Mother and Child will be closed from Saturday 23rd December to Monday January 1st inclusive.

We will reopen on Tuesday January 2nd, 2007.

We wish all our clients, partners and staff a joyful holiday season and best wishes for 2007.

The first Well Baby Clinic for the New Year will be on Wednesday January 3rd 2007 from 10am to 1pm.

Clients are reminded to arrive before 12.30pm to ensure that they can see a Health Visitor on the day.

Open 2-4pm Mondays, except Public Holidays.

On Monday April 24th, Mother and Child were delighted to open the first Baby Café in Singapore and the region following the successful British baby café concept. Our café was opened by world-renowned, Toronto Paediatrician Jack Newman MD. Dr Newman is a consultant to UNICEF’s Baby Friendly Hospital initiatives and author of “The Ultimate Breast Feeding Book of Answers” He was in Singapore as part of an Asian tour to lecture health professionals and mothers about breast feeding benefits and myths, and also to remind audiences of the risks to babies who are artificially fed.

In his address he supported wholeheartedly the café concept stating that “getting the RIGHT advice is paramount in making breastfeeding a success”. Following the baby café ethos means that mothers can be sure of receiving expert up to date evidence based advice. On opening day, the centre was filled with mothers, babies and staff of Mother and Child. One of our own health visitors, Diane Cronly, set up Café Number 11 in Didcot Oxfordshire and brought the concept to Singapore. She was delighted with the launch.

Our expert staff will operate the clinic every Monday afternoon from 2-4pm, except public holidays. Please note that only breast feeding related questions will be answered. Any other concerns should be brought to the Well Baby Drop-In Clinics.

More information about The Baby Café can be accessed at www.thebabycafe.co.uk

The Mother and Child Centre are proud to announce that two of our staff have become newly certified Lactation Consultants. Diane Cronly and Julia Briscoe have added to their existing certifications the IBCLC (International Board of Certified Lactation Consultants) certificate. We now have four Lactation Consultants at M&C, with Julia and Di joining Uma and Sue to provide lactation support to our clients.

Well done Di and Julia!

BABY WALKERS ARE DANGEROUS
By Allana Robertson RN, RM, BA. Master Nursing, Grad Dip Education.

There is growing concern about the dangers associated with the use of baby walkers to the extent that the American Academy of Paediatrics (AAP) feels that baby walkers should be banned. They feel this way because baby walkers put children at greater risk for injury and there are no clear benefits from using a baby walker. In fact, in Canada, it is against the law to sell, advertise and import baby walkers.

Facts about baby walkers

• Baby walkers are associated with more injuries than any other type of nursery equipment.
• Research has shown that at least one third of babies using baby walkers will be injured.
• Baby walkers do not help your baby to walk earlier. In fact they can delay it. Rolling, sitting, crawling, and playing on the floor are the building blocks for learning to walk and for normal child development.
• Most injuries associated with baby walkers are caused by falls. Babies can move about one metre per second in a baby walker. This speed combined with the weight of the baby and baby walker hitting the floor, hot oven, heater, sharp object or down stairs increases the severity of injuries.
• There is an increased risk of burns because the baby’s upright position and steadiness enables them to reach up higher and for longer than they would without the walker. Being upright also means that many of the burns are on the face and head. Research in a Welsh burns unit revealed that a quarter of babies aged 6-12 months who were in hospital with burns had been in a baby walker when the injury occurred.
• An increase in reach allows greater access to household poisons including perfume and alcohol. A study in Australia found that baby walkers were the second most common factor associated with poisonings in children less than 12 months of age.
• Most baby walker injuries happen while at least one parent is watching the child. A child in a baby walker needs greater vigilance and supervision than they would if they were not in a baby walker. This is because the child can move faster and is more able to reach dangerous objects.

Alternatives to baby walkers
Children can be entertained in other ways or placed in a safer piece of equipment. Stationary walkers have no wheels but have seats that rotate and bounce such as the exersaucer. Playpens are great safety zones for children. Stationary activity centres, infant swings and high chairs are alternatives. Be sure to use safety belts if you put your child in a high chair or swing.

If you insist

• Do not use a baby walker if your child cannot sit without assistance.
• Do not use baby walkers if your child can walk unaided.
• If you decide to buy a baby walker, look for safety features, such as braking mechanisms and wide bases.
• Check that any locking mechanism works and is out of your baby’s reach.
• Baby walker proof your home. Block off stairways and put barriers around cookers, heaters and fires. Keep items such as kettles, irons and hot drinks out of the way.
• Do not use baby walkers on surfaces where there is a change in floor level.
• Always supervise your child in the baby walker.

References
Australian Physiotherapy Association (2001) Baby Walkers APA Position Statement APA Sydney.
Child Accident Prevention Trust (2004) Baby Walkers Fact Sheet CAPT London UK.
NSW Health (1998) Baby walkers, stairs and nursery furniture as potential factors for head injuries in infants. A case control study. State Health Publication (HP) 980064, North Sydney.

www.aap.org/family/babywalkers.htm www.med.umich.edu/1libr/pa/pa_walkers_hhg.htm www.ocba.sa.gov.au/consumersafety/babysafe/02_walkers.html

PNEUMOCOCCAL DISEASE AND VACCINATION IN CHILDREN
By Dr. Mark Loh. Consultant Paediatrician and Neonatologist. International Medical Clinic.

The success of immunization programs has led to a sharp decline in many lethal infections like diphtheria, polio and measles in young children around the world. Of the bacterial infections that are still prevalent, pneumococcus is a leading cause of morbidity and mortality. Every year, up to one million children less than 5 years of age around the world die of severe pneumococcal disease.
Pneumococcus can cause severe invasive diseases like pneumonia, meningitis and blood sepsis, especially in children younger than 2 years. It is also commonly responsible for other less severe but significant illnesses like middle ear infections and sinusitis. Whilst traditionally responsive to antibiotics, the rising emergence of resistant strains of pneumococcus in recent years has made treatment more complicated.

A new pneumococcal vaccine (Prevenar) is now available in Singapore and has been part of the recommended childhood immunization schedule in western countries like the United States and Australia for some years now. It provides protection against the 7 most common strains of pneumococcus causing illness in childhood. Vaccination has been shown to prevent pneumococcal disease and reduce its spread to other children and adults. It will also reduce the presence of antibiotic-resistant pneumococcus in our population.

The pneumococcal vaccine is indicated for active immunization in infants from 2 months onwards. The number of injections required for effective protection depends on the child’s age. Your doctor can advise you on this. The pneumococcal vaccine has a good safety profile and can be given concurrently with other vaccines in the immunization schedule. It is generally well tolerated in young children; although like all vaccines, can come with some side reactions. These are usually mild and transient in nature and include fever, injection site redness/swelling, rash and irritability. Some can be prevented with sensible use of paracetamol before and after vaccination, and most resolve completely after 2-3 days.

Childhood vaccination remains one of our most effective weapons against severe infections. The pneumococcal vaccine is set to take a significant role within this arsenal.