Is screen time affecting my child's development?

As a doctor and a parent, I know the struggle with screen time and kids is real.

Cocomelon is the surest way I can get my kids to stay in one spot and quieten down if needed. At the same time, I try to make a mental note of how much time they are spending on their screens and whether it's past the 1 hour suggested limit by the American Academy of Pediatrics (AAP) for pre-school children aged 2-5.

The concern behind this screen time is - Is it affecting my child’s development?

The quick answer is that it may actually affect development in children with higher screen time exposure. Findings in a study with more than 2000 mothers and children in the USA linked high levels of screen time with delayed development.

A Singapore study found that toddlers who spend more than three hours a day looking at a screen are more likely to be less physically active by the time they reach kindergarten-age. The researchers suggest that limiting the exposure of young children to screens (such as TVs, computers and handheld devices) to one hour a day may promote healthier behaviours later in life. This is in line with recommendations by the World Health Organization (WHO) to limit screen time to an hour or less per day among two- to five-year-olds.

What can I do about screen time for my kids?

Screen time is going to be increasingly challenging for parents, especially during the COVID-19 pandemic. The AAP published this statement on March 17 2020: “While limits are still important, under these stressful circumstances, kids' screen media use will likely increase.”

Dr Cheryl Ngo put together some useful tips on how you can optimize screen time for your children, focusing on how you can keep screen use positive and helpful. These include the following: - Use screen time together to engage with your child on what they are watching - Balance screen time with healthy activities offline to help your child play, relax and communicate - Ensure regular breaks from the screen

What should I do if I think my child may have developmental issues?

Child developmental milestones should be evaluated by a doctor at specific age touch points. MOH has introduced standardized recommended Child Developmental Screening (CDS) touch points, which involves screenings that can be typically conducted together with the recommended childhood vaccinations.

From 1st November 2020, all CDS-incurred charges will be completely subsidised by MOH in both polyclinics, as well as CHAS-approved GP private clinics such as our clinic.

These are the recommended touch-points for CDS:

Credit: moh.gov.sg

Our recommendation at Intemedical would be arranging the touch-points for CDS at the ages of 2, 4, 6, 12, 30 (2.5 years old) and 48 (4 years old) months of age, in conjunction with the timing of the vaccine due at that time.

Here's how you can book an appointment with us for your child's fully subsidised CDS visit.

Appointment Portal: Kovan Clinic / Potong Pasir Clinic

(click and book with instant confirmation!)

WhatsApp: 8879 9404

(available during clinic opening hours, 8am to 12am)

Mobile: 8879 9404

(messaging preferred)

Landline: +65 3165 9251

(please be aware that the phone might be engaged due to high call volume)

Source: https://sph.nus.edu.sg/2020/02/too-much-screen-time-for-young-children-may-lead-to-unhealthy-behaviours-growing-up/

https://www.gleneagles.com.sg/healthplus/article/covid-19-manage-screen-time

Pfizer BioNTech COVID-19 vaccine is now FDA approved in USA. What does it mean for us?

The US Drug regulator FDA (Food and Drug Administration) granted full approval to the Pfizer-BioNTech COVID-19 vaccine on 23 August. This is the first, and currently only, vaccine to secure such validation from the FDA - which is regarded as the one of the lead regulatory bodies for drugs and vaccines.

What does it mean for us in Singapore?

1. Full approval in the US would pave the way for full approval in Singapore Singapore’s equivalent of an approval authority is the Health Sciences Authority (HSA). Currently, the Pfizer-BioNTech vaccine in Singapore has been granted interim authorisation under the Pandemic Special Access Route. It was extended to those aged 12 and above from May 2021. Similar to how many countries take reference to the FDA for approval, it may not be long before we see the same approval in Singapore.
   

2. Pfizer BioNTech vaccine now has plenty of data to be deemed safe It is probably the first time a vaccine has had more than 1 billion patients use it at the time of approval. This has created a significant wealth of safety data after more than 6 months of usage, for regulators to determine the safety and efficacy of the vaccine.
   

3. Once approved in Singapore, more private clinics may be able to offer the vaccine, booster shots facilitated too Full HSA approval in Singapore would mean that private healthcare clinics and institutions in Singapore would be able to purchase from the distributors directly, instead of current special access routes. There is strong suggestion that regular booster shots may be needed for protection, much like the flu. Hence, having easy access to COVID-19 vaccination in these clinics will likely become a norm.
   

If you have not been vaccinated or have a family member or friend who has not been, please book an appointment for your COVID-19 Pfizer BioNTech vaccination at our clinic.

From 18 August 2021, all eligible Singaporeans, Permanent Residents and Long-Term Pass holders aged 12 years old and above can walk in to Intemedical Clinic for first dose vaccination. Vaccination is free for these groups.

Getting your Pfizer BioNTech Vaccine at Intemedical Clinic

Before your visit - Book your appointment through https://www.vaccine.gov.sg/ and select Intemedical Clinic (Kovan) - Both doses must be taken at the same centre - Appointment times are between 1pm - 9.30pm

At your visit - Bring proof of your identification (Eg. NRIC/Passport) - Patients <18 years of age will require parental consent - Patients between 12-13 years of age will need parent/legal guardian to come along - Set aside about 1 hour for the visit including 30 minutes of observation time

After your vaccination - Remember to book your appointment for your 2nd vaccination - Rest and hydrate. Take medications for symptomatic relief for common side effects such as pain over the injection site or fever. If your fever lasts more than 2 days, consult a doctor. - Avoid alcohol for 2 days. Avoid vigorous exercise for 1 week.

Source:

https://www.channelnewsasia.com/world/covid-19-pfizer-biontech-vaccine-us-fda-full-approval-2131206

Tips for itchy skin in kids with eczema

Itch and pain are the main complaints for children with eczema. It can be frustrating for both affected children and their parents, especially when these symptoms cause disrupted sleep and lower productivity in daily activities like schooling.

Eczema is considered a chronic condition and requires commitment to care for.

Here are our top tips for children and parents living with eczema!

1. Use lots of moisturiser Patients with eczema lack a natural barrier in their skin. Using moisturisers helps to act as that barrier to prevent eczema flares. Be prepared to use moisturisers liberally and regularly, especially since with the frequent hand washing practiced during the current COVID-19 pandemic.
   

1. Use 1 finger tip worth of steroids to treat 2 palm size worth of redness Adequate amounts of steroids are needed to treat flares (acute episodes of redness and pain). The amount should span the length of the finger tip (as seen in image) to cover the surface area of 2 palm sizes of an adult hand.
   

2. Apply until rash has settled Related to the first poins is that it is important to continue to apply the topical steroids until the eczema rash has settled. You may need to review again with your GP to check on the response to treatment.
   

3. Avoid triggers Common external triggers include house dust mites, pets, stress and certain foods. If you have identified what usually triggers the eczema flares, see if you can modify the environment your child is in to reduce exposure to these triggers.
   

4. Seek treatment if steroids aren’t working, quality of life affected or lack of sleep Some patients may have eczema conditions that require more potent steroids and even other therapies such as phototherapy or immunosuppressants. If your child is having problems with treatment that is affecting their daily function, it is important to have your GP review it to see if he should be referred to a specialist.

If your child is having itchy and painful skin, you can come down to our clinic or book an appointment (click ‘Book Appointment’ on the top right) to get it checked. Our team will be happy to advise you on what the appropriate treatment steps are.

Should there be any concern with regards to your child’s eczema condition that is affecting their quality of life despite treatment, we would arrange for the appropriate referral to a specialist.

How to make an appointment with Intemedical?

Appointment Portal: Kovan Clinic / Potong Pasir Clinic

(click and book with instant confirmation!)

WhatsApp: 8879 9404

(available during clinic opening hours, 8am to 12am)

Mobile: 8879 9404

(messaging preferred)

Landline: +65 3165 9251

(please be aware that the phone might be engaged due to high call volume)

Source:https://specialty.mims.com/topic/managing-paediatric-eczema-in-primary-care-