QUESTION 1

Dear Doctor,

My daughter is 4 and a half years old. For this past week, she has been going to the toilet at very frequent intervals. However, each time she urinates, it is only a small stream. I also noticed that she wets her pants unknowingly. I brought her to the doctor and he gave her some vaginal cream and wash saying that it could be a urine infection. Do we need to bring her for further tests?

Mrs Yeo
 

ANSWER:

Dear Mrs Yeo,
If her symptoms persist, you should bring her to your paediatrician for a full assessment. It would be useful to do a urine test to confirm if she has any urine infection, as well as an ultrasound scan of her kidneys and a bladder function test.

– Dr Lim Kwang Hsien

QUESTION 2

Dear Doctor,

Hand, Foot and Mouth Disease (HFMD) is becoming more and more common. However, in certain cases, it is hard to diagnose or confirm, especially in the early stages. What precautions should I take to protect myself and my child and is there a vaccination available?

Rina Lum
 

ANSWER:

Dear Rina,
Unfortunately, there is currently no vaccination against HFMD. As this illness is spread in communities of children, maintaining personal and environmental hygiene is the best way to prevent its spread. Some useful steps would be to wash toys regularly and to ensure that both the child and caregiver wash their hands regularly especially after going to the bathroom or changing diapers. It is also important for children who are sick or have symptoms of HFMD to be isolated from other children till they have fully recovered.

– Dr Lim Kwang Hsien

QUESTION 3

Dear Doctor,

My son is now 7 months old. He was born at 3.16kg but his weight increased rapidly to more than 6kg by the time he was 3 months old. Now, I believe his weight has hit 10kg. He is very chubby especially around the thighs and stomach. He was totally breastfed till 6 months of age when we introduced 1 serving of cereal to him during the day. Is this normal or is he growing too fast? Is there anything I can do? His father is European, by the way.

Janardhanan Manikandan
 

ANSWER:

Dear Janardhanan,
Your son has grown really well. Do not worry if he is feeding well and his developmental milestones are normal. Most babies’ weight gain will slow down after 6 months as they are taking less milk once they start their weaning diet (and thus less fat intake). They will also be more active and will burn up more calories. His European heritage may also make him a little bigger compared to Asian babies of the same age. However, if his growth does not slow down over the next 3-4 months, do bring him to your paediatrician for a full assessment.

– Dr Lim Kwang Hsien

QUESTION 4

Dear Doctor,

My son is 2 years old. I have noticed that he does not chew his food properly most of the time. Instead, he just swallows it. I am concerned whether he will get sufficient nutrition if he keeps swallowing food without chewing. I often observe that food materials such as corn and small carrot pieces appear in his stools. Does it mean that the food he’s eaten has not provided any nutrition to him?

Vivian Low
 

ANSWER:

Dear Vivian,
Do not worry about your son not chewing his food. This is rather common and will not impair his ability to digest his food. The food he eats will all enter the stomach where it will be mixed with acid and other digestive juices to break it down. This occurs to all food whether it is chewed or not. Once it becomes a slimy paste, the stomach will slowly empty the food into the intestine where it will be further broken down, digested and absorbed. Nutrients from foods like carrots, corn, fibrous vegetables and fruits will be absorbed by the body while the fibrous components of these foods (which have no nutritional value but are essential for healthy bowel habits) will be expelled by the body via the faeces.

– Dr Lim Kwang Hsien

QUESTION 5

Dear Doctor,

My 5-year old boy has been diagnosed with thalassaemia. Are there any special precautions we should take especially in terms of diet? He is a very picky eater and doesn’t eat meat (unless very finely minced), vegetables (except spinach) or fruits. Will his condition affect his growth? Is there a need for my husband and me to undergo a test for thalassaemia? Any advice would be deeply appreciated.

Vivian
 

ANSWER:

Dear Vivian,
I presume that your son has been diagnosed with thalassaemia minor. This means that although he carries the thalassaemia gene, his blood levels are normal. Children who are thalassaemia minor will grow just like any other child and do not need any special diet. It would be a good idea for your husband and yourself to undergo a test for thalassaemia especially if you are planning to have more children. In the event that your husband and yourself each carry the same thalassaemia gene (i.e. you are both thalassaemia minors too), then there is a possibility of you having a child who is thalassaemia major. Unlike thalassaemia minor, children affected with thalassaemia major will have very low blood counts, and may need a regular blood transfusion each month.

You can obtain more information about thalassaemia from the National Thalassaemia Registry located at KKH Children Hospital (refer to Childhood Illnesses). Do give them a call if you need any further information or if you want to be tested for the thalassaemia gene.

– Dr Lim Kwang Hsien