Benefits of Infant Massage & Hydrotherapy From Birth

Infant Massage Course For Parents and Baby

The benefits of infant massage have been enjoyed in other cultures for centuries, and now parents in Sabah can learn the techniques to help their babies enjoy this gift of loving touch as well. Learning infant massage is made easy with a certified infant massage instructor to guide you through each stroke diligently until you are confident in using these simple techniques.

Baby massage in Little Penyu is usually taught in a small group setting, or alternatively, parents can opt for a private individual session in Little Penyu or at the comfort of your home. Each session will run over a course of 4-5 weeks period (once a week), so that parents can learn the strokes gradually and to allow babies time to adjust to being massaged.

*Little Penyu infant massage instructors are experienced and they are Certified Infant Massage Instructors with the International Association of Infant Massage.

BENEFITS of INFANT MASSAGE
- Assist to relieve gas, colic, constipation or teething pain and Improve sleep patterns.
- Reduce stress hormones and promotes happy hormones especially in lactating mothers.
- Increased flexibility and muscle tone.
- Promoting bonding, secure attachment, feelings of love, respect and being valued.

Kids SPA

With Kids Spa, the adventure begins with a warm feet soak, a gentle homemade feet scrub, a yummy chocolate/honey homemade face mask, manicure & pedicure (Mermaid) / nail trimming (His Royal Highness) and a fun 15-20 minutes of jacuzzi time!

Hydrotherapy From Birth

Finding ways to effectively bondwith your baby can be challenging especially for busy working parents. When you do have time, there is only so much you can do especially with babies who are in their pre-crawling stage. This is where Little Penyu comes in. Little Penyu Baby Swim Spa is the first baby swim spa in Sabah providing indoor hydrotherapy (floatation and exercise in water) and swimming service for babies as early as 0 month without the risk of harsh chlorinated water and the outdoor elements.

Water therapy from birth is fantastic for baby’s brain health and physical development even before they start crawling. It utilizes their whole body movement and also assists baby to sleep and eat better. In each hydrotherapy session, the more your baby uses his/her brain and muscles, the stronger they will grow.

As your baby kicks around in the water, the small rocking waves he/ she creates will help to improve their balance and coordination and, ultimately, support their ability to crawl, walk and swim. Even if your baby falls asleep in the water, that rocking motion will continue with his/her rhythmic breathing.

Nurturing bonds especially for busy parents is important for us. At Little Penyu, every parent is encouraged to be hands on; from the baby warm up session to dressing them up. Our trained physiotherapist will guide and demonstrate every movement to make sure it is done safely and correctly.

BENEFITS of HYDROTHERAPY
- Muscular and skeletal strength is increased through the water’s gentle resistance.
- Subtle water pressure on the chest can increase lung capacity by strengthening intercostal muscles and the respiratory system.
- Regular visits can benefit the cardiovascular system.
- Innate swimming reflexes are stimulated and co-ordination is developed as they learn to control their movements.

Little Penyu Baby Swim Spa, 
Lot J-1-5, 1st Floor, Block J, (In Front of Lucy's Kitchen),
Lorong Metro Town, Jalan Bunga Ulam Raja,
88300 Kota Kinabalu, Sabah.

For enquiries, please call 088-383 639 or visit www.littlepenyu.com today. Follow them on Facebook!

Can Your Baby Hear?

CAN YOUR BABY HEAR?

By Dr. Gavin Coad | Audiologist | Jesselton Medical Centre


Most children hear from birth, they learn to talk by imitating the sounds around them and the voices of their family. It is very difficult for parents to notice hearing loss in their baby, often the child is using their other senses to know what is going on around them. Only when the child does not develop speech do parents usually start to worry.

I often see children in clinic at around 3 years of age with speech delay, these parents have similar stories of a family member that was late to start talking so they thought everything would be fine.

Unfortunately, it is very hard for these children to catch up on this lost time and development. The first 2 or 3 years of life are critical for brain development; it is very important that a child has access to language very early in life. If a child is left too long with an undiagnosed hearing loss it will lead to delay in cognitive and language development in early childhood and to difficulties at school.

Research suggests that children with hearing loss who get help early develop better language skills than those who do not. Early detection with newborn hearing screening is essential in order to prevent language delays.

On average about 2 or 3 out of every 1000 babies are born with hearing loss, making it the one of the most common birth defects. The World Health Organisation recommends all babies have their hearing screened before they are a one month old, diagnosed by 3 months and receive intervention services by 6 months of age.

WHAT IS THE SCREENING TEST?

Two types of hearing screening tests are used:

1. Otoacoustic Emissions (OAE)
2. Auditory Brainstem Response (ABR).
Each test takes around five minutes and will not cause your baby any pain. Many babies sleep through the screening.


WHAT HAPPENS IF MY BABY FAILS THE TEST?

If your baby fails the hearing screening test, it does not necessarily mean that she has any hearing loss, but it does mean that more testing is required. It’s important that your baby has a repeat screen within 1 or 2 weeks of the failed test.

Babies sometimes fail the first test because they have ear wax in the ear canal, or fluid in the middle ear, or because they were too noisy during the test (crying or restless).

Many babies who fail the first screening go on to pass follow-up testing. Typically, if a baby does not pass the hearing screening tests, she will be referred to an audiologist to do more complete tests to find out whether it does have hearing loss. If you are not sure if you baby has had their hearing tested ask your doctor or see an audiologist for a hearing test.


LIST OF SERVICES OFFERED BY JESSELTON MEDICAL CENTRE AUDIOLOGY DEPARTMENT

1. Full Range of Hearing Tests -
Children and Adults (VRA, CPA, OAE, CPA, Tympanometry and AR)

2. Hearing Aids – Children and Adults
(with REM)

3. Tinnitus Assessment

4. Auditory Brainstem Response (ABR) –
Natural sleep or under sedation.

We are the only private centre providing this full range of tests in Sabah. For more information, please call 088-366 333.

Jesselton Medical Centre

Jalan Metro 2, Metro Town, Off Jalan Lintas, 88300 Kota Kinabalu, Sabah, Malaysia.
Tel: +6088 366333
Emergency Hotline (24x7): +6088 366399
GPS: 5.975581°N, 116.112438°E

Website: www.jmc.my/
Follow them on Facebook!

Sex and Pregnancy

By Dr. Alagammai Ramanathan | Consultant Obstetric & Gynaecologist
Gleneagles Kota Kinabalu Hospital (Tel: 088-518 888)

Sex is considered a taboo subject especially for Asian community. Both women and men are just too shy to bring the subject up for discussion and hence do not get accurate information on this subject be it.

Most women wait at least six to eight weeks after giving birth to have sex again, according to a new study published in BJOG: An International Journal of Obstetrics and Gynaecology. It may also be the absolute last thing in your mind especially while you are dealing with nausea and vomiting and later on with the baby, breast feeding and diaper changings through the night.

Most women avoid sex during pregnancy for the fear of losing the baby. It is good to take time and
discuss it with your partner as intimacy is an important part in life. Other women, however, may crave sex in pregnancy. And men, too, are split into different groups regarding sex during pregnancy. Some men may find nothing sexier than a pregnant woman, but other men may be too afraid of hurting the baby. But desire aside, is sex during pregnancy even safe?

Can I have sex during pregnancy?

A lot of times the male partners are more frightened to have sex than the women. In most cases, sex is 100% safe for mom and baby. During the first trimester most women needs to deal with nausea, vomiting and hormonal changes to the body so sex may be the last thing in your mind. During the second trimester women most feel better, there is more lubrication, and have engorgement in the genital area and the tummy is not so rounded yet. This is usually the best time.

As for third trimester the stomach grows and it becomes more tiring, sex may seem less attractive- not to mention physically difficult during the final weeks of pregnancy. There are some exceptions, which your gyny doctor will warn you about. Among other issues is, if you have an incompetent (or weakened) cervix, unexplained bleeding, diagnosed with placenta previa, frequent premature contractions with no known cause or rupture of the amniotic membranes. The best will be to discuss with your gyny doctor along with your partner. It is important for both partners to be there during this session.

Sex can hurt the baby?

Babies are well cushioned. Below the skin is our fat layer, followed by muscles, thick uterine muscles, amniotic fluid only then the baby. As there is water surrounding the baby, it is well cushioned and most movements do not harm the baby. So go ahead! babies are very safe inside the womb and the jolt will not affect the baby.

Can infection occur due to sex?

Well from below the cervix is closed and it has a mucous plug to seal and hence infection does not enter into the cavity. So it is safe. Same goes for swimming, it is ok to swim during pregnancy, the water does not enter the vagina and into the uterus and harm the baby, so there is no need to change your lifestyle. In fact swimming is a good form for exercise during pregnancy.

Can I develop contractions during sex and will that lead to delivery prematurely?

If you start cramping after sex, don’t jump. An hour or two of mild cramps isn’t unusual because both orgasm and the prostaglandins in semen can cause uterine contractions. Increased blood flow and congestion makes blood vessels more fragile on the cervix surface, and they may bleed a bit if
your partner’s penis rubs against the cervix.

However, heavy bleeding warrants call to your gyny because the placenta could be breaking away from the uterus and other causes needs to be looked into for example a cervical growth. But don’t worry - it’s all unlikely to happen. Having an orgasm causes the release of prostaglandins, which can theoretically cause contractions, unfortunately never been completely validated in scientific studies. Does it work? Well...if you’re ready to deliver, a little sex might jump-start the process.

Sexual positions during pregnancy.

This is by far the most difficult question to answer. Well usually what is good and comfortable for the baby is good and comfortable for you. The traditional man-on-top position is more uncomfortable for pregnant women and in the 3rd trimester it is not advisable for women to be flat on the back as the pregnancy can compress the blood vessels and cause a little fall in the blood pressure.

If possible avoid oral sex as bowing air into the vagina may predispose to air embolism though it is very rare.

You can have satisfying sex when pregnancy. You will need to find the most comfortable position, it is the time to explore and experiment together. Communication and openness are the keys to maintaining or improving sexual satisfaction during your pregnancy.

Riverson@Sembulan Block A-1, 
Lorong Riverson@Sembulan, 
88100 Kota Kinabalu, Malaysia
Tel: 088-518 888 
Website: www.gleneagleskk.com.my
Facebook: Gleneagles Kota Kinabalu
EMERGENCY 088-518 911

Pregnant Women Should Not Travel to These Countries

The Centers for Disease Control and Prevention (CDC) have issued an alert for travel to countries and regions experiencing Zika virus outbreaks.

Some of these countries include Mexico, Brazil, Colombia, Guatemala, Puerto Rico, Venezuela, Thailand and the Philippines. (View the full list here.)

Recent reports from Brazil indicate that the virus, which is spread to humans through mosquito bites, is responsible for a birth defect that causes babies to have abnormally small heads. Expectant mothers infected with Zika virus while pregnant have given birth to infants with microcephaly, a condition defined by abnormal cerebrums and improperly developed brains, WSBTV reports.

Centers for Disease Control and Prevention

The CDC advises  all travelers to countries where the virus is ongoing to take precautions to avoid mosquito bites: wearing long sleeves and pants, using insect repellent, and sleeping under mosquito nets. The organization also recommends the following precautions specifically for pregnant women:

Consider postponing travel to the areas where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctor or other healthcare provider first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant, or who are thinking about becoming pregnant should consult with their healthcare provider before traveling to these areas.

The Zika virus has been linked to one U.S. case of the birth defect, according to the Hawaii State Department of Health. At this time, there is no medication to prevent or treat Zika.

Areas with Zika, click HERE.

For more information regarding this topic, please visit Centers for Disease Control and Prevention website HERE.

Skin Care For Tiny Tots

What is the BEST practice?

By Dr. Joanne Lee Guey Feng
Consultant Paediatrician & Lactation Specialist
KPJ Sabah Specialist Hospital | Tel: 088-211 333

For most parents whom I came across, have different ideologies in caring for the delicate skin of their
newborn babies. For some new parents, bathing a baby can be a huge task with lots of ‘EXCITEMENT’ and ‘ANXIETY’ (more so if you have to bath a crying baby in a tub of water, who is just a few days old). How stressful! What a struggle!

Parents Frequently Asked Questions (FAQ) would be:
• Does a newborn baby who has just delivered truly need a shower? Do they need a bath time after coming out from labour room?
• Must you bath your young baby every day?
• How many times do you need to shower your baby in a day?
• Can I use plain water to clean them? Or must I use a baby shampoo/ body cleanser?

Surprisingly, the approach to skin care for newborn babies has created some confusion among neonatal staff from 9 nurseries in United Kingdom, and even in our local setting among the confinement ladies of Sabah. So, what is the best practice that we can refer to?

World Health Organization (WHO) and National Institute for Health and Clinical Effectiveness (NIH) published a statement in 2006 with recomendations for the issue of caring for the newborn skin.

Below are the guidelines adapted by North Trent Neonatal Network, United Kingdom:

1. Leave Vernix Caseosa to absorb into the skin. Do not rub it off.
2. Only bath a baby when he/ she is physiological stable.
3. If necessary, bath a ‘well’ baby when his/her temperature has been within an acceptable range for 2-4 hours after delivery, but preferably delay the first bath until the second or third day of life to assist with skin maturation.
4. Ensure the temperature of bath water is maintained at 37°C. Use a bath thermometer.
5. Avoid baby toiletries and other cleansing products until the baby is at least a month old—use plain water to cleanse baby’s skin.
6. Only bath baby 2-3 times a week—‘top and tail’ in between bathing.
7. Use the best quality nappy available to the baby—changed soiled nappies frequently and cleanse the nappy area with plain water or unperfumed, alcohol-free baby wipes.
8. Expose the nappy area as often as possible and consider using a thin layer of barrier ointment in nappy area to protect the stratum corneum –ensure ointment is preservative-free and does not contain
anti-septic, fragrance or colourings.
9. Avoid the use of ointments/ lotions/ talc powder on the baby’s skin unnecessarily.
10. Ensure the umbilical cord is kept clean and dry, allowing it to be exposed to air as frequently as possible.

Dr. Joanne’s Q & A

Q: What is Vernix Caseosa?
A: Vernix is the sticky, whitish covering on the outer skin of a newborn baby. It is formed from the skin epithelial cells during the last trimester (6 months of pregnancy). It is said to be the ‘Natural Skin Cleanser & Moisturizer’ for the baby with important protective functions, preventing the invasion of harmful bacteria attaching to the skin as well as preventing excess water/ temperature loss to the environment.

Q: Do we need to remove this Vernix immediately after birth?
A: No need to. You could just wipe it off from baby’s eyes and mouth, but leave the Vernix on the skin over 24 hours.

Q: When would be the best time to give a newborn baby his/ her ‘FIRST’ bath?
A: Recommend to bath baby after day 2 or 3 post-delivery, when the baby’s temperature is more stable with less risk of hypothermia (low body temperature). For premature babies or a baby who is ill, it is best to delay the bathing until baby is more stable.

Q: What is ‘Top-Tail’ bathing?
A: Most hospital baby nurseries or neonatal units adopted this method to clean the baby’s skin, mainly cleaning baby’s face and buttocks.
i. Before starting, wash your hands clean with soap and running tap water.
ii. Place baby is a safe and flat changing mat or changing table.
iii. Soak some cotton balls into a bowl of warm water. Then squeeze the cotton balls dry.
iv. First, wipe the inner part of the eyes softly and spread to the outer eyes. Using seperate cotton buds for each eye.
v. Take another cotton ball to wipe the face, nose and mouth.
vi. Wipe the earlobes, back of the ears and neck area.
vii. You can then wipe the baby’s hands and feet with cotton balls or a piece of towel.
viii. Lastly, use a cotton ball to wipe the baby’s buttocks clean. You can apply a layer of the nappy barrier cream to the buttocks before changing a new diaper.

Q: If we bath our babies 2 to 3 times a day, will it give any effect to baby’s skin?
A: For the first 1 month of life, it’ll be enough to just bath a baby 2 to 3 times per week (once every 1 or 2 days). Babies don’t tend to sweat as much as a normal grown-up toddler. If we bath them too frequently, their delicate skin will lose the acidic protective barrier and its moisture.

Q: How do I make choices between different brands baby body cleanser in the market?
A: A good baby skin product should be non-fragrant without chemical ingredients that can irritate the skin. However, during baby’s first month of age, bathing with plain water will be sufficient.

Q: Is there any difference between cloth diapers versus disposable diapers in the prevention of nappy rash?
A: 17 collective reports in the Cochrane Review reported no difference between the usage among these two. Frequent changing of diapers and strong absorptive diapers are proven to reduce the risk of
nappy rash.

Q: Which nappy rash cream should I consider buying?
A: From my personal experience, I actually kept 3 different nappy rash creams for my little one. It’s more of preference with affordability of the purchase, there’s no one magic cream to suit all ‘bum bums’. The main factor is to consider having is a good habit of frequent washing of the buttocks each time your baby wees or poops (my boy poops up to 8 time per day!) remember to change their diaper before you go to sleep.. ZZzz

Please feel free to call KPJ Sabah Specialist Hospital 088-211 333 should you need more information or advice regarding to this topic.

Gastro-oesophageal Reflux in Infancy

Blergggh!! Regurgitation in young infants - should I be worried?

By Dr. Alvin Khoh, Consultant Paediatric Gastroenterologist

Gleneagles Kota Kinabalu Hospital | Tel: 088-518 888

A newborn baby!

Congratulations all around! The birth of a child is definitely a joyous occasion for the family. One can spend hours just staring at a newborn baby - watching every expression and every movement that the baby makes. And then suddenly, the baby regurgitates out its milk! And not for the first time. The baby seems to regurgitate various amount of milk every now and then.

The above scenario happens quite frequently to many newborn babies and causes a lot of distress among parents. Various unhappy thoughts would often come into mind: Will my baby have enough milk, since he seems to “vomit” everything out? Will my baby grow well? Am I feeding my baby correctly? Is there anything wrong with my baby’s digestive system? Will the milk go into my baby’s lung and cause damage? Should I change formula? Thankfully, for the majority of these babies, these episodes of regurgitation are not harmful to them.

Gastro-oesophageal reflux (GOR) is a common condition and is a normal phenomenon in healthy babies. Reflux happens when there is movement of stomach content back up into the oesophagus. The oesophagus is the food tube that carries food from our mouth into our stomach. When reflux happens in babies, the milk may regurgitate all the way up into the mouth. This manifests as regurgitation or “posseting”.

Many parents often perceive these episodes of regurgitation as vomiting. From a doctor’s perspective, vomiting occurs when there is a forceful contraction of the stomach, leading to emptying of the stomach content out through the mouth. Usually, vomiting is a symptom of an underlying illness.

Compared to vomiting, the process of regurgitation is effortless and occurs spontaneously. Some babies regurgitate more than others - this does not necessarily mean that anything is wrong. It does not harm your child and is unlikely to cause problems in later life.

Why does reflux happen in babies?

The lower oesophageal sphincter (LES) is a muscle the closes the oesophagus from the stomach after we swallow. In babies, this muscle relaxes more frequently, thus allowing the stomach content to reflux upwards into the oesophagus. Studies have shown that a healthy baby can reflux up to 30 times a day, although not all reflux leads to visible regurgitation. Most babies tend to regurgitate at least once per day, although in some, it can be as frequent as after every feed. It mostly happens after feeding, but it can occasionally occurs at other times, e.g. after coughing or crying.

For most babies, you don’t have to do anything about reflux and regurgitation. It is a natural process and will resolve by itself with time. This is because as the baby grows, the oesophagus gets longer, the stomach grows larger and more importantly, the lower oesophageal junction also becomes more mature and stronger. After 6 months of age, an infant also starts to take more solids and spend more time sitting upright, and this will also lead to an improvement in symptoms. Generally, the problem disappears around 1 year of age.

When should I worry about my baby’s reflux?

Generally, if parents have any concerns or uncertainty about their baby, they should seek medical advice. You should also seek treatment if your baby has the following:

• blood or bile (greenish) in the vomit
• fever, unwell, irritable
• choking episodes
• breathing difficulty or fast breathing
• not gaining weight or losing weight
• feeding refusal

What is the treatment for reflux?

In most babies with reflux, there is NO need for medical treatment. As mentioned before, reflux is a normal phenomenon and will get better over time. However, the following practice may help in some

babies with frequent regurgitation.

You should regularly burp your child after each feed. In babies with more frequent regurgitation, some parents find it helpful if they stop and burp their baby midway, or hold the baby upright for 20 to 30 minutes after each feed. You can also try giving smaller and more frequent feeds, but definitely avoid overfeeding, especially with bottle-feeding.

Changing from breastfeeding to bottle feeding/formula is NOT RECOMMENDED as it does not have effect on reflux. If your baby is already on infant formula, it is also not recommended to routinely change formula for the same reason. There are some special infant formulas in the market that may reduce the frequency of visible regurgitation, but it is generally better to consult your doctor first before switching formulas.

Gastro-oesophageal Reflux Disease

In a small percentage of babies with reflux, it can lead to problems. This is when doctors call it Gastro-oesophageal Reflux Disease. These babies may have breathing problems due to milk aspiration, or sometimes poor weight gain. In these group of babies, the doctor may start some

medication or suggest the use of a special thickened infant formula.

Conclusion

Regurgitation or reflux is a common problem in young infants. In most cases, it does not cause harm to them and will improve with time. It does however cause parents to be distressed and often leads to

tired parents from constant washing and mopping up. It is best to seek professional advice is you are worried about your baby’s condition.


Please feel free to call Gleneagles Kota Kinabalu Hospital 088-518 888 should you need more information or advice regarding to this topic.