Let us continue with AskMeDoctor! Episode 3, Part 2 – on Uncovering Children’s Health Myths.
Similar to the first part (children’s health myths), we have Dr Foo Chee Hoe, a paediatrician from Pantai Hospital Ampang and Dr Foo Child Specialist Clinic – to answer all of your questions on these outrageous children’s health myths.
Q6: Can diarrhoea be contagious?
Dr Foo: First of all, just because by sharing the same room or the same lift or even sleeping on the same bed with another child with diarrhoea, the statement that said “You will usually get diarrhoea too,” is NOT TRUE!
But again, it is true that some diarrhoea is caused by infections, especially through:
- Rotavirus infection
- Typhoid infection
The pathway for the infection is faecal material to the mouth. Usually, it is by hands that are contaminated by the faeces.
The process is like this: When that person does not wash his hand properly, and then he touches on dirty surfaces or the surface is contaminated by food which then passes to another person who also forgets to wash his hands.
If all they eat are contaminated drinks and foods which would cause an infection in their intestines, then the pathway would be touching.
So, hand hygiene is very important. It is very different from a respiratory infection.
There is also a lot of diarrhoea that is not related to an infection at all. The person may be having:
- malabsorption
- lactose intolerance
- take too much antibiotic and might get antibiotic-associated diarrhoea
These are not infective diarrhoea. There are also patients who are having Dengue Fever or Influenza Infection, who has parenteral diarrhoea means they have diarrhoea as a side symptom of their infection but they do not carry any germs in their faecal material.
That type of diarrhoea is not infectious but they are infectious in other ways.
It is not correct to just over-generalize saying that diarrhoea is contagious. Hand hygiene is paramount to prevent this kind of food poisoning and hygiene-related illness.
Q7: Does exposure to the cold weather causes cold?
Dr Foo: Not true. In the Malaysian context, you are talking about playing in the rain and would get cold from it, right? Well, I do not agree at all.
I think the core factor for a strong immune system is not whether you are playing in the cold or exposed to the cold weather.
It is actually more about your strong immune system – whether you have a good diet, a balanced and healthy lifestyle, adequate sleep, eat proper food, and a healthy environment.
Factors for a strong immune system:
- Good diet
- Balanced lifestyle
- Healthy lifestyle
- Adequate sleep
- Eat proper food
- Healthy environment
If your child eats healthily, has adequate rest, growing up well with all the nutrients that come from food, then they won’t get sick by just playing in the rain for a while or when they are exposed to the cold.
Q8: “If your child has a speech or language delay, it’s nothing to be concerned about as children usually overcome these problems with age.”
Dr Foo: The main message here is that NO, we can’t just take it for granted as the child grows older just because the child will learn how to speak eventually.
I think it is also true that some may be a bit slower to pick up and they will end up like those late bloomers after the age of 2. They may be a bit slower but in the end, they are able to speak so well later in life.
But, there are also a group of children who obviously have a speech delay and you must make sure they do not have hearing impairment because hearing problems would also lead to the inability to pick up the speaking.
This is because we learn speaking by making sounds.
We must also ensure that they do not have:
- Social interaction problems
- Social development disorders
- Difficulty learning to verbally communicate
- Difficulty learning to non-verbal communication
- Learning disability
If your kids have these kinds of symptoms, we should expose them for early interaction so that we can really help them to resolve some issues to improve and to achieve speech ability as soon as possible.
You can easily find those developmental milestones even on online reputable websites or talk to your paediatrician.
I think paediatrician’s expectations are very low that it doesn’t raise a red flag until real certain features are not met.
For example, we expect a baby at 1 year of age should be able to call “mama dada” or to start to babble. I think the receptive component of the language ability is very important.
Even though they may not speak yet, they should be able to understand simple commands or respond to them. Yes, after 1 year, they should turn when their name is called and they should understand the ‘yes or no’ kind of command.
When they are 18 months, they should be able to tell at least 3 body parts, “Where is your ear?” “Where are your eyes?” “Where is your mouth?”.
By the time they are 2 years old, they should be able to speak short sentences about 2-3 words. Children Development Milestone happens in a period of 12 months, 18 months or 2 years old.
I think there is a broad spectrum of expectation, but my key point is that even when they are not speaking yet, you should be able to tell if they are able to understand your words or your language.
Comprehension is Important
If they cannot understand anything you say, not responding to any of the instructions, or have poor eye contact, then it really raises a red flag and we should take action.
You can’t just say “nevermind la, wait until they bigger then surely they can talk”, because it may not work that way.
Another thing is that they may not use their mouth like verbal language but non-verbal communication will also tell that they are able to achieve verbal language later on.
Such as when they are pointing to things, they want this, they want that, or when they are hungry, they will be pointing to some bread.
They can also use some baby words like “mamamm..”, they are not real words but those indicate that they have that kind of speech and language ability. So, those are good signs they are going to achieve that.
But, if at the age of between 1 to 2 and they do not demonstrate that kind of pattern at all then it does raise an alarm. We should be more attentive and consider taking further action.
Q9: Most children will go through ‘terrible twos’.
Dr Foo: Terrible twos, is it true or not? For many parents and for the observation, it is very obvious. I would say that there is no timeline.
You cannot have a timeline to say “Oh once you enter the age of two, for sure your child will be terrible and then when you are 3 years old, you graduate from the terrible childhood,” – it doesn’t work that way.
I would say at the end age of a baby, infant, or toddler can have their very cute, sweet and also very terrible difficult moments.
Your child is exploring the world, they are learning about their surroundings. They are testing the limits of themselves, their parents and people around them.
It is an emotional roller coaster where we can get frustrated sometimes.
They can throw tantrums when they are at frustrating times such as having a dilemma of choosing things.
Also at the age of 2, coincidentally their speech development gets better. They can talk well, they can talk back, can understand most of your language and they tend to react in a way that can be more responsive and more rebellious!
They can also start to be very mobile because by the age of two, they can walk so well. They can run and climb as well.
The difficulty becomes more obvious but it is not to say you are surely going to be terrible and difficult when you are 2 years old.
Sometimes the challenges do not stop at two. It increases as they age. I think this is how they develop and how they learn their surroundings which they get in peace with the limits.
Q10: Does using a baby walker will help a toddler walk sooner?
Dr Foo: Actually, the walker does not help the child to walk independently and does not make them learn faster to walk independently.
Instead, it actually encouraging the baby to use their buttocks muscles to propel themselves forward. So, they are actually bottom shuffling.
Babies who use too much walker would end up bottom shuffling instead of crawling and learn to walk earlier than expected.
It is not normal to call an object as a walker because it does not help your child to walk faster.
I would like to say that our knowledge and understanding is not absolute and conclusive. We are all still learning, even doctors are learning.
Whatever we say today, we accept universally as facts and one day may be exposed as untrue or not accurate anymore by future study.
We are always learning and that is why a lot of research and studies are being done to understand more.
Let’s keep an open mind on what we know about parenting and healthcare evolving, to not jump to conclusion because some myths can be dangerous while some myths are harmless.
But it is always good to keep an open mind and learn together, continuously.
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