QUESTION 1

Dear Doctor,

I am diabetic and currently 34 weeks pregnant. I would like to know if it is advisable for me to breastfeed my baby. Will breastfeeding increase her chances of becoming diabetic?

Sally
 

ANSWER:

Dear Sally,
You can definitely go ahead with breastfeeding and your diabetes should not compromise that at all. However, your diabetes control remains very important even during this period of breastfeeding. If you are unable to keep to blood sugar targets without medication, you will need to continue with insulin, just as you did during pregnancy.

Her chances of getting diabetes are determined by your husband’s genes and yours and also only later in life. Therefore her risks are higher if both you and your husband have diabetes. However, she can still help prevent its onset by leading a healthy lifestyle through keeping an ideal body weight (not being overweight) and regular exercise.

– Dr Kevin Tan

QUESTION 2

Dear Doctor,

My sister is 43 years old and overweight (95kg and 1.65m tall). She has a thyroid disorder and is taking Thyrozol (2x2mg) and Euthyrox (100mg) daily. Her weight seems to be increasing at an alarming rate. Please advise.

Woo Choy Yeok
 

ANSWER:

Dear Choy Yeok,
Your sister has an overactive thyroid gland (hyperthyroidism) and is on treatment for it. She needs to understand that before treatment, with her overactive condition, her metabolism was very high. She probably could eat anything she wanted with little exercise and still not gain weight. In fact, a lot of people find out that they have hyperthyroidism because of a large amount of weight lost.

However, now that she is being treated, her metabolism is very much lower than it was previously. The idea is that if she were to continue with her previous lifestyle, she would naturally gain a lot of weight. To avoid this, she should start eating less and exercising more, especially when she begins to feel better.

The balance between the two types of medication is also very important. Thyrozol blocks the production of thyroid hormones from the thyroid gland and Euthyrox is the thyroid hormone (T4) itself. The thyroid hormone levels in the blood should be maintained at ‘not-too-low’ levels to prevent weight gain.

She should discuss this with her doctor and not stop any medication.

– Dr Kevin Tan

QUESTION 3

Dear Doctor,

My child is 3 years old and is currently in a childcare centre. She is prone to catching colds and coughs from her schoolmates. What can I do to strengthen her immune system?

Jolin How
 

ANSWER:

Dear Jolin,
It is very common for children to fall sick when they start attending childcare centres. This is because they are constantly exposed to new viruses through close contact with other children. Each time she catches a viral infection, she builds up her immunity to that virus. As time goes by, her immune system will learn how to fight more and more viruses.

Some steps you can take to help her strengthen her immune system include:

1. Feed your child well especially with fresh food

2. Give her vitamin supplements especially Vitamin C and Zinc

3. Avoid school if there is an outbreak of diseases like hand foot mouth disease

4. Choose a school with fewer children

5. Choose a half day programme instead of a full day school

6. Consider yearly vaccination against the influenza virus

7. Keep your child at home to rest if she is unwell

– Dr Lim Kwang Hsien

QUESTION 4

Dear Doctor,

My daughter will be 3 years old in April. At the moment, her speech is still slow and she has difficulty in expressing herself vocally, especially when she is excited. We enrolled her in a playgroup about a year ago in the hope that interaction with other kids would help her improve. Is her speech development normal or delayed?

Jamie Ng
 

ANSWER:

Dear Jamie,
A three-year-old child should have a vocabulary of 200-300 words and should be able to combine words to form simple sentences. She should be able to repeat nursery rhymes and songs. Most kids would be able to express their thoughts in sentences and some may even make up stories. Interaction with other children during this period is very important as it teaches them social skills as well as stimulates their speech development.

The best person to determine if Camille has a speech delay would actually be her teacher. If she indeed has some speech delay, do bring her to your paediatrician for a formal assessment. She might benefit from a repeat hearing test to ensure that she is able to hear well. Early intervention from a speech therapist could also help.

– Dr Lim Kwang Hsien