epstein.html

[2] http://blog.dilbert.com/post/102892943361/perceptual-super-power

[3] http://articles.latimes.com/2012/sep/25/entertainment/la-et-mn-steven-spielberg-on-unlocking-tremendous-mystery-of-his-dyslexia-20120925

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Life, Love & Autism

Life, Love & Autism

May 7, 2022   Return

Words Lim Teck Choon

Dr Sharifah Aida Alhabshi  
Consultant Paediatrician


The word “autism” keeps ringing in your brain. Your voice breaks and you are tired of discussing it with doctors, family members, friends. You are bombarded by conflicting emotions – confusion, anger, grief, shame, worry. You want to hold your child, but your child shrieks and breaks out of your embrace to stare at something in the distance.

It is not pleasant when your child is diagnosed with autism, but it is not the end of the world. It can be, in fact, the beginning of a cherished journey for both parent and child. To illustrate this point, paediatrician Dr Sharifah Aida Alhabshi, who has a special interest in child learning difficulties and child psychology, helps to answer some questions parents may have about raising a child with autism spectrum disorder (ASD).



Question one

What is happening to my child?

The best explanation comes from a study published in 2014 in the Journal of Neuroscience. This study raises the possibility that children with autism spectrum disorder (ASD) can get triggered because their brain experiences some delays (temporal acuity) when processing information sent by their eyes and ears.

Because it takes longer for the child to make sense of the sights and sounds around him or her, it will take more effort to grasp simple concepts and to behave like other children.

Also, Dr Sharifah Aida points out that a child with autism tends to have some increasingly heightened senses compared to other children, while other senses may be delayed or require intervention in order to develop fully. Heightened senses may manifest in various ways that seem extreme to other people. For example, one child will find the soft whirr of a fan to resemble a painful screech in her head, making her scream in discomfort. The rub of the label of a shirt against the nape may cause great discomfort to another child, causing him to try to pull the shirt off.

It is also common for children with ASD to behave in ways that seem to suggest that they are living in their own world. See “The Girl That Makes Herself at Home” for an example of such behaviour.

This doesn’t mean that the child is stupid or mentally handicapped, far from it. With proper intervention sessions and plenty of love and support, a child with autism may learn to adapt to the world like fairly normal people. For children with more severe autism, they will need a little more support, but don’t lose hope – there are still ways to help them grow up to become fairly self-sufficient.



The Girl That Makes Herself at Home

Whenever her mother brings Molly (not her real name) to see Dr Sharifah Aida, Molly will happily move to sit on Dr Sharifah Aida’s lap. She will then play with the paediatrician’s computer, examine and play with  various objects at the desk, and generally act like she has never noticed Dr Sharifah Aida at all. The  paediatrician doesn’t mind at all; in fact, she assures the mother that such behaviour is quite common  among children with autism.



For a good idea of what the world looks and sounds like through the eyes of someone with autism, go to bit.ly/1RQSNNg for a video made by UK’s National Autistic Society.



What Is Autism Spectrum Disorder (ASD)?

It is a set of complex disorders of the brain and nerves. The child usually shows a unique repetitive behaviour, and can experience difficulties with social interaction.

There is a wide range of symptoms, skills and levels of severity, hence the word “spectrum” in the name of this condition. One child may experience only mild autism, while another child may need a little more help before he or she can perform basic daily activities.

What ASD Is Not

It’s not our fault. What we ate or did during the pregnancy did not cause our child to develop ASD.

Dr Sharifah Aida shares that there is no scientific evidence that it can be caused by foods, vaccines and medications. Some researchers speculate that environment may be one of the causes of ASD, but to date no one has found evidence to back up that speculation. There is likely a genetic component to ASD, though.

Therefore, don’t be so hard on ourselves – there is nothing to feel guilty about. Our child needs us. It is time to look to the days ahead, rather than to dwell on matters that we have little to no control over.

Our child is not stupid. Someone with ASD may still learn to interact well with other people, even forming meaningful relationships and holding jobs. Even those with severe ASD can learn to be self-sufficient when they are adults. Therefore, there is no reason to assume the worst for our darling just because he or she has ASD!

Our child is not deliberately naughty. He or she is not deliberately testing our patience or embarrassing us in public. It’s just that our darling’s brain is wired to perceive the world in a different way. Once we can understand what this is like for our child, we will be able to communicate better with him or her.

Autism is not a curable disease. There is currently no specific treatment that can cure autism. While there are medications and supplements out there that claim to do so, Dr Sharifah Aida points out that these claims have not been scientifically proven. Despite a lack of cure, there is still an opportunity for a child with autism to grow up to be a relatively well-adjusted adult, as we shall soon see.

 “I don’t want my thoughts to die with me, I want to have done something. I want to make a positive contribution – know that my life has meaning.” – Mary Temple Grandin, a person with autism who only started speaking when she was three and a half years old, and who went on to become a professor of animal science at Colorado State University.

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A Child’s First Flight

A Child’s First Flight

May 7, 2022   Return

Words Hannah May-Lee Wong

Flying for the first time sure is exciting. Soaring thousands of feet above the air, waving goodbye to the tiny houses below, seeing clouds float by and anticipating arriving at a new destination. Yes, it is an exhilarating experience… right up until the little one gets tired, bored, hungry or scared. To curb a possible meltdown, here are a few tips you can use to keep the young ones happy (or calm, at least).  

#1  Snack attack

In preparation for countering those hunger tantrums, come armed with your own nutritious selection of munchies. Pack some whole-grain crackers, small boxes of raisins, cereal, nuts or sandwiches. These wholesome snacks will keep the child’s fingers occupied while filling their tummies. For drinks, besides plain water, you could pack some milk powder to make a comforting warm beverage on board. Just ask the flight attendant for some hot water.

#2  Games and activities

The unfamiliar and confining space of an aeroplane may make some kids uncomfortable. Keeping them engrossed or entertained can help to relax or distract them. Bring along their favourite storybooks and read to them. You could also pack some colouring pencils for drawing or colouring, or workbooks that have puzzles or mazes to solve. Join in the fun and play a few rounds of “I spy with my little eye”. Yet another option is to bring some child-friendly travel version of board games such as tic tac toe, bingo and snakes-and-ladders.

#3  Nap time

When the kids are tired out (and they surely will be after all those tedious check-in processes), take the opportunity to put them down for a nap. Although plane seats aren’t the most conducive to sleep in, make the best of the situation by bringing along a small blanket, a pillow and a favourite soft toy for your child to cuddle up to.

#4  Prepare for take-off (and landing)

With air pressure changes, loud noises and lots of sudden movements going on, take-off and landing can be distressing for the young ones. Keep them calm by holding their hand and getting them to look out the window to take their mind off the scary stuff. As young ears are especially sensitive to pressure change, it could get quite painful for them during the plane’s ascent and descent. Let them sip on some water, suck a lollipop or chew on some dried fruit to reduce ear discomfort.

Have an enjoyable flight!

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Sibling vs. Sibling

Sibling vs. Sibling

May 7, 2022   Return


Words Hannah May-Lee Wong

Cathie Wu

Counselling Psychologist


The relationship between siblings can be complex. If all goes well, a sibling can be a dependable anchor of family support through the course of your life. They will be there to celebrate with you during special occasions, mourn with you through life’s sorrows and reminisce with you about the good old times growing up – they’re your best and greatest ally. Sadly, that’s not always the case in many families. In contrast, a rivalrous and bitter sibling relationship can feel like an unrelenting thorn in the flesh – a painful reminder of the hurts and trauma of childhood.

Rivalrous relationships between siblings do exist. It can get quite intense and aggressive, and resolving such conflict requires the cooperation of both parties. It is a matter of choice. In some families, the issues resolve, but in many others, they don’t. Psychologist Cathie Wu tells us about the psychosocial aspects of sibling rivalry.  

What causes sibling rivalries?

The psychosocial explanation is that it happens when children, specifically the older child, gets ‘dethroned’ when the younger child is born. This makes the older child feel insecure. A firstborn often feels like there was once a period of security and love. When the rest of the children come along, he or she will get a sense that the love and attention is now divided. Because of that, it is not uncommon to feel insecure, and they start to compete for the attention of parents. It’s usually a competition for perceived scarce resources – they perceive their parents’ love and affection as scarce resources. We use the term “perceived” because the love of a parent isn’t necessarily quantifiable. Other perceived scarce resources could be privileges or material things: they might fight over a toy that they perceive as the only one or the best one. 

Furthermore, parental issues such as playing favourites would exacerbate the rivalry.

Does sibling rivalry occur the same way across ethnic groups?

There isn’t really a difference in sibling rivalries found in Western and Eastern families. But what I sometimes find in Asian societies is that Asian families seem to value harmony more. Asian parents may be very quick to cut in and try to balance the relationship – a move which is not recommended. Among young kids, some competition is natural and quite common.

Even though research is still quite lacking in this area, sibling rivalry can be found across different socio-economic levels and ethnic groups. It tells us that it’s more likely a psychosocial issue rather than a biological issue.

Does personality play a role?

Personality, which is the slightly more biological aspect, does come into play and can affect the situation. If you have children who are very flexible, then they may not have such intense rivalry.

Does age gap affect how siblings get along?

The more similarities children have, the more likely they are to fight. Similarities like gender and a close age gap increase the likelihood of fighting because their developmental stages are more similar. They tend to perceive things the same way and want the same things, and that’s when they vie for attention.

Does birth order affect behaviour and personality?

Yes. A very famous psychologist named Alfred Adler has done extensive research in this area. Findings show that the first child is typically more responsible, independent and nurturing. There’s also an interesting correlation of firstborn children being more likely to hold higher positions in corporations (more leadership positions). But on the flip side, there is a higher likelihood for firstborns to have psychological maladjustments. Because of those years of carrying burdens, responsibilities or expectations, firstborns tend to be people pleasers. They also tend to be more confident.

The middle child is usually a little bit quieter, more patient and seemingly more reserved. They find their place in the middle, and thus it defines their identity.

The youngest child is the baby of the family. Because they grew up in a secure environment, they may feel freer to explore and this is perhaps why they tend to be more risk-taking, life-of-the-party kind of people. They also are more likely to seek attention because they are so used to getting it.

These are some common patterns in relation to birth order, but they aren’t definitive.

Is competition among siblings always a bad thing?

Competition among siblings is not necessarily unhealthy as children can learn and develop through this. They learn social skills, verbal skills, how to adjust their emotions, how to bargain and negotiate. Building all these soft skills in the safe environment of home is often the best way. Mild to moderate types of vying for attention is perfectly normal. That’s how most kids play and learn.

On the other end, if assault or abuse happens, it’s no longer sibling competition or rivalry – it turns into sibling maltreatment and that’s unhealthy. Research has indicated that if an individual shows persistent violence towards family members, he or she is very likely to carry on with it outside of the family. They become bullies. This points to a red flag and the individual should receive help.

How should family members react when siblings get aggressive towards each other? Should they take sides, ignore or intervene?

For mild to moderate cases of sibling rivalry, it is best for parents to first observe as a third party. If the kids are still trying to figure things out between each other in an argument, you may not need to interfere. If you’re too quick to interfere, there may be consequences and it gets tricky. What seems fair and logical in the eyes of an adult or parent may not be so from a child’s point of view. Many times, parents want to interfere immediately to break apart potential fights. But their children can perceive this as the parent taking sides.

If you feel like things are going to get aggressive and physical, interfere in a way that does not point out who is right or who is wrong. Interfere by using ground rules. For example, if the kids are hitting each other in the backseat of the car, instead of saying “don’t hit your brother”, remind them of the ground rules: “in the car, we treat each other nicely” or “there is no beating each other in the car”. When you refer to the ground rules, you are alluding to whoever is breaking the rules. The difference may be subtle, but it can give very different effects.

Can such rivalry carry on into adulthood?

Most of the time, after kids have learnt how to navigate with their social skills, they enter adolescence and their attention shifts from home to school or even outside of school. They will naturally have other things to worry about, so the sibling rivalry gradually lessens.

That said, in some cases, sibling rivalries can carry on. Certain feelings of unfairness, extreme insecurity, inferiority, feeling the need to retaliate by aggression can linger and collect. As a psychologist, I do see many adults that come in for a set of symptoms, some even have clinical symptoms and after some analysis, the issues connect back to the family. 

The competition and rivalry between kids turn into envy as they get older. The vying for parents’ attention evolves into a competition for other forms of scarce resources, perhaps money or prestige. They may start to compare with their siblings and develop feelings of envy.

The prolonged conflict between siblings and even other family members can be unhealthy and can lead to psychological issues such as anxiety, depression or low self-esteem. It is especially a struggle in Asian societies because most people feel the need to put on a façade, pretend to get along during festivities and put on a show for their elderly parents. In the West, individualism may ultimately prevail, and toxic relationships and individuals may be more readily cut out if things cannot be patched up.

How can parents foster a close and strong bond among their children?

This gets tougher the more children you have. My professional advice is to try and develop a quality relationship with each child individually. That way, even if other children come along, it is less perceived as a loss of attention. If a child can see that he or she gets quality time and has a good relationship with the parents, the rivalry is less likely to develop.

Don’t be too quick to interfere and try to prevent potential fights.

To foster close and strong bonds among your children, try to develop a quality relationship with each child individually.

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“Sure or Not?!!!”

“Sure or Not?!!!”

May 1, 2022   Return

“Sure or Not?!!!”

 December 13, 2018   Return

Professor Dr Ng Chirk Jenn

Senior Consultant in Family Medicine

Department of Primary Care Medicine,

University of Malaya Medical Centre


Words Lim Teck Choon


It is about time you bring your baby to be vaccinated, but your mother-in-law tells you that she has heard that overloading a little child’s body with too many vaccines can be dangerous for his health. “Wait, surely there is more about this online,” you think as you fire up the browser on your phone.

Let’s see… you type “vaccine”, “safety” and “children” into the search browser and sit back to scan through the search results. Well, the World Health Organization (WHO) website states that vaccinations are safe, but wait, this professional-looking website claims that vaccines cause autism and all pro-vaccine advocacy is part of a conspiracy to enrich pharmaceutical companies.

Confused, you come across arguments from people advocating for vaccination, as well as people claiming that there are alternatives to vaccines that are more effective and safe. Who do you believe? How can you be sure as to who is telling the truth?

The above is just one of the common examples of what happens when one is faced with too much information on the Web. It can be hard to sift through the facts often mixed with hype, misconceptions, commercial interests of various advertisers and even outright fake news.

Well, good news! HealthToday managed to catch up with Professor Dr Ng Chirk Jenn from University of Malaya, who has some useful tips to share when it comes to navigating through all the health-related information found on the World Wide Web.




The World Wide Web can be seen as a big neighbourhood in the virtual world. Therefore, everything online – whether they are websites, blogs, social media platforms such as Facebook and Instagram – has an address. This address (called the uniform resource locator or URL) can be seen at the top of the browser when the page loads – see Image A.

Now, take a look at the last few alphabets in the address, after the second period.

Prof Dr Ng shares that these last few alphabets, called extensions in Internet-speak, tend to reflect the nature of the website.


A table of some of the most common extensions.

Note that there are many others.


Likely Nature of the Website


A commercial website. Because most websites are intended to generate revenue for their owners, this extension is the most frequent one you will encounter online.


A website of a non-profit organisation. Malaysian ones often have the extension “org.my”.


A website of an educational institution (such as a university). Malaysian ones often have the extension “edu.my”.


The website of a government-linked agency, ministry or department. Malaysian ones often have the extension “gov.my”.


HOT TIP! Generally, there is a higher likelihood of finding accurate unbiased health information in websites that end with the extensions “.org”, “.edu”, and “.gov”. This is because these websites are launched to educate and promote awareness first and foremost, often without any vested commercial interest on the owners’ part.

However! There are exceptions. Here are two examples: the World Health Organization’s website is www.who.int (“int” here stands for international organization), while our Director-General of Health posts the latest health updates at www.kpkesihatan.com. While looking at the extension is one way to have an idea of the nature of the website, you should also look at other aspects of the website first before you consume its contents.



In real life, you will want advice only from people who know what they are talking about – the real experts, in other words.

It’s the same with the Web and social media. If you’re going to take advice, let’s make sure it’s good quality advice from people who are the real deal.


HOT TIP! Prof Dr Ng has a handy checklist for you to determine whether the content of a website is worth your time.



  • The content is written by someone with the right professional credentials.
  • The article has been reviewed by another person with the right professional credentials.
  • The website has an editorial board comprising people with the right professional credentials (it’s usually listed on a separate page somewhere on the website).
  • The article lists down the sources of its information, and these sources come from reputable institutions or scientific journals.
  • The article has the date of publication (or in some cases, the date of the article review or revision) clearly indicated, and the date is not too long ago.



But! Anyone can be anybody on the Web, so it is likely that someone without the right qualifications can pass himself or herself off as an expert. However, the likelihood of fraud is reduced when the website implements the rest of the good practices on the checklist mentioned earlier. For example, if every article is reviewed by another expert, articles by frauds are less likely to slip through and get published.




According to the Internet Users Survey 2017 conducted by the Malaysian Communications and Multimedia Commission, about 80 percent of Malaysians “mostly trust” what they read online.



There are concerns about bias and vested commercial interests in online content these days, especially when digital marketing is on the rise.


HOT TIP! Prof Dr Ng has some tips to help you make sure that you are getting information that is as unbiased as possible.



  • Watch for logos of brands that show up on the web site. If you are comfortable with the presence of content that may be skewed towards these sponsors, you may still want to make sure that these brands are reputable. 
  • Sponsored content should be clearly indicated as such. Reputable websites tend to have a short paragraph stating that the content is sponsored, placed either at the beginning or the end of the article.
  • Be especially careful of claims that promise quick and easy solutions. Nothing is “top secret” on the Web, and if the solution is really as quick and easy as promised, you have to wonder why it is not promoted more extensively by reputable healthcare organisations!
  • Take testimonials with a huge grain of salt. The truth is, anyone can write a testimonial. That’s not to say that all testimonials are lies; testimonials aside, you should also look for more science-based evidence as proof that a certain product works as advertised.


However! Some websites rely on sponsorships and advertisements to update and maintain the website. Hence, they are not necessarily an indication of unreliable or biased website content. In these cases, what is more important is that these websites are upfront about the presence of such elements, and they make the effort to indicate clearly the sponsored content while keeping the non-sponsored content free from bias.

Of course, you don’t necessarily have to rely on such websites when there are other websites with zero or little commercial interests involved (such as WHO, the US National Library of Health’s Medline Plus at www.medlineplus.gov and more) that may also offer the information you seek.

The choice is up to you. Just make sure that you are aware of what you are getting into when you visit a website.



Prof Dr Ng assures that most doctors are happy to discuss health matters with their patients. It’s all in the art of communication, though: sometimes doctors become annoyed when their patients become aggressive, overly defensive over the content they found online or close themselves off from the possibility that the content they found may be inaccurate or even flat out wrong. Once that happens, there is nowhere to go but down.

Don’t let this dissuade you from discussing the things you read online with your doctor. In fact, it is always good to double- or even triple-check the accuracy of the things you come across online.

  • To avoid any chances of miscommunication, print out the relevant web page(s) and bring it or them along with you for discussion.
  • Keep an open mind. It is possible that your doctor is right and Dr Google may not be as accurate as you first thought! Having said that, you also don’t have to accept wholesale what your doctor tells you. So, feel free to ask questions and seek clarification during the conversation.
  • Don’t be afraid to ask for a second or even third opinion from another doctor if you feel that you have hit a dead end with your current doctor. If a few doctors say the same thing that contradict what you find online, perhaps your online source is not so accurate after all!

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Our Children’s Kidneys

Our Children’s Kidneys

April 29, 2022   Return


E_Dr Wan Jazilah Wan...

Dr Wan Jazilah Wan Ismail   Head of Paediatric Department, Hospital Selayang

World Kidney Day is celebrated on the second Thursday of March every year. This year’s theme is particularly close to consultant paediatric nephrologist Dr Wan Jazilah Wan Ismail’s heart, because for the first time since World Kidney Day was conceptualised, the focus is on children.

When a child has kidney disease

For most parents, discovering that their child has kidney disease can be a terrifying notion. Dr Wan Jazilah reassures these parents that, today, there are available treatments to help allow these children to lead fairly healthy and normal lives.

But parents do not have to rush into a treatment plan, she adds. “Normally, I will first explain the child’s condition and the treatment options available. If the test results show that there is still time for the parents to go home and think about these options, I would advise them to do so.”

Parents can take this time to research or even seek a second opinion, to give them confidence that they are doing the right thing as they embark on the road to treat the child. It will most likely be a bumpy road ahead for all parties involved, but the healthcare team would be there, to provide treatment as well as advice and emotional support.

Some parents and their children may not be so fortunate when it comes to time. Dr Wan Jazilah sighs softly as she thinks back to those times when she had to inform parents that their child’s kidneys were failing and the child would require dialysis.

“But I will still try to give the parents time to collect themselves. They are already stressed – some of them may have traveled a long way from hospital to hospital, and now I have to tell them that their child needs dialysis,” she says. No, it never becomes easier no matter how often she has these conversations with her patients’ parents. Still, she will give them time whenever possible, because she needs both the parents to be with her when it comes to helping their child heal.


Yes, it may hurt, sometimes a lot

Children tend to be more sensitive to pain, so they need plenty of emotional comfort and support, often more than adults, throughout treatment. “We tend to be both doctors and counselors sometimes,” says Dr Wan Jazilah with a smile, “as we provide treatment as well as emotional support to both our patients and their parents!”

Because pain can potentially leave lingering trauma in a child’s mind, she thinks long and hard, weighing the advantages and disadvantages of each option, when devising treatment plans for her young patients. However, this may mean that some treatments which are effective for adults, or certain children, may not be suitable for another child.

“Often, we have to adapt and make necessary changes to our treatment plans,” explains Dr Wan Jazilah. “Everything may seem clear cut in medical textbooks, but real life is different, it is never so straightforward. I may be faced with a child who is in so much pain after the last treatment, so I have to reconsider the options if I know that the next recommended step will also cause pain.”

Working together for the child’s recovery

Perhaps the most comforting assurance for these parents is that the healthcare team will be there by their side for the long haul. Personally, Dr Wan Jazilah will be happy to continue to care for and evaluate the treatment progress of her young charges all the way until they turn 18. She will not transfer out her young charges after they receive their identity card (about 12 years old), unless it is a request from the parents, naturally.

This way, the child will continue to receive treatment with minimal disruption. For the child, there is comfort in continuing to see a doctor whom he or she has become comfortable with, and the parents would also find some peace of mind in knowing that their child is under the care of a trusted doctor who understands the child’s medical history as well as his or her whims and moods.

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The Healing Journey 

Dr Wan Jazilah Wan Ismail gives honest insight into the ups and downs of medicating children with kidney diseases.

There are many types of kidney diseases, so we do not have the space to describe all the available medications in this article. Regardless of the type of medications prescribed, most parents will always have questions and concerns. Dr Wan Jazilah will address some of the more common concerns.

What are these medications for?

Depending on the type of disease they address, medications work either by reversing damage caused by the disease, or they slow down the damage.

Dr Wan Jazilah points out that most of the medications available today to treat kidney problems have been tested on adults but there is a lack of information to support their use in children.   

“Take blood pressure medication for example,” she says. Kidney problems can sometimes raise blood pressure, possibly causing organ damage and the incurable chronic kidney disease. “There are many new drugs available to treat blood pressure, but there are no studies conducted to determine whether they are safe to be used by children. As a result, I do not dare to prescribe the newer drugs to my young patients, as I fear that there is a possibility that these medications can affect their brain development. So, my options to treat high blood pressure remain small.”

Nonetheless, things are not as bleak as they may seem. With their expertise and knowledge, paediatric nephrologists will tailor the types of medications and their dosages to meet their young charges’ needs without compromising their developmental process. The journey is not always smooth sailing, but it has brought healing to many young children with kidney problems in this country.

Will my child require additional tests or hospital stays?

Dr Wan Jazilah shares that it is common for children with kidney disease to have their blood samples taken to evaluate the progress of treatment. Depending on the child’s health status and the nature of the disease, other tests may be required, to an extent that the child may need to stay in the ward for a period of time.

A certain degree of disruption to the child’s schedule is unavoidable, but Dr Wan Jazilah personally tries not to admit the child or disrupt his or her routine as much as possible.

There are parents who may wish to restrict their child’s activities (such as playing sports) out of concern for the child’s health. Dr Wan Jazilah, however, prefers to let the child try what he or she wants to do first, and both the parents and the healthcare team can make any necessary adjustments to the child’s routine based on the child’s ability to perform these activities.

What happens when the medications don’t work?

Unfortunately, there is a small possibility that a child may not respond well to prescribed medications.

When this happens, the paediatric nephrologist will take a step-wise approach, going down a list of appropriate medication options to select the next most suitable medication(s). Going down the list, the choice of medications becomes increasingly potent, more fraught with side effects and also more expensive.

“It all comes down to a balancing act,” Dr Wan Jazilah says. “We have to evaluate the benefits versus the risks very carefully, with the child’s safety always the top priority.”

She adds, “We will explain to the parents about the benefits of this stronger or more potent medication, as well as the potential side effects. It’s not an easy situation. On one hand, we want to treat the child but on the other hand, there may be side effects that will not go down well. The parents must agree before we can proceed with the stronger medication.”

What if the cost of medication is too high for my family?

Dr Wan Jazilah advises parents concerned about the cost of medication to consider sending their child to a government hospital, as medication is always free of charge there.


Important Tips for Parents

  • Children will never take their medications in front of their school friends, so make sure that your child takes his or her medications before going to school.
  • Some children may try to throw away their pills when their parents are not watching, so supervise your child and make sure that you see him or her take those medications.
  • Therefore, the best time for the child to take his or her medications would be in the morning (before school) and in the evening – times when someone would be at home to supervise the taking of these medications.
  • Next month, join us as Dr Wan Jazilah touches on the treatment options available for more serious cases: kidney transplant and dialysis.

”Sleepyhead, close your eyes, for I’m right beside you.

Guardian angels are near, so sleep without fear.”

Johannes Brahms, The Cradle Song

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