Dr. Long Wai Lup , Paediatrician

Dr. Long Wai Lup

Dr Long is passionate to improve overall healthcare of children and newborns.

Parenting is not easy, especially for new parents. Whether you are raising a newborn or a growing child, parents need to tackle many challenges.

Many choose to follow traditional methods passed down from their parents. Others join a maternal care group and adopt methods from other mothers based on experience. While people recommend these practices out of good intentions, these practices can cause some misconceptions and unintentional harm to your children.

Parents should heed the advice of a paediatrician. UCSI Hospital’s paediatrician Dr Long Wai Lup, who has 12 years of medical experience, was admitted as a paediatrician at the Royal College of Pediatrics and Child Health (MRCPHC) in 2019.

Here are his advices to parents when facing the following situations.

Neonatal Jaundice: Doctor, is that just jaundice?

What is neonatal jaundice?

Jaundice is the yellow discolouration of the sclerae (whites of the eyes) and skin. It occurs in ˜60% of mature babies and 80% of premature babies during the first week of life.

What cause my baby to contract jaundice?

A baby could contract jaundice due to the deposition of a yellow pigment called bilirubin in the tissues. When the bilirubin exceeds a certain level, jaundice becomes visible to the observer.

Is neonatal jaundice dangerous?

It depends on the type and severity of jaundice. The unconjugated bilirubin may penetrate the brain cells. However, jaundice can lead to progressive brain damage, mental retardation, and death if there is no medical intervention.

What is the treatment for neonatal jaundice?

Depending on the bilirubin level, phototherapy may be the go-to treatment. Your baby may need additional intravenous fluid therapy if he or she appears dehydrated. Regular monitoring of bilirubin level will be done from time to time.

Asthma: Doctor, my kid can’t stop coughing, is that asthma ?

What is asthma?

Asthma is a chronic (long-lasting) inflammatory lung disease that causes airways to swell up, tighten, and narrow.

What causes asthma?

  • Anyone can get asthma, both children and adults.
  • Children are more prone to get asthma if a parent has asthma.
  • Children with asthma have sensitive airways.
  • An asthma flare makes it hard for your child to breathe.
  • A flare can be triggered by exercise, smoke, allergies, viral infections, breathing in cold air, and weather changes.

What are the symptoms of asthma?

  • A child with asthma wheezes.
  • During an asthma flare, your child may cough, wheeze, sweat, feel tightness in his chest, and experience shortness of breath and palpitation.
  • Your child may cough a lot at night and may not to do so during the day.
  • A child with asthma may enervate faster than other children or avoid activities and places that make it hard for him to breathe.

How is asthma treated?

  • If you think your child has asthma, take him to the doctor.
  • Your doctor will probably want to know your family's history of asthma and allergies.
  • Also, be prepared to tell your doctor about your child's condition.
  • If the doctor thinks that your child has asthma, your child will need a plan to control his symptoms and flares.
  • Asthma is often treated with medication. Medication helps to both prevent flares and treat symptoms.

Infant Constipation: Doctor, why my kid can’t poop?

What is constipation?

Constipation is an abnormal pattern of bowel movements in which stools are passed less frequently than usual and are often harder than expected. Everyone has a different normal pattern. However, a child is constipated whenever his/her pattern slows down noticeably. Sometimes constipation can cause recurrent tummy pain.

What causes constipation?

In most children, there is no disease. However, once constipation begins, it tends to continue. These are some of the factors that may contribute to the onset of constipation:

  • Poor eating habits
  • Poor bowel habits
  • Small tears (fissures) at the bowel opening (anus), causing pain at the time of bowel movements.
  • Some medications such as iron.
  • Illness (vomiting, fever) in which a lot of lost fluids.

What should parents do?

  • If the pain is severe, your child's doctor may use a medicine to soften your child's stool or apply an ointment around the anus.
  • Visit the doctor if you notice a tear (fissure).
  • Be patient. Improvement may be slow, and it can take several weeks of active treatment before your child returns to his or her normal bowel pattern.
  • Always ask your child's doctor before giving a laxative.
  • Increase fluids and fibre (vegetables, cereal, fruits) in diet.
  • Do not punish your child if he or she does not have a bowel movement or if he/she soils his/her underclothes.

Infant colic: Mommy, my tummy hurts.

What is infant colic?

We do not know what causes colic, but it is usually harmless and lasts for a few months before getting better on its own. However, it can be upsetting for parents and caretakers.

Colic has been the common word used to describe regular crying and unease in a baby. This crying can happen at any time but often occurs in the late afternoon and evening, especially in babies between two weeks and four months of age. It is common for young infants to have crying and unsettled times.

What cause colic?

Sometimes, there is a medical reason for the baby's crying. You may need to check with a doctor or nurse. It can be helpful as it is hard for parents to reassure their baby if they are worried that there may be a medical problem. However, in most babies, no medical cause is found. Crying is a communication from the baby to their caregiver that they are in discomfort or distress. It is a normal part of their growth and development. However, it can be upsetting for parents and caretakers.

What are the symptoms of colic?

Colic usually starts when your baby is a few weeks old. The symptoms last for a few months. Most babies grow out of it by the age of three or four months or six months at the latest.

Your baby may cry for several hours a day. You might find it hard to soothe or comfort him or her. A baby with colic can weep at any time of the day, but you may find that the weeping is worse in the late afternoon or evening. Although colic may not be painful for your baby, he or she may look uncomfortable.

How to treat infant colic?

There is no single treatment for colic that works for every baby. Different babies are comforted in different ways, and you may need to try a few methods to see what works best. In time, colic will stop, and your baby’s crying will get better after a few months.

  • Let your baby suck at the breast. It may help them to settle for a short period.
  • Gently rock or hold your baby in your arms.
  • Try to speak softly to your baby. Your voice and presence may help soothe them.
  • Try playing some soft music.
  • Try giving a warm bath.
  • Try to massage your baby. It may calm the baby and help you to relax.

Attention Deficit Hyperactivity Disorder (ADHD): Doctor, I cannot control my kid! Is he hyperactive?

What is Attention Deficit Hyperactivity Disorder?

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental problem that results in poor concentration and control of impulses. It is not an illness. With medical treatment, understanding and care, a child with ADHD can live an ordinary life.

What cause ADHD?

ADHD is a complex disorder with multiple causes that remain poorly understood.

What are the symptoms of ADHD?

These are the common signs:

  • Inattention: Difficulty concentrating, forgetting instructions, and moving from one task to another without completing anything.
  • Impulsivity: Talking over the top of others and losing control of emotions easily
  • Overactivity/Hyperactivity: Constant restlessness.

How to diagnose ADHD?

The diagnosis of ADHD must be made by a trained and experienced health professional, using information from both the family and the school.

How to treat ADHD?

Stimulant medication is the single most effective treatment for the symptoms of ADHD. Positive parenting, home, and classroom strategies such as keeping structure, boosting self−esteem, building social skills, planning the physical and learning environment can help the child. Sometimes the child needs counselling. Children with ADHD need support and understanding from family and teachers.

Autism: Doctor, my kid has speech delay, is that autism?

What is autism?

  • Autism is a developmental disability.
  • It is sometimes called autistic spectrum disorder.
  • It causes a wide range of developmental problems in young children.
  • An autistic child often has difficulties with social skills, communication, and behavior.

What causes it?

  • The cause is unknown.
  • It may have something to do with genetics or how the brain works.
  • Parents do not cause autism.
  • Vaccines do not cause autism. Symptoms usually become more evident in the second year of life, which happens to be around the same time most children get a vaccine for measles. The vaccine does not cause the symptoms.

Who can get it?

  • Anyone can get autism.
  • Parents of a child with autism are more likely to have another child with autism.

What are the signs my child could be autistic?

  • An autistic child's physical appearance is normal.
  • She may not like to be touched or held.
  • She may have strange and repetitive behaviours.
  • She may seem to be in her world and lack interest in other people.
  • She may prefer to play with toys or objects instead of people.
  • Autistic children often seem withdrawn.

How is it diagnosed?

  • It is usually diagnosed by the time a child is three years old.
  • The child should be seen by a doctor as soon as parents notice the symptoms.
  • The doctor will watch your child and ask you about his or her symptoms. How have her social and language skills changed over time? Her behaviour?
  • She may need tests.

How is it treated?

  • The designated treatment aims to help your child reach her highest potential (learn as much as she can).
  • Every child has strengths and weaknesses.
  • Children often benefit from special education programs and behaviour training.
  • Some children may need special teachers or classes or may need to go to a special school. Other children may work best in a "regular" classroom.

Eczema: Mommy, what is happening to my skin?

What is eczema?

Eczema in children is a non-contagious skin condition. It usually appears in early childhood and disappears around six years of age. In some cases, eczema may continue into adulthood. Sometimes, it is called atopic dermatitis. The skin becomes dry, cracked, itchy, and may weep. Eczema can vary in severity and alter daily.

What cause eczema?

The causes of eczema are unknown. However, some things seem to make it more likely to appear, for example:

  • A family history of eczema, asthma, or hay fever
  • Occasionally when travelling to other climates or countries
  • Some children get rashes after eating a particular food
  • Mites in house dust, plant pollens, pets, foods, chemicals, and clothing materials might provoke or inflame eczema.

What are the signs and symptoms for eczema?

  • There will be patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs (but it can occur anywhere). In children, the inner creases of the knees and elbows are often involved.
  • If scratched, dry patches of skin and open sores with crusts may develop and may get infected.

How to treat eczema?

Doctors may prescribe a range of creams include steroid cream, moisturiser, bath oil, antibiotic cream, and medications to control itch to treat the condition

Febrile fit: Doctor, is febrile fit an epilepsy?

What is febrile fit?

Febrile fits are seizures triggered by high fever. They are the most common convulsion (occurring in three to five percent of children) and are generally harmless. The children are usually between six months and six years of age. A febrile fit is not epilepsy and does not cause brain damage.

What cause febrile fit?

It usually occurs with a high fever at an average of 40oC, but it can occur with any temperature when there is a sudden temperature rise. An infection in any part of the body can cause a fever. They do not cause any brain damage, unless in exceptional cases where the seizure is unusually prolonged for more than half an hour.

How to treat febrile fit

  • If your child has a febrile seizure, act immediately to prevent injury.
  • Place your child on the floor or bed away from any hard or sharp objects.
  • Turn his or her head to the side so that any saliva or vomit can drain from the mouth.
  • Do not put anything into his or her mouth; Objects placed in the mouth can be broken and obstruct the child's airway.
  • If the seizure lasts longer than 10 minutes, the child should be taken immediately to the nearest medical facility for further treatment.

When should I bring my child to the hospital?

  • First episode of febrile seizures (generally, children with first febrile seizures are admitted for observation)
  • The neck becomes stiff.
  • Your child becomes confused or delirious.
  • It becomes difficult to wake your child (usually, the child becomes drowsy immediately after a seizure).
  • Your child starts to act sickly.
  • Your child has more than one seizure in a day
  • Your child’s seizure is prolonged (generally, get your child to hospital by the quickest route possible if the seizure is more than 10 minutes)

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