Bedwetting refers to uncontrollable urination while being asleep. It is commonly seen in some children as it is viewed as part of growing up. However, it can be worrisome and stressful for the parents if the problem persists beyond early childhood.
Most three to four year old children are able to achieve daytime control, and most by age four to five will achieve night-time control. However bedwetting occurs when there is regular (≥ 2 times a week) involuntary passage of urine while asleep in children who are 5 years and above of age.
Bed wetting may be classified into two categories, primary bedwetting and secondary bedwetting. It is important to differentiate between the two categories as secondary bedwetting in particular may be attributable to an underlying medical or psychological condition.
1. Primary bedwetting: This applies to children who have never been consistently dry at nights for a period of ≥6 months.
2. Secondary bedwetting: This applies to children who have previously stayed dry at nights for ≥ 6 months.
Causes of Bedwetting
Bedwetting is believed to be caused by the interplay between the following three factors:
Bedwetting is also often due to:
Types of foods that might trigger bedwetting
Limiting the amount of fluids before sleep, and avoiding caffeine containing food and drinks such as tea, coffee, energy drinks, chocolates are often recommended. There is no need to ban these foods completely, but they can be enjoyed earlier in the day to wear off some of the effects before bedtime.
Some parents are concerned about spicy or citrus foods as they believe that such foods may irritate the bladder. However, there is no scientific evidence that shows the relationship between spicy or citrus foods and bedwetting currently.
Continue reading on the next page for strategies and tips...
What are some top 5 or more strategies or tips parents can adopt in preventing their kids from wetting the bed?
Here are some tips that parents can use to help their child who is bedwetting:
1. Communicate with your child
2. Limit liquid intake two hours before bedtime
3. Establish a toilet schedule
4. Awakening routine
5. Waterproof your mattress
6. Use positive reinforcements
What are the options for bladder training?
Bladder training usually consists of exercises to strengthen the muscle that controls the release of urine from the bladder, and increase the amount of urine the bladder can hold.
Muscle strengthening exercises (also known as start-stop training) often involve asking your child to practice starting and stopping the urine stream while urinating, while the bladder stretching exercises (also known as retention control training) involve getting your child to drink lots of liquids during the day, and have him or her practice holding his or her urine for successively longer intervals, with the aim of increasing his or her bladder capacity.
While bladder training is sometimes considered as part of a multi-modal therapy program, especially for children who also have daytime wetting symptoms, there is currently insufficient evidence to recommend bladder training as an initial treatment for children who experience bedwetting.
Dr Tan Zhen Han
Paediatrician
SBCC Baby & Child Clinic
MBBS (S’pore), MRCPCH (UK), FAMS (Paediatrics)
This article is brought to you by Healthway Medical.
Raising a troop of fussy eaters? Here’s how to cope and stay sane.
As working parents, you and your spouse rely on convenient takeaways most days of the week to feed the entire family. Perhaps mealtimes are a daily struggle to get your child to clean everything off from their plates, or at least, most of it. Your child seems to be sustaining on mere (forced-fed) mouthfuls, making you constantly wonder if her daily nutritional needs are being adequately met. Then you are amazed how your kid can even sustain Energizer Bunny levels. Before bed, you mull over whether your kids are fed or famished for the day. And so it continues…
By now, you’re probably getting the drift where all this is headed. Indeed, if you relate to anything in the previous paragraph, then welcome to the club, where kids who are fussy over food regularly turn the dining table into a battlefield!
These choosy chompers, however, can be placed into two camps: picky eaters and problem feeders, with notable characteristics and differences that identify them both:
Picky Eater |
Is more receptive to touching and tasting new food(s) after 10 or more times of exposure. Usually consumes 30 foods or less, which are confined to just one food group (eg. carbohydrates), or a few preferred foods in each category (eg. May eat only fish from the Meat & Others group, and refuse dairy and soy). Has a tendency to keep eating a particular food, meal after meal, for several straight weeks (“food jag”). May stop for a while, but will resume eating that specific item after an average of two weeks. |
Problem Feeder |
Is more resistant to change and variety. Tends to need a fixed routine during meals and may react strongly to new food(s) “disrupting” this predictability. May stick to just one taste and texture (eg. only smooth and sweet foods) and reject other flavours and textures. Will exhibit the repetitive behaviour of food jag, but once they quit that specific food, it is unlikely they will eat it again, despite their initial tolerance or acceptance. Over time the number of foods eaten will be reduced to an extremely restricted range. |
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Problem eaters, however, are saddled with the more severe aspects of fussy eating, and often require the intervention of such professionals as occupational or speech therapist, psychologist, nutritionist or paediatrician to address the underlying problem. If left unchecked, problem feeding may lead to malnutrition and a possible stunting of social growth, as eating is such an integral but often overlooked part of building interpersonal relationships.
It’s natural to be concerned about whether your children are eating enough to be optimally nourished, and that they’re not forcing themselves to go hungry. Try not to judge your child’s nutritional intake based on just a day of two of almost non-eating. A more accurate assessment of their diet would be on a weekly basis, as kids often eat in spurts. While your child may not have a balanced diet every single day, most children’s diets will usually fall within their recommended eating guidelines.
In the meantime, you can include a daily multivitamin into your child’s diet to ensure his nutritional needs are met. Also schedule regular visits to the paediatrician to monitor your child’s growth and developmental progress.
Despite these best efforts, the fundamental rule is that healthy eating habits should be inculcated and encouraged from young and at the dining table, although it can sometimes feel like an uphill task. The idea is to slowly reverse the bad eating habits of your average picky young eater (while problem feeders may require more extensive therapy and counselling as earlier mentioned, good eating practices can still be promoted and reinforced at home).
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Here is some advice to get you started:
Don’t Frown on Snacking
If your child eats poorly during meals, regularly scheduled snack times can actually help supplement their diet, especially if healthy snacks are offered. Some ideas include graham crackers, cheese, yoghurt, bread sticks or fresh fruit. Don’t worry about snacks ruining your child’s appetite even if they are consumed an hour or so before dinner as kids have a small stomach. Empty calories or overly salty or sweet snacks such as chips, candy and sodas should be avoided.
Involve Your Kids
Bring your child along when you are grocery shopping and use this as an opportunity to explain healthier food choices and even allow them to make the right selections. Give them small tasks to do during meal prep to give them a bigger sense of responsibility and ownership in what they are eating, knowing that it takes time and effort.
Make it Attractive
Use your imagination to create a visually appealing meal; one that has a variety of foods with different colours and textures. You can even cut them up into unusual shapes with cookie cutters.
“Playing” with Food
“Playing” with food needn’t be a bad thing as long as you’ve set rules and boundaries (not at the dining table, for example!). Instead, take this as a useful way to expose them to new and different ingredients by allowing them to “interact” with the food through smell and touch (not necessarily taste but it’s a great leap forward if they eventually do!).
Don’t Have Expectations
The most important thing to remember in all of these suggestions is to not expect your child to eat anything. This is especially so for children who are already picky eaters or problem feeders, as forcing them to eat may only add to an already stressful situation. Instead, try offering the new food, and if it is refused or tried but disliked, move on to alternatives that will provide the same nutrients. Or continue to add a tried-and-true favourite food of your child’s when serving something new, as this approach may be met with less resistance.
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Seek Advice
If you’re new to planning weekly menus, hit the Internet or the library for inspiration, or ask other families what they do for meals and snacks. Sometimes professional guidance is in order too, to provide informative and reliable perspectives to deal with what may seem like the toughest challenge initially. “The hardest thing for a parent sometimes is not to pester your kids into making better decisions, so utilise the help of a dietitian trained to work with children if needed,” suggests registered dietician and nutritionist Danielle VenHuizen. “You also need to plug the knowledge gaps you have around shopping for and preparing healthy meals. This is where a preliminary visit with a dietitian can also come in handy just to get an idea of what a healthy diet for your family might look like,” VenHuizhen adds.
Food for Thought
The fact that your child is a fussy eater should in no way be an accurate reflection of your true parenting abilities. Besides, there are other parenting issues that should be taken much more seriously than a few foods your child refuses to eat. Despite their resistance or aversion towards certain foods, most kids will still grow healthily, but parents should seek the counsel of medical professionals to address any other specific concerns regarding their child’s development.
The next time you find yourself on a guilt trip, remember this advice from dietician Danielle VenHuizen who acknowledges that, yes, while “you are responsible for what your child eats, they are responsible for how much and whether” they want to. For now, just live mealtime to mealtime and take advantage of the time spent eating together with your child to foster closer bonding.
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Are you worried how your toddler will react when you transfer him from his crib to the bed? Well, you need to know that there are no developmental checklists involved that shall indicate he is ready for the transition. However, read along for some helpful tips.
You should focus on your toddler’s safety while choosing his new bed. Transfer him to a toddler’s bed only when he is capable of climbing down on his own. It will help you rule out chances of him hurting himself while trying to come out. If he has been in the crib for long, he may have an emotional attachment with it that may make the transition difficult.
If you find him jumping out of the bed, it means he is not ready to let go of his crib yet. It simply means he needs more time to graduate to a new toddler bed. Do not lose heart just be a little patient, and you will see he will accept the change and get comfortable with it.
It is always exciting to see your toddler attain all developmental milestones. Some of the signs that indicate that your toddler can shift to a new bed are as follows:
As long as he is comfortable in his crib, there is no need to worry much about it. You just need to be patient and give him some time. He will surprise you by showing his interest in the new bed one fine day. However, here are some strategies that you can try to make transition from crib to toddler bed smoother:
1. If your toddler is big enough to choose, take him shopping with you. Let him look through the catalogs of beds. Let him choose his pillows and bed sheets. He will be very excited for his new bed.
2. You can consider setting up a bed in the same spot where you had his crib. It might get difficult for him to cope with too many changes at a time. So if you are transferring him to a new bed this is a good option you can consider.
3. If you find your toddler resisting the change strongly, introduce him to the bed in stages. You can place him in the bed during the naps initially. You can also use the new space as a reading spot. It is a good way to help him familiarize with his new bed.
4. Remember, you should not stress over the fact that the transition is not as easy as you thought. A laid-back attitude on your part will help him adjust to the new place easily.
Once he has agreed to sleep in the bed, you need to help him feel comfortable there. He might need you around while falling asleep in the new bed initially. You need not worry as these are normal reactions, and he will outgrow these soon.
Make sure to stick to the normal bedtime routines to help him feel safe and secure. A daily routine will help him know what to expect next. The transitional phase shall be easier for him this way.
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Article written by Moumita Ghosh
When do you think is the correct age for a child to start brushing? A mother looks after a child’s every need, be it singing him a lullaby or ensuring he gets his food when he feels hungry. Amongst the various daily chores of a mother, keeping her child’s teeth strong and healthy is one. It is needless to say that the first step to maintaining good oral hygiene is to brush his teeth regularly.
Till the age of two, as a mother, you can just brush the teeth of your toddler with plain water. But beyond the age of 2, mothers, often, have this common question in their mind – “how to get my toddler to brush his teeth?” Well, the answer to this question is that you need to be persistent and patient.
A visit to a dentist for your little one is something that you want to avoid for sure. Apply the following tips that can help you know how to encourage toddler to brush teeth.
Inculcate the habit of brushing the teeth as part of his daily morning routine. You should also incorporate the activity of brushing the teeth as a part of the bedtime routine. Brushing his teeth should be the first thing your son does once he wakes up in the morning. He has to repeat the activity before he goes to bed.
Toddlers like to copy their elders. So, you need to brush your teeth in front of your toddler so that he can emulate you.
It might sound weird, but there might be days when you may have to play tooth brushing all day. Let your little one brush the teeth of a doll, a puppet, or even your teeth for him to get used to the idea of brushing the teeth.
Make sounds like “tee” and “ahh” so that he wide opens his mouth for you to get access to the front and back teeth. You can also encourage him to make a roar like a lion so that he opens his mouth that can help you brush his teeth. These activities can help the mundane ritual of brushing the teeth turn into a fun time.
Give your little one a number of options of toothpaste. There are a number of kid’s toothpastes available in the market that he can choose from. After your toddler settles with a particular brand or taste of toothpaste, use it regularly to make brushing his teeth a fun activity.
You definitely do not want your little darling to undergo the trauma or fear the activity of tooth brushing. So, refrain from using force to brush his teeth. Be patient and try out these tips for brushing toddlers teeth.
Remember, do not expect your toddler to make tooth brushing a regular habit almost instantly. He might take time to get into the habit. Initially, he may hate it. Your cute may also cry his eyes out to prevent you to brush his teeth. But after a few days, he will get used to it.
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Article written by Aayantika Choudhury
Image credit: Flickr
First things first – whether it’s giving your child breastmilk, formula, or a mix of both, what’s most important for your child is that they’re well fed; mums and dads will have their own reasons for the choices that they make, and they’ll definitely be in the best interests of their child.
Formula can be given to your children from the moment they’re born (either exclusively or to supplement your breastmilk), but fresh/UHT (ultra-heat treatment) cow’s and goat’s milk should only be given to them after they’ve turned a year old.
The reason being they won’t be as easily digested, and the high amounts of protein and additional minerals could strain baby’s still developing kidneys.
Let’s take a look at the three different types of milk that we can use to supplement our breastfeeding.
1. Formula Milk
Even though we believe in the power of breastmilk, we also understand that sometimes our bodies aren’t able to keep up with the needs of our little ones – keeping them well-fed and healthy is more important than keeping to a strict ‘breastmilk only’ diet.
Try to establish your breastmilk supply as best as you can before starting to supplement baby with formula.
Doing an exclusive formula feed is still a healthy way to feed baby, as formula has all the nutrients that baby needs and is specifically made for them to consume.
Women who choose to formula feed could be doing so due to these reasons:
An article published by The Straits Times in March 24, 2017 stated that the average price of milk formula is around $56 (for a 900g tin), and babies could go through 3-4 tins of them per month.
How much will you spend on cow's milk formula?
The average cost of 3-4 tins in Singapore is around $196/month, which amounts to around $2,352/year. Now that’s definitely not a small amount, especially if you factor in other costs such as diapers and wet wipes.
Continue reading on page 2 for the benefits of goat's milk...
2. Goat’s Milk
After baby is a year old, you can start introducing them to goat’s milk. Feeding goat’s milk to toddlers is on the rise in Singapore recently, while other countries have already experienced its benefits for quite some time!
The benefits that goat’s milk has over cow’s milk are rather straightforward:
Properly refrigerated fresh milk can be kept around 7 days (regardless of whether it’s opened or not), and UHT milk can be kept around 30-60 days unopened and refrigerated, and for 7 days refrigerated after its been opened.
How much will you spend on goat's milk?
A quick search online shows that 1 litre of fresh goat’s milk is around $12, and its UHT version is around $7-8. A year’s supply of fresh goat’s milk should be around $600, and UHT goat’s milk should be around $336. This is assuming we drink 1 litre of it per week for a year straight.
That said, there is goat’s milk formula available in the market as well, and this is definitely not a cheaper option (it costs even more than cow’s milk formula!). However, mothers who are feeding this to their baby comment that it’s the most similar in taste to breastmilk, making baby more acceptable to it. Most also comment that goat’s milk formula does not cause their baby to have phlegmy cough as compared to cow’s milk formula.
Continue reading on page 3 for the benefits of cow's milk...
3. Cow’s Milk (Fresh / UHT)
The ever-present cow’s milk is something of a staple that kids drink when they’re growing up, and should only be given to our children when they’re more than a year old. Cow’s milk may be less nutritious than goat’s milk on the whole, but it does have its benefits:
The shelf life of cow’s milk is the same as goat’s milk. Properly refrigerated fresh milk can be kept around 7 days (regardless of whether it’s opened or not), and UHT milk can be kept around 30-60 days unopened and refrigerated, and for 7 days refrigerated after its been opened. If you're big on food wastage, you might consider the UHT option as it has a longer shelf-life.
How much will you spend on cow's milk?
One obvious benefit that cow’s milk has over formula and goat’s milk is that it’s a LOT cheaper – 1 litre of fresh and UHT milk is around $2.50 to $5.
A year’s worth of cow’s milk (fresh and UHT) should be around $120 to $180, assuming we drink 1 litre of it per week for a whole year.
So… Which Would You Choose?
Out of the three choices, only formula should be given to our children before the age of one. Formula is your go-to option if you wish to supplement your breastmilk or do exclusive formula feeds. However, once they’ve hit the one year milestone, then your options open up greatly as you can start to round out their nutritional needs through solid foods too.
As long as our kids eat a normal, balanced diet, they’ll get all the nutrients that they need. A 2017 Channel News Asia article titled “Children over one do not need formula milk, experts say” states that “formula milk offers no nutritional benefit over a balanced diet”.
They also state that “an infant who weans well and is having excessive formula milk intake can become obese. This carries a negative impact on long-term health with the child having a higher risk of developing metabolic conditions such as adult obesity, diabetes and heart disease”.
For parents who are a bit more kiasu and money conscious (who isn’t, in Singapore?!) they can see if their kids are open to drinking goat’s milk. Otherwise, sticking to cow’s milk is a good choice – just ensure that your kids are eating enough fruits, veggies, eggs, and meat.
Remember that formula is by far the most expensive choice out of these three, at around $2,352/ year, followed by goat’s milk at around $600/year (fresh) and $332/year (UHT), and finally cow’s milk at $120 to $180 (fresh and UHT).
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Once your little one is 2-3 years old, you must use effective methods to potty train him. Your kid easily adapts to the new changes in his life and performs the activities independently. Teach him all the basic activities related to toddler potty training, like washing his hands or using the toilet properly. Proper potty training makes your toddler more aware of the basic hygiene prospects. In this article, we talk about some important tips on potty training for toddlers.
Here are some of the physiological aspects or signs toddler is ready to potty train. They may help you determine whether your toddler is ready for potty training:
Your toddler’s bladder and bowel function reach maturity stage at 18 months of age. In such stage of maturity, your toddler gains proper control of bladder and rectal sphincter. As soon as your toddler learns to control urination and stool for several hours, you can effectively start potty training your little angel.
As your growing toddler can walk and sit on the toilet seat independently; her body allows her to learn the new things. She becomes capable of pulling clothes up and down and uses her expressive language skills to indicate her toilet urge verbally.
Your toddler needs to be mature enough to learn the potty training basics interestingly. With proper behavioral maturity, she tries to imitate you and learn the potty etiquettes properly. But with oppositional or immature behavior it becomes hard for you to potty train toddler.
Continue on page 2 on the steps to take...
Here are some of the preliminary steps to potty train your toddler:
The below toddler potty training tips will definitely help to make your little one easy adaptable to the nature call.
Before you art potty training your toddler, try telling her some fun potty stories. Explain that potty is a normal human function, and life process and every person including you went through the stage of potty training. Tell them few interesting potty stories, so that they are keen on learning the procedure. Explain how the complete thing works and make your toddler understand the importance of flushing and personal hygiene. If possible, buy some video DVDs or book of animated characters that explains about potty learning to your kid. Involve your complete family and talk about the thing in most casual manner.
The best process to potty train your growing toddler is to show her the exact sitting posture and educate how to perform the complete activity. For your little girl, show her how to take off her pants or skirts and sit in the potty chair properly. You can take her to the potty and tell to do it in front of you. You can rectify her mistakes and show her the correct procedure. Make the learning process more fun and interesting, rather than scolding your little one hard. Small children often love to imitate their parents and perform the activity exactly the same way as the elders perform. This trick of imitation is helpful in potty training as well. Ask your little angel tries to imitate your act and sitting posture, she learns the process faster.
Your toddler always feels happy and overwhelmed to receive lovely presents from her parents. Induce the habit of bribing your little kid, whenever she uses the potty well. Your kid may feel hesitate to use the wipes and clean the poop all by herself. In such circumstances, the bribing seems quite effective. Motivate her to wipe the Poop using clean tissue paper and wash hands after using the toilet. As she completes the task with great accuracy, gift her few candies or chocolates, as a bribe.
One of the most successful methods of potty training toddler involves letting your little angel go around the room naked and with a top only. As there are no diapers, they may have to rush to the toilet to pee or poop. It ensures that your toddler understands the importance of toilet. When your little angel heads towards the toilet, follow her to observe whether she follows the proper toilet etiquettes including flushing and hand washing. In fact, you toddler may love doing flushing and feel happy to listen to the whooshing sound of flushed waters.
One effective tip to succeed in potty training your toddler involves target practice. If your toddler is a boy, teach him how to stand at the time of peeing. If your boy targets the aim correctly, the urine always falls into the correct place, and your toilet remains clean. For girls, show them the accurate sitting postures on the potty chair, so that they can release the urine completely.
A successful and good potty training procedure involves praising your little one. As your toddler makes a successful trip made to the potty praise her, to make her feel proud. If they are unable to perform the task perfectly, never scold them. Try to remain calm and patient and make your kid understand the importance of potty and urination. With consistent encouragement and praises, you can potty train your toddler efficiently.
For successful toddler potty training, you must check the level of interest and readiness in your toddler. Some of the children are hesitant and are not interested in going through potty training. Do not compel your toddler to learn the thing. It is important for you to consider your toddler’s mental, social, physiological and emotional readiness to use the potty.
One of the great parenting tip to potty train your little toddler involves introducing the topic in the most casual and non-threatening manner. Make your toddler understand that it is a normal physiological process that everyone has to perform in their daily life. Set examples and talk about all other children who are using the same thing in their life. You can bring her to visit the toilet and demonstrate using dolls how the complete process continues.
The best way to motivate your toddler is a continual encouragement. Keep cheering her as long as she sits on her potty chair. Clap your hands and make her complete task all by herself. You can use a daily potty chart, and rate your toddler on the basis of her performance every day. Put a five star on the potty chart when she does well. In addition to consistent praises, never shout at your kid when she cannot perform the task successfully. Smile and motivate her to do the task again. Don’t get angry at her, as it can frighten her, and your little one may end up making a mess on the carpet.
One of the most confusing things for your toddler is if you stop the potty training regime and make changes abruptly. It is important to make the decision firmly and start training your toddler. On first few days of potty training, you need to have a lot more patience. Do not start the potty training for a couple of days and then in for your hectic schedule make your toddler wear her diapers again. It will confuse your little angel and would make the process of potty training more difficult and rigorous.
Here are some important points to remember while potty training your child:
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Article written by Ria Saha
Many parents worry that pacifiers will harm baby’s teeth development. Truth is, it doesn’t really have any effect on a child under 2 years old.
Pacifier Pros
Pacifier Cons
When is a good age to stop?
From a dental health perspective, it’s best to limit the pacifier when a child is 2 years old and stop it entirely by the time she is 4 years old. Past age 4, pacifiers can cause an overbite, open bite, or crossbite – problems that affect chewing, speech and teeth alignment.
Methods to wean child off
1. Slowly limit the use of the pacifier
Offer the pacifier only during nap or bedtime. After a couple of weeks, stop offering it at naptime. If she fusses, try giving her her favourite toy instead, or comfort her through rocking or patting. Once your child is adjusted to this arrangement, work on bedtime.
2. Offer alternate comforts
When you first take away the pacifier, you’ll probably need to sooth her in other ways. Rocking, soft singing or patting are some ways to settle her down.
3. Create a story for them
Get creative here, mummies! This will work better if your child is old enough to understand and reason with. You could explain to your child that she is a big girl and that there are other babies out there who needs her pacifier. Get them to decorate a gift box and pack it in – make it a big deal! Be sure to offer a lot of praises and a small present to them for being so kind and generous.
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