THE STAR, FRIDAY 20 NOVEMBER 2020
CHILDREN’S DAY
Parenting tips for newborns
“OVERWHELMED” is a word that is often
used by new parents when they first bring
their little ones home from the hospital.
The main reason for this is because parents
would often get their information online,
from friends, their parents or the antenatal
classes that they attended. They have
plenty of information and it’s typically a lot
to process.
ParkCity Medical Centre consultant
paediatrician Dr Lai Eng Meng shares that
on top of all the information available,
there are four main areas of concern.
“What I often tell new parents when they
first bring home their little one is that they
have to go back and pay attention to the
basics – the sleeping, the peeing, the
pooping and the feeding,” he says.
It is natural to be anxious about
handling a newborn. However, in a few
short weeks, first-time parents would have
developed a routine to be confident at it.
Dr Lai urges all new parents to seek the
help of a paediatrician or nurse should
Sleep
Good sleep is essential to a baby’s
overall health, cognitive ability and
mood. However, parents would also
need to pay special attention to their
newborn when he sleeps. Dr Lai
recommends, “Take note of the baby’s
sleep cycle and his sleeping positions. A
newborn baby’s sleep cycle should
follow the feeding cycles, meaning that
every two to three hours, he should be
woken up, fed, burped and put back to
sleep again for another two to three
hours even throughout the night.”
Besides that, parents must pay close
attention to the sleeping position they
place their baby in. Always put a baby
on his back for every sleep, whether day
or night. The reason behind this is to
avoid sudden infant death syndrome in
which a baby suffocates. The best way
to make sure that a baby sleeps on his
back is to do it from the start for the
first few months. Only once the baby
has learnt to roll over (around four to
five months) should sleeping on the
tummy be fine. “It is important not to
share a bed with a newborn, and
instead get a cot for the baby to sleep in.
This is because there have been
instances where babies suffocate when
placed in between their parents. Parents
must also not let their babies sleep in a
Passing stools
A baby’s bowel movements can also
be indicators of his health – hence,
paying attention to the frequency,
consistency, smell, texture and colour is
important. Parents would want to
ensure that their baby passes his bowel
movement every day. For the first few
days, a baby’s faeces would be black and
sticky, which is known as meconium
stool. After three to four days, the faeces
would start to change colour from black
to dark green; and later around five to
seven days, they’ll change to a golden
yellow colour. “Parents must pay
attention to this because if there is blood
in the stool, or if it is any colour other
than these three mentioned, they should
alert their doctor,” cautions Dr Lai.
Regarding the consistency of a baby’s
stool, Dr Lai says parents know their
child best and would be able to
Dr Lai Eng Meng.
they have any concerns.
n For more information, call 03-6279 3111
or 03-5639 1212.
swing bed at all because there have been
scenarios where babies develop shaken
baby syndrome and they have bleeding
inside the brain,” notes Dr Lai.
On comforting techniques for a
newborn, Dr Lai says, “Try swaddling
the child. Think of it this way, the baby
has been inside his mother’s womb all
this while and he isn’t used to open
space. So, a blanket wrapped around
him simulates the mother’s womb and
psychologically helps to calm him down.
Another way to comfort a baby is to try
singing to him so that he can listen to the
voices of his mother and father. Also,
dim the lights in the baby’s room – but
let some daylight stream through open
curtains so that he gets used to the
sunlight and night time, developing a
circadian rhythm.
determine what the normal consistency
is. However, if the stool is too hard or too
soft, it means that something isn’t right.
Additionally, having bowel movements
two to six times a day is normal, but it is
not normal if a baby passes motion more
than 10 times a day.
Feeding
Doctors always encourage parents to
breastfeed and to always burp their
baby. Before going home with the baby,
the doctors will teach parents how to
breastfeed, the position in which they
should breastfeed, as well as the
frequency (every two to three hours)
and quantity. Keep in mind that
breastfeeding mothers should drink
plenty of liquid to have good milk
production. If they are struggling with
producing milk, they shouldn’t be
stressed out about it as they can always
speak to their doctor to help figure out
the best solution.
As an indicator, mothers who wish to
express their breast milk should take
note on the quantity when feeding their
baby:
l Newborn full-term baby – Around
two ounces/60ml every feeding
l One month old – Around three
Passing urine
Dr Lai says parents should also be
focusing on their baby’s urine. “It sounds
like a minor topic, but there is a lot of
insight to get when paying attention to a
baby’s excretion. Things to pay attention
to include the smell, quantity and, if it’s a
boy, the urine stream,” he elaborates. If a
newborn baby drinks plenty of milk and
is well hydrated, then he should be fully
soaking four to six diapers a day. If he
pees less than this, it is recommended for
parents to increase the frequency and
quantity of the baby’s feed. Four to six
fully soaked diapers are an indication
that a baby is well hydrated.
The next thing to pay attention to
regarding a baby’s urine is the colour. If
a baby is drinking enough, his urine
would be clear or a little yellow.
However, if a baby’s urine is noticeably
getting more concentrated with darker
yellow and tea-like colours, he may be
dehydrated and parents should thus feed
him more. Another thing to look out for
is any pinkish stains on the diaper. If it
isn’t blood, then the stain could be due to
a condition called urate crystals – which
ounces/90ml every
feeding
l Two months
old – Around four
ounces/120ml every
feeding
Always remember to give extra
feedings on the baby’s demand.
Moreover, frozen and refrigerated breast
milk usually have an expiration date.
When reheating frozen milk to feed a
baby, Dr Lai advises parents to heat the
milk to body temperature (around 37°C).
“It’s important for fathers to
participate in the feeding process as well
– whether it’s with burping the baby, or
topping up the baby’s feed with
expressed breast milk – because this
can help reduce the tension and stress
that may be felt by mothers,” encourages
Dr Lai.
is another signal that the baby hasn’t
been drinking enough.
Moreover, the smell of a baby’s urine
could be an indicator of something
amiss. According to Dr Lai, parents
usually get used to the normal scent of
their baby. If they notice an odd smell
when changing diapers, it could be a
possible infection and they should
consult their paediatrician.
Where baby boys are concerned, the
urine stream is very important. When
possible, Dr Lai suggests for parents to
observe the stream. A good stream is a
sign of healthy urine flow. However, if
there is a weak stream (dribbling from
the urethra), this could be an
indication of phimosis
which is when the
baby’s foreskin is
unable to retract
yet. If parents
have this
concern, they
should discuss
the matter with
their paediatrician.
THE STAR, FRIDAY 20 NOVEMBER 2020 5
6 Children’s Day
CHILDHOOD obesity has reached
epidemic levels. Overweight and
obesity issues among children are
known to have a significant impact
on both physical and psychological
health, and it is all the more
concerning when it is happening
right here in our backyard.
“The condition of childhood
obesity occurs when there is
excessive accumulation of fat in
the body of a child that leads to the
impairment of his health and well-
being. This is dangerous because it
is associated with many risk
factors that are damaging to
various parts of the body,” says Dr
Wu Loo Ling, consultant
paediatrician and endocrinologist
at Subang Jaya Medical Centre.
While many parents would
think that the excess weight sheds
with age, that isn’t entirely true.
Overweight and obese children are
likely to stay obese into adulthood,
and are more likely to develop
non-communicable diseases such
as diabetes and cardiovascular
diseases at a younger age.
Contributing factors
There are many factors that can
contribute to childhood obesity,
shares Dr Wu.
“To understand who is most at
risk, we must first understand
what the causes of childhood
obesity are. There are both
modifiable and non-modifiable
causes. The non-modifiable factors
can include genetics or underlying
illnesses, while the modifiable
factors are related to an
individual’s lifestyle,” she explains.
Genetics, understandably being
a non-modifiable factor, places a
child at a higher risk of becoming
obese. If the child has one obese
parent, then there is a 50% chance
that he will also live with obesity,
as compared to an 80% chance if
both parents are obese.
There are other modifiable
factors contributing to excessive
weight gain in childhood such as
underlying illnesses, hormonal
disorders, diseases of the
hypothalamus, and not forgetting,
excessive consumption of steroids.
This happens when the child has
prolonged use of steroids, whether
by injection, orally, inhaled or
topical for an underlying illness,
or when the body is producing
excessive steroid (which is a
medical condition that requires
urgent medical attention).
Besides that, some babies that
are born with some form of
syndromic disorder also tend to
be overweight.
However, according to Dr Wu,
Cause for concern
As of 2016, the World Health
Organization (WHO) estimated
that 41 million children all
over the world below the age
of five are either overweight,
or obese. On a more alarming
note, WHO reported that
nearly half of these children
are living in Asia.
The prevalence of
overweight and obesity cases is
rising and among the South-
East Asian region, Malaysia
ranked as No.1 with a study by
the South East Asian Nutrition
Survey showing that in 2011,
21.6% of Malaysians aged six
months to 12 years were either
obese (11.8%), or overweight
(9.8%). What is even more
worrying is that the National
Health and Morbidity Survey
2019 showed that among
children aged five to 17, 29.8%
were either obese (14.8%), or
overweight (15%).
Weighing in on the health
risks of overweight children
Overweight and obese children are likely to stay obese into adulthood, and are more likely to develop
non-communicable diseases.
the main contributing factor of
childhood obesity is lifestyle. She
emphasises, “The kinds and
quantity of food, the eating habits,
the types of drinks consumed and a
lack of physical activity all play a
role in making a child obese.”
Obesity and being overweight are
generally assumed to be the result
of an increase in caloric and fat
intake. On the other hand, there are
supporting evidence that excessive
sugar intake via soft drinks,
increased portion sizes and a steady
decline in physical activity have
been playing major roles in the
rising rates of obesity not only in
Malaysia, but all around the world.
Starting them young
It is fundamental that parents
understand their role in
!
With the rising prevalence of
this disorder, environmental
factors, lifestyle preferences
and cultural environment play
pivotal roles. Childhood obesity
can profoundly affect
children’s physical health,
social and emotional well-
being, and self-esteem. It is also
associated with poor academic
performance and a lower
quality of life. Many co-morbid
conditions like metabolic,
cardiovascular, orthopaedic,
neurological, hepatic,
pulmonary and renal disorders
are also seen in association
with childhood obesity.
determining whether their kids
will grow up with weight issues.
Dr Wu notes that this can start
even before the child is born. Poor
antenatal care is one of the
reasons that babies are born with
a higher tendency of becoming
obese. Overweight mothers
during pregnancy tend to produce
large babies and obese children.
Babies born small for gestational
age are also at risk of being
overweight or obese later in life
due to insulin resistance. “The
notion that a woman is eating for
two when she is pregnant is
wrong. While mothers should
have good quality food, there
should not be any increment in
the quantity of food,” she says.
She also encourages mothers to
feed their child breast milk for up
to two years as that is still the best
food for a growing baby.
During childhood, constantly
spoiling a child with his favourite
When given the choice, children are more likely to pick foods that are
rich in sugars or fat. Parents need to set an example and help their child
live a healthy fulfilling life.
food is damaging too. If parents
give children the choice of what
food they wish to eat, they would
typically make the wrong food
choices. Often, they pick the
foods that they like to eat which
happen to be very rich in sugars
and fat. Besides that, children
tend to lead more sedentary lives
these days, spending more time
in front of the television, playing
computer games, doing
homework or having their days
filled with tuition. If an
individual leads a life without
much activity, and doesn’t burn
off the energy and excess calories,
he will have a higher tendency of
developing obesity.
In most cases, parents become
too complacent and comfortable
with where they are. They play
down the seriousness of the issue
and would not admit that their
child is overweight, or obese.
They avoid using the word
THE STAR, FRIDAY 20 NOVEMBER 2020
Dr Wu Loo Ling.
It is vital that parents
understand that
obesity is a disease,
and that childhood
obesity tends to track
on and remain very
stable, continuing on
into adult obesity.
Treatment of obesity
is very difficult and
often a frustrating
uphill journey.
“obese”, instead they refer to the
child as big-sized or heavy-boned.
The first step to overcoming any
issue is to admit that there is an
issue in the first place.
There needs to be a paradigm
shift in the minds of parents. A lot
of parents themselves are
overweight, and are poor role
models for their children.
“Children tend to observe their
parents and imitate them. So, if a
parent doesn’t practise a healthy
lifestyle, chances are, the child will
do the same,” says Dr Wu.
Therefore, parents need to set
an example and help their child
live a healthy fulfilling life. “They
need to make sure that their child
develops the right discipline in
eating habits and exercising so
that in the long run, he will be
able to make the decision to eat
the right food and make the right
choices regarding his health,”
elaborates Dr Wu.
“It is vital that parents
understand that obesity is a
disease, and that childhood
obesity tends to track on and
remain very stable, continuing on
into adult obesity. Treatment of
obesity is very difficult and often a
frustrating uphill journey. It needs
a lot of endurance and family
participation,” she says.
Her advice to parents is to start
their children on the path to
healthy living from a young age.
Make it a point to spend time
together exercising daily for at
least 30 to 60 minutes, as well as
having family meals. Her
reasoning behind it all is that it
sets the foundation for children to
lead a healthy life, one that they
are more likely to carry on doing
as they age.
n For more information, call
03-5639 1212.
THE STAR, FRIDAY 20 NOVEMBER 2020 7