Q&A

Alison Chee, a Singaporemom asks:

Q: I am just wondering whether it's true that the antibodies from breastmilk reduces once a child reaches 6 months of age. I am currently TBF my child and also giving him semi-solids twice a day. I usually give him Frisocrem Rice Cereal plus some pureed fruits. I am going slow on these semi-solids and not introducing him to too many new foods for fear of allergic reactions. Please also advice which are good starter foods for my baby?

A: Protective antibodies from the mother are transmitted through the placenta to the baby and these generally last till about 3 months of age, after which it will decline. Usually by 6 months of age, there will be practically no more protection from the mother. There are some enzymes and protective antibodies that are passed through the breast milk that helps boost the immunity of the child.

Breast feeding is good for the baby but by about 6 months of age, weaning should be started as breast milk alone is insufficient for optimum growth. One should start with something less allergenic and rice cereal is a material to start of with. As the baby will eventually need to take solids, it would be good to make the cereal into a paste form and feed from a spoon so that baby starts to get used to the spoon.

It is good that you are going slowly on the weaning process. You should allow the baby to get used to the rice (or the new food), before starting on another new food. If he likes the rice and is happy with it, you can add onto the rice another vegetable like carrot/potato/ pumpkin. It is advisable to let the baby adjust to the new food before starting anything new. This way, if baby reacts to the new food, you would know which food it is that he is sensitive to. There is no hard and fast rule as to which food one should go to. Generally, one would wean to vegetables and fruit first before starting out on the meats.

Dr June Lou,
MBBS (S'pore), M. Med (Paediatrics) FRACP,
FRCPE, FRCPCH, FAMS
Consultant Paediatrician
Ovspring Developmental Clinic, Singapore
http://www.ovspring.com

-------------------------------
Janice Lye, a Singaporemom asks:

Q: Hi, I’m the mother of Terris Heng Junyang, who was born in 21 Sept 2003. He is my first child. My boy has only started to said “Apple” sometime during the last few week. Even then, he can't pronounce the word clearly - and it sounds like "app….ple!" Also he not as sociable as other kids. Please give me some advice.

A: Terris would be about 20 months now. He should be able to say some single words by now. Sometimes, the articulation may not be very accurate as he is only just starting to talk. Speak to him slowly, pronouncing your words carefully and watch how he develops over the next couple of months.

You have not mentioned how many words he can say or he can only say “apple”? He should have a vocabulary of at least 10 to 20 words or more and by 2 years, he should be able to put 2 words together. However, there is range to this and his development should be looked at holistically. You mentioned that he is not as sociable as other children. If he likes to play by himself and does not play with other children, is interested only in his own things and a few toys, does not communicate with you or the family, then you should seek medical advice.

Dr June Lou,
MBBS (S'pore), M. Med (Paediatrics) FRACP,
FRCPE, FRCPCH, FAMS
Consultant Paediatrician
Ovspring Developmental Clinic, Singapore
http://www.ovspring.com

-------------------------------
Lum Mei Peng Sharon, a Singaporemom asks:

Q: My daughter was diagnosed with reflux at about 3 months plus and has been on Enfalac AR since then. She was previously on NAN 1. She has just turned 5 months last week and her pediatrician told us to slowly switch her to Enfalac A+. But when we do so, she will cry and refused to finish her milk. She does this even when I only put half a scoop of A+ into her AR formula. She even vomited a bit once. I thus have the following questions on her milk intake:

1: Is it ok to be on Enfalac AR for so long?
2: Is Enfalac AR less nutritious than Enfalac A+? If yes, how can we supplement her loss of nutrition?
3: She currently drinks 4 to 5 times a day and each time about 150-210 ml. Is her drinking volume too low? And is the range too wide?
4: The American calculation of standard milk intake is 2.5 ounce multiply by per pound in weight. Is there a different calculation for Asian babies?

A: BY about 6 months of age, baby is starting to be weaned. The reason for this is that baby needs more nutrition than breast milk itself can support. Early infant formulas are prepared based on the breast milk and so the milk companies have increased the protein content to enhance the growth of the baby. However, there are some fussy babies who may not like the taste of the new formula and hence reject it. There is no strict rule that you must change the formula at 6 months. You can start trying to change but this may take time, and I think this is what you are finding. There is no harm in continuing Enfalac AR beyond 6 months. However, you should also start to wean baby to solids to improve the nutrition to her.

At the age of 6 months, a baby would require 100 to 120ml per kg of milk per day. So long as the baby is growing nicely, and you can follow this on her growth chart. The key is to see that she is happy and contented with her feeds. Watch her growth and development and enjoy your baby.

Dr June Lou,
MBBS (S'pore), M. Med (Paediatrics) FRACP,
FRCPE, FRCPCH, FAMS
Consultant Paediatrician
Ovspring Developmental Clinic, Singapore
http://www.ovspring.com

-------------------------------
Venus Chia, a Singaporemom asks:

Q: I breastfed my baby boy partially until he reached 5 mths of age. All this while, I was supplementing his diet with formula milk, S26 Gold. After I started to gradually switch to formula milk and introduced rice cereal, he started to constipate and the stool is green in colour.. Is this due to the formula milk or rice cereal?

A: The green color in the stool comes from the fat that is present in the formula. If the stool is of a normal consistency but is green, the stool is normal and this is coming from the milk formula.

Dr June Lou,
MBBS (S'pore), M. Med (Paediatrics) FRACP,
FRCPE, FRCPCH, FAMS
Consultant Paediatrician
Ovspring Developmental Clinic, Singapore
http://www.ovspring.com