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Paediatrics - Frequently Asked Questions

 

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Can G6PD deficiency be cured?

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My baby is now 10-month-old and has not started teething. Is there something wrong with his development?

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1. My baby was blue at birth but he turned to pink soon after. Is it normal?
 
It is normal. Most of the newborns are blue at the moment of birth, but they will turn pink after 5 minutes when they start breathing normally.
 
   
2.
My baby was born at full term. Why did the doctor put my baby in incubator? I thought only prematurity baby needs incubator?
 
There are other reasons to put a baby in incubator apart from prematurity baby. The baby could be small-to-date or having breathing difficulties.
 
   
3.
I was told that my baby is normal during neonatal screening. Does this mean that my baby will be perfectly well?
 
Neonatal screening only tells that your baby is normal and healthy at the point of screening. Your baby continues to grow and develop and certain illnesses will appear after a few months. E.g.: Certain congenital heart disease will only be apparent after a few months of life.
 
   
4.
I was told that my baby has a healthy heart at birth. Now my baby is 3 months old and the doctor said that there is a hole in his heart. Why didn't the doctor detect it during neonatal screening?
 
Certain 'hole' in the heart is not detected at birth because as the baby grows and develops, the heart has to work harder for the growing body. The blood flow will increase and  heart murmur or reversal of blood flow will occur.
 
   
5. My baby's eyes and skin are yellow in colour. Is it due to jaundice?
 
The most common cause of yellowness of the newborn's eyes and skin is jaundice. Most jaundice in newborns are harmless and physiological and will occur within 1 week after birth. This happens in more than half of the newborns. You will need to consult the paediatrician on whether there is need for phototherapy
 
   
6. My friends tell me that breastfeeding can cause jaundice in the baby. Is it true?
 
There are 2 types of jaundice that are related to breastfeeding, namely breast-feeding jaundice and breast milk jaundice. Breast feeding jaundice occurs in 13% of the newborns during the first week after birth. This is due to insufficient of milk intake of the breast-fed babies and the incident can be reduced by increasing the frequency of breastfeeding. Breast milk jaundice occurs in 0.5% and it appears during the first week and it continues for several weeks after birth. This is due to certain substances in mother's breast milk that causing the increase of bilirubin level (yellow pigment that causes jaundice) in baby's blood.  You can stop breastfeeding for 1 or 2 days and then resume breastfeeding after your baby's bilirubin level drops. Normally the level of bilirubin will not increase after breastfeeding is resumed. 
 
   
7.
My newborn has jaundice. What should I do?
 
Neonatal (newborn) jaundice usually does not require treatment when the level of bilirubin is low. The jaundice will disappear spontaneously after a few weeks. But if the baby's bilirubin level is high, he will need phototherapy (exposure of the baby to ultraviolet light).
 
   
8. I was told that my baby has G6PD deficiency. What is G6PD deficiency?
 
G6PD stands for Glucose-6-Phosphate-Dehydrogenase. G6PD deficiency is a hereditary disease which will cause haemolytic anemia (anaemia that is caused by increase breakdown of red blood cells). This occurs after the child is exposed to certain foods and drugs.
 
   
9. Can G6PD deficiency be cured?
 
G6PD deficiency is a hereditary disease and so it is lifelong. There is no definite cure. But with certain precautions, patients with the disease will live a normal life. The affected patient should avoid the followings:

1. Chinese herbal medicines such as Rhizoma Coptidis (huang lien), Calculus Bovis (neu huang), Flos Chimonanthi Praecocis (lei mei hua), Flos Lonicerea (kam ngan fa) and Margarita.

2. Drugs such as certain Antipyretics and Antibiotics (Nitrofurantoin, Nalidixic Acid, Sulfamethoxazole, Trimethoprim), Antimalarials (Primaquine) and Antispamodic (Phenazopyridine). Consult a registered doctor and alert the medical staff before being prescribed any medicine.

3. Fava or broad beans (kacang parang) and their products.

4. Close contact with mothballs (Naphthalene) and Naphthalene-containing products.

 
   
10.
I have 2 boys and 2 girls. One of my boy has G6PD deficeincy while the others are normal. I have friends whose family are like me, and only their boys have G6PD defeiciency. Why only yhte boys are affected?
 
Because you have a normal X-chromosome and an abnormal X-chromosome, the disease does not surface in you. You are a carrier and you will pass either a normal X-chromosome or an abnormal X-chromosome to each of your kids. Your girls will receive a normal X-chromosome from your husband. So, your girls are either a carrier for G6PD deficiency or chromosomally normal. 50% of your boys will receive normal X-chromosome and 50% of them will receive abnormal X-chromosome from you. So, 50% of your boys will have the disease.
 
   
11. When should my baby start weaning off milk and start solid foods?
 
Your baby can start on solid foods when he is 4 months old. It is not good to wean too early because the baby's digestive system cannot cope with solid foods yet. It is advisable to seek advice from paediatrician before introducing solid foods.
 
   
12.
My baby is now 10-month-old and has not started teething. Is there something wrong with his development?
 
Baby's first teeth will appear some time between 14 weeks and 14 months of age. Do not worry if your baby starts teething late, it is normal and would not prevent him to have normal diet.
 
   
13. When should I start to clean my baby's teeth?
 
It is a good idea to have your baby's teeth cleaned as soon as they appear. Cleaning once a day is sufficient.  You can start with rubbing the teeth gently with a cloth wrapped around your finger and move on to a soft toothbrush later.
 
   
14.
Does every baby develops nappy rash? How do I prevent this?
 
As your baby's bottom is constantly exposed to urine and stools, nappy rash is common. Give him a gentle wash to his bottom and pat it dry whenever you do nappy changing. Moisturizer can be applied to keep his skin supple and protect his bottom from urine and stools. Give him some nappy-free time whenever possible.
 
   
15.
Why is my baby always crying? Is he ill?
 
Babies usually cry because of the following reasons: hungry, soiled nappy, wind, or they need attention. After some time, you will learn how to distinguish all these. Never let your baby cries for a long period unattended, because most of the time, baby cry with a reason.
 
   
16. I wonder if my baby put on enough weight after birth, because he looks so small.
  During the first few days after birth, he will lose some weight due to water loss. But he will gain weight after the 5th days at a rate of about 150g to 225g per week.