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Dear Doctor,
I have started potty training for my 2-year-old son. He is willing to sit on a potty (after much coaxing) but will always withhold his urine even when he has a full bladder. I even bought a boy's urinal for him to use but to no avail. I have stopped the training as he can withhold his urine for many hours when not on diaper. Please advise how I should potty train him. Thank you.
Dear Sandra,
It may be a good idea to ensure readiness for potty training before starting to ensure better success. For boys, most are ready to start at about 2 ½ - 3 years old.
Signs of readiness include:
The following may help:
Dear Anna,
My child is 8 months and 3 weeks old, and weighs 6.7 kg. He drinks 120 ml milk 4 times, plus 2 meals a day. However, his poo is dark green in colour, may I know if this is normal?
I would like to check is my child is underweight, and how to increase his intake of milk. I brought him to a dietitian but there is no improvement.
Dear Jane,
Based on the information you have provided, your son is below the 3rd percentile for weight-for-age based on the World Health Organisations' Child Growth Standards. Your physician is the best person to help you understand the clinical relevance of this observation.
The Health Promotion Board's recommends that toddlers between the ages of 7 - 12 months should drink about 750 ml of milk and consume 1 - 2 servings of rice and alternatives, ½ serving of fruit, ½ serving of vegetables and ½ serving of meat and alternatives. Keep a food diary of all that your child eats over a few days and review this with the attending physician. If your son is eating small volumes only, your physician may recommend a higher energy formula and, observe the growth outcome over time.
The color of a child's stool varies depending on the diet, normal physiological changes and due to health conditions. You may want to check the colour of the stool against the Diaper Decoder. Please discuss your concerns and findings with your child's physician.
Children will learn to eat enough to support normal growth and development. Some may need more support and encouragement than others to achieve adequate energy, protein and micronutrient intake. As a parent, you must continue to offer the right food and beverage options, but do not force feed.
We encourage you to follow-up closely with your child's physician and the healthcare team to help your child grow appropriately.
Dear Doctor,
My elder son is 29 months and suffers from frequent flu and cough. I am aware he is susceptible to flu and cough when placed in a childcare centre but he is practically falling sick for at least 2 times a month. Each cycle lasts for about 2 weeks. Is he having a weak constitution and will this affect him in his growing stages? I have started him on multi-vitamins, hoping to improve his immunity. What else can I do? He is unable to sleep through the night for few months already. He wakes up crying in the middle of the night for no reason. Will it affect his development if this continues?
My second son is 6 months old, and suffered at bad cough at the age of 2 months. Since then, he is prone to frequent bouts of cough. Will this affect his lungs in the long run?
Dear Clarie,
You are indeed right that your elder son is susceptible to frequent flu and cough especially since he is now attending childcare. It is also likely that each time he falls sick, he passes the germ to your younger son who may also have frequent coughing spells. Most of these infections are viral in origin, and they will recover uneventfully. However, the younger the child is, the higher chance of the virus spreading to the lungs. This may lead to an infection of the lungs also known as bronchiolitis. Children who have bronchiolitis may present with persistent fever, breathlessness, food refusal or persistent coughing. Do bring your sons to see your family doctor should any of them develop these symptoms. Although not common, frequent bronchiolitits in a toddler may have long term issues.
There are other medical conditions which can present with recurrent cough and rhinorrhoea. These includes allergic rhinitis (sensitive nose) or asthma (sensitive lungs). Should their symptoms persist, do bring them to your doctor to rule out these conditions.
Preventive measures which you might like to try include isolating your sons should they fall sick. This prevents them from passing the germ to the other. Supplements like vitamins might help. Do ensure that they eat well, and that they have enough rest each day. For your older son, consider shortening his hours at school (e.g. half day program) and try finding childcare centres with smaller groups of children, and are non-air conditioned.
Your older son's sleeping pattern may or may not be due to the symptoms of his recurrent infection. Some children may have interrupted sleeping pattern because of associated medical problems (e.g. ear infection). Often 2-3 year old children have disrupted sleeping pattern due to nightmares or dreams. If persistent, you might like to bring him to your doctor for a full evaluation.
Dear Doctor,
My son has just turned 18 months and refuses to chew his food. He recently grew 3 new teeth and one of his lower molars is growing out too. We know he can chew because he chews on biscuits, but he just swallows his food at mealtimes. His usual meals consist of pasta or thick porridge with minced vegetables and meat. I tried introducing textured food like bread, rice, and pancakes. He gags on such foods, spits them out and starts a crying episode. He has always been eating well, but these days, meal times are a struggle. I feel he is getting tired of his food, but how do I introduce new food to him when he refuses to chew? He choked once and I'm afraid it'll happen again. He has no history of reflux problems.
Dear Lee Ser,
If it is a simple problem with chewing only, it may be related to his teeth and an opinion from a paediatric dentist will help to exclude this as a contributory cause.
It appears however that your son also has problems with new foods of different textures and tastes associated with mealtime struggles, frequent crying, gaging and choking. In this instance, seeing a paediatric speech therapist for further assessment will help as the symptoms suggest possible oral defensiveness or oral sensitivity. The speech therapist will be able to make an assessment and recommend strategies for treatment and oral stimulation.
Dear Ms Yeo,
The doctor has informed me that my 3½ year-old-son has delays in development and speech. He has been in child care for 4 months, and I have been notified that he cannot sit still in class, not even for a minute, and is suspected of ADHD. He is alright at home, displaying the ability to follow instructions, or work on activities lasting 1.5 to 2 hours on a chair. He is attending speech and occupational therapy. I thought children who are afflicted with ADHD cannot stay still regardless the environments they are placed in.
I've reduced his milk intake. He eats 4 bowls of rice, with meat, vegetables, ikan bilis, with no snacks and junk food. Is this healthy? He used to eat bread but the diet's changed because bread contains gluten which makes him more hyper. He is better-behaved after the change in diet, but I do not understand why he is facing problems in school.
Dear Lizhen,
It is true that children with ADHD show difficulties in at least more than one setting (e.g. school, home or therapy centre). Having said that, children with ADHD can also display very good attention when they are doing something they like (e.g. watching television). There are many reasons why a child is inattentive in school. Often children with delayed development have poor attention and concentration and it may be due to the delayed language skills rather than an attention deficit. How is your child's sleep? Does he snore? Does he have any allergies, allergic rhinitis, enlarged tonsils? Children who have sleep problems can also affect their ability to pay attention in school.
Dear Ms Yeo,
I have 2 daughters, aged 3+ and 9 months. 3 months ago, my elder daughter has become defiant, always showing anger and an inability to focus in class. Many teachers have commented that she is unable to pay attention and is quite disruptive in class. At home, she purposely does things we tell not to, e.g. she spits out food and throws them across the table; screams on purpose to wake up the sleeping baby. Her favourite phrase when we scold/discipline her is "I don't want to talk to you" and "You don't love me, right". I am very concerned and would like to seek your advice - should I bring her to see a psychologist? Please advise me how to handle a defiant child and how to help her to manage her emotions better.
Dear Ko Chen,
It sounds like your daughter may be displaying some difficulties adjusting to having a sister. Try the following tips:
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