Download Document 8028229

A PUBLICATION BY REGISTRATION No. 198901967K
MICA (P) 047/11/2009
COMPLIMENTARY COPY
ISSUE 01 / 2010
Route to Parenthood:
Boosting Your Chances
of Pregnancy
Health Screening
for My Babe
Excuse Me,
I am Pregnant
Your pregnancy is your
best excuse
Happy Labour Day
All you need to know about
delivery without labour
Premium Delivery Packages
For Mums-to-be
Raffles Hospital offers a comprehensive range of maternity packages and services.
Enjoy your pregnancy as you prepare for the arrival of your bundle of joy.
Room Types
Normal Delivery
Caesarean Delivery
S$2,876 (Valued at S$3,317)
S$3,946 (Valued at S$5,136)
2-Bedded Room
S$2,662 (Valued at S$3,103)
S$3,411 (Valued at S$4,494)
4-Bedded Room
S$2,555 (Valued at S$2,996)
S$2,983 (Valued at S$4,066)
Single Room
(Upgrade to Deluxe Room,
subject to room availability)
Packages include:
•
•
•
•
•
•
•
•
2-day stay with nursing care in our inpatient room for the new mummy
2-day stay with nursing care in our nursery for your newborn baby
Daily breakfast, lunch, afternoon tea and dinner with choices from Western, Asian, Japanese and traditional confinement menus
Complimentary internet and wireless broadband access at the wards area and Raffles International Patients Lounge
Complimentary 3-course romantic Celebratory Dinner for you and your loved one worth S$95
Complimentary postnatal massage (single session, subject to specialist’s certification of fitness) worth S$139
Complimentary gift hamper
Complimentary breastfeeding & infant care guide (Breastfeeding to be supervised by lactation consultant)
* Special rates extended for confinement stay.
* Package prices exclude doctor's fees and non-standard medical supplies or tests, lodger and miscellaneous charges.
* Terms and conditions apply.
* Prices inclusive of GST.
To sign up, or for more information, please call 6311 1111/ 6311 1507.
Operating hours: Monday - Friday (8.00am - 6.00pm), Saturday (8.00am - 1.00pm)
NewsRoom
Contents
4
Supplements FoodNotes
Ask a Raffles Doc
Promotions
27
28
29
30
New Doc on the Block | New Centre: Raffles Dialysis Centre |
New Clinic | Hospital Treats Rare Tumour | Superbrands
Features
Route to Parenthood: Boosting Your Chances of Pregnancy 6
Health Screening for My Babe
8
Having problems conceiving? Find out how you can increase your
chances of getting pregnant with some help from your doctor.
Assessing your unborn child’s health is no longer an impossible
dream. Learn about the various types of screening available
and their use.
Eat Away Your Pregnancy
Symptoms 16
Learn to combat common pregnancy symptoms with the right diet.
Happy Labour Day 17
Pregnancy: An Emotional Roller
Coaster 21
Find out about the different labour stages and what you need to do
to ensure a smooth and an unforgettable delivery experience.
Update on Old Wives’ Tales 10
UpClose
Guidelines for Sanity: Surviving the
12 first 3 months of parenthood
23
Do you often dismiss pregnancy beliefs from your elders as
old wives’ tales? Let our experts tell you the common myths
that you can dispel for good.
Phan Nhung enjoys putting a smile on her patients’ faces.
She shares about her work and the joy of helping patients
cope in a foreign land.
Excuse Me, I am Pregnant
Understanding your emotions can lead to a happier, healthier
pregnancy for you and your family. Our experts share tips on
how you can sail through this tumultuous time.
Feeling overwhelmed? Not sure what to do?
Learn to calm those nerves as you take on new
challenges brought on by parenthood.
14
Pregnancy offers you the perfect excuse to enjoy nine months
of bliss. Read on and learn to make the most of it.
DIRECTORY
www.rafflesmedicalgroup.com
Corporate Accounts Enquiries
Fax No. 6311 1333
6311 2383
www.rafflesmedical.com
General Enquiries Fax No. • Anchorpoint • Ang Mo Kio • Anson Centre
• Bedok North
• Bishan • Capital Tower • Causeway Point • Centrepoint • Changi Business Park
• Clementi • Compass Point • Fusionopolis • Harbour Front • Hougang Central • Jurong East • Lot 1 • Loyang Point • Marina Square • Millenia Walk 6311
6311
6479
6453
6225
6441
6456
6323
6894
6733
6781
6872
6881
6466
6273
6386
6899
6765
6585
6339
6337
2222
2392
3818
2288
2188
1736
7122
5212
0777
8775
7337
9043
7337
7366
3078
7896
6688
3363
3333
6644
6000
• Ngee Ann City • Northpoint • Ogilvy Centre • OUB Centre* • Raffles Airport Medical Centre
Passsenger Terminal Two* Passsenger Terminal Three* Airport Transit One Airport Transit Two Changi Cargo Complex
• Raffles City • Raffles Hospital
• Science Park I • Sembawang • Siglap Road
• Sixth Avenue • Tampines Junction • Tampines 1*
• TechPlace II
• Toa Payoh Central
* Clinics with X-ray Facilities
Hong Kong Clinics
6734
6755
6223
6535
6543
6241
6543
6543
6543
6339
6311
6776
6853
6442
6462
6788
6260
6556
6254
7355
0049
1188
2222
1118
8818
1113
1118
1038
6911
2233
7155
7703
0488
3426
2222
5116
2318
7667
(852) 2525 1730
www.raffleshospital.com
General Enquiries
6311 1111
Call Centre Fax No. 6311 2136
24 Hour Emergency 6311 1555
Admissions / Business Office
6311 1888
Raffles International Patients Centre 6311 1666
International Patients Centre Fax No. 6311 2333
24 Hour Appointments Hotline 6311 1222
Fax No. 6311 2136
Email
[email protected]
Raffles Aesthetics
Raffles Cancer Centre
Raffles Children’s Centre
Raffles Chinese Medicine
Raffles Counselling Centre
Raffles Dental
Raffles Dialysis Centre
Raffles ENT Centre
Raffles Executive Medical Centre
Raffles Eye Centre
Raffles Fertility Centre
Raffles HealthScreeners
Raffles Heart Centre
Raffles Internal Medicine Centre
Raffles Japanese Clinic
Raffles Orthopaedic Centre
Raffles Skin Centre
Raffles Surgery Centre
Raffles Women’s Centre
Physiotherapy Centre
Radiology
Regional Representative Offices /
Liaison Centres
Indonesia
Jakarta Representative Office Semarang Representative Office
Jogiakarta Representative Office
62 21 5785 3979
62 24 841 9600
62 274 623288
Vietnam
Hanoi Representative Office 84 4 39367999
Bangladesh
Dhaka Representative Office
88 02 8835984
Editorial: Dr Prem Kumar Nair, Magdalene Lee,
Clara Cai, Fann Khoo & Manjit Kaur
Creative: Edd Chua & Jenny Cheok
The information contained in this publication should
not be regarded as a substitute for detailed medical
advice in individual cases.
All rights reserved. No part of this publication may
be reproduced in any form or by any means without
the written permission of the publisher.
Please address all correspondence to
The Editor, Raffles HealthNews,
Fax no. 6311 2378
Email: [email protected]
Raffles HealthNews is published by
Raffles Medical Group Ltd
585 North Bridge Road, Raffles Hospital
#11-00, Singapore 188770
www.rafflesmedicalgroup.com
Printed by Olympia Printing Pte Ltd
Feb 10
Newsroom Raffles HealthNews
1New Doc on the Block
Dr Wendy Sinnathamby, Specialist in Paediatric Medicine at Raffles Children’s
Centre, graduated with MBBS from Guy's and St Thomas' Hospitals in UK in 1997 and
obtained her MRCP (UK) in 1998. She completed her paediatric training in the UK and
worked as a Consultant in Paediatric Medicine at Medway Maritime Hospital in Kent for
two years prior to moving to Singapore.
Dr Wendy became a Fellow of the Royal College of Paediatrics and Child Health
(FRCPCH) in 2007. Her main area of interest is in general paediatrics managing a wide
variety of paediatric conditions including chronic cough, asthma and allergy. She is
also experienced in follow up of newborns, developmental screening and adolescent
medicine.
Dr Christine Hyun Jin Lee, Specialist in Dental Surgery at Raffles Dental, graduated with
Bachelor of Dental Surgery from the University of Otago School of Dentistry New Zealand in
2007. She worked for the New Zealand Defense Force in year 2008. Thereafter, she worked
at a private dental clinic in Hamilton City in 2009.
She enjoys being a general dentist as she has the opportunity to explore a wide range of
dental conditions. Treating a variety of patient groups is also a valuable part of fulfilling her
role as a dentist. Her main areas of interest are paediatric dentistry, oral diagnostics and oral
surgery.
Dr Scott Chao, Specialist in Dental Surgery at Raffles Dental, obtained his Bachelor of
Dental Surgery degree from the University of the Pacific, School of Dentistry in 2001. In
2001, he received his Doctor of Dental Surgery degree from the University of the Pacific
School of Dentistry in San Francisco USA. Coming to Singapore in 2009, Dr Chao
focuses on general dentistry with a special emphasis on solid periodontal foundation.
Dr Chao provide a wide range of general dental services, including aesthetic crowns
and bridges, dentures, extractions and minor oral surgery.
2Superbrands
Raffles Medical and Raffles Hospital were
awarded the Superbrands status in 2009.
Superbrands is an independent arbstractor on
branding which pays tribute to brands that it considers exceptional through its
programs such as the Superbrand reference book, events and PR activity.
The independent Superbrands survey (a brand recollection survey) was
conducted by the Nielsen Company in March 2009. Raffles Medical and
Raffles Hospital came up first when interviewees were asked about brands
under the private healthcare institutions/hospital category.
Said Dr Loo Choon Yong, Executive Chairman, of Raffles Medical Group,
“We are proud to have two of our strongest brands included in Superbrands
Singapore 2009. The consumers voted for us because of the quality, reliability
and distinction of our brand. Raffles will continue to strive towards providing
high quality and excellent healthcare services.”
3
The new clinic at
Changi Business Park (CBP)
is open
Operating Hours
Monday - Friday : 8.30am to 1.00pm, 2.00pm to 5.30pm
Saturday : 8.30am to 1.00pm
Address
1 Changi Business Park Crescent, Plaza 8 #01-11
Singapore 486025
Tel: 6781 9033
Email: [email protected]
Raffles HealthNews Newsroom 4
Raffles Hospital Treats
Rare Tumour
ellor,
nsen, Couns
r Gong Chu
ore visited
Xiaokang, M
ap
ng
ng
ha
Si
.Z
in
.E
y
ss
bassador H
China Emba
e, from left to
Chinese Am
es. In pictur
ary, from the
On behalf of
Third Secret
eir good wish eneral Manager,
o,
th
ta
ai
em
H
th
ng
nd
se
and Mr Cha
rence Lim (G
r mother to
Fen and he
acar, Mr Law and Ms Wu Xiao Fen.
Ms Wu Xiao
r Diarra Boub
en
D
ns
o,
hu
ta
C
ai
g
H
on
ng
Mr G
right: Mr Cha
u ’s mother,
pital), Ms W
os
H
s
fle
af
R
For 25-year-old Ms Wu Xiao Fen, from the Yi minority from China, the
pain on her head is not just a figure of speech. Eight years ago, a tumour
started growing on her head. Today, it covers 30% of her scalp.
In October last year, Medical Directors of Raffles Hospital, Prof Walter
Tan and Dr Yang Ching Yu, together with a team of plastic surgeons,
went on a medical mission to Kunming. While they were there, they
attended to Ms Wu and found her suitable for surgery. However, due to
the complexity of the surgery, the team felt it would be best to do it with
a multi-disciplinary medical team.
Ms Wu was suffering from a malignant tumour, arising from the scalp and
skin. It had eroded through her skull bone. Prior to her operation, Ms Wu
was in pain and her tumour bled constantly.
On 10 January, a team of three plastic surgeons led by Prof Walter Tan,
Specialist in Plastic Surgery and Reconstructive Surgery, operated on Ms
Wu to excise the tumour. The operation was then taken over by a team of
5
Raffles Dialysis Centre is now open. As a hospital-based dialysis
centre, it offers safe, accessible and affordable haemodialysis for
outpatients and inpatients. In additional, professional services and
facilities are in place to support high dependency and complicated
cases. The centre is supported by a dialysis team of nephrologists,
dialysis nurses and a dietitian.
At Raffles Dialysis Centre, you will receive your dialysis in a
private area equipped with a flat screen LCD television with cable
channels. Private rooms are available upon request. Meal services
customised to personal preferences are also available to you
during your dialysis treatments.
For more information, please call 6311 1222
or email [email protected]
Ms Wu’s scans show that the tumour has grown to 14.0cm by 11.0cm
in size. The tumour has also made two indentations on to the skull.
neurosurgeons, led by Dr Ng Puay Yong, a sessional Neurosurgeon at
Raffles Hospital, who worked to remove the affected cranial bone. During
the third stage, the plastic surgeons reconstructed the huge defect with a
full scalp rotation flap and skin graft.
“We had anticipated that the surgery could take up to eight hours to
complete,” said Prof Walter Tan, “However, the multi-disciplinary team
took less than four hours to complete the entire surgery. We are delighted
that Ms Wu recovered so quickly.”
The surgery and hospital stay of approximately $56,000 is co-funded
jointly by Raffles Hospital and the Asian Medical Foundation - the
charitable arm of Raffles Medical Group.
Said Mr Lawrence Lim, General Manager of Raffles Hospital, “Ms Wu’s
treatment represents a humanitarian effort of Asian Medical Foundation
and Raffles Hospital, and a contribution to the close people-to-people
relationship between Singapore and China.”
Feature Raffles HealthNews
Route
to
Parenthood:
Boosting your chances of pregnancy
D
id you know that humans are among the least fertile species on earth? For some couples,
conceiving a child is relatively simple. However, that does not apply to everyone.
Conception difficulties are more common than you would imagine.
Raffles HealthNews Feature Age does play a role in the reproductive
game. The ideal age for conception for
women is between 22 and 26 years of
age. For every year after 30 years old,
the chances of conception decline by
2.5% and this drastically declines after 40
years of age.
Statisticians have estimated that the
chances of conceiving are about 10% per
month for a couple in their forties even
if tests do not detect any abnormalities.
The American Society of Reproductive
Medicine guidelines have shown that the
chances of conception at age 46 are less
than 1% even with In Vitro Fertilisation
(IVF).
If you haven’t conceived after 12 months
of trying, (or six months if you’re 35 years
or more), it may be time to consider
seeking medical advice. You should seek
advice earlier if you are on long term
medication for a medical condition such
as thyroid disorder, diabetes, depression
or autoimmune disorders.
About one in ten couples experience
difficulties conceiving. Fertility treatment
can bring you a step closer to your
dreams of having a child. There are many
different treatment options available.
They include:
1.Lifestyle modification
“The most important correctable
factors for fertility are weight control,
abstinence from smoking and alcohol
for both husband and wife, and
optimisation of the female pelvic organs
through the removal of cysts, fibroids,
scars (adhesions) and damaged
fallopian tubes,” said Dr Sheila Loh,
Specialist in Obstetrics & Gynaecology
at Raffles Women Centre.
Body mass index below 18 and above
25 may be associated with ovulatory
disorders in women. Obese men
may also have poorer sperm mobility.
If you’re a smoker, it’s time to stop.
Smoking causes accelerated ageing of
a woman’s eggs and if the husband also
smokes, chances of conception in an
IVF cycle would be significantly lower
as compared to non-smokers.
2.Reproductive surgery
There are a variety of structural
causes of female factor infertility that
have surgical solutions. For example,
reproductive surgery and diagnostic
procedures
can
correct
tubal
obstruction, endometriosis, uterine
fibroids, and scarring from pelvic
inflammatory disease.
3.Medications to induce ovulation
Examples include Clomiphene,
Metformin and Gonadotrophins.
According to Dr Koh Gim Hwee,
Specialist in Obstetrics & Gynaecology
at Raffles Women Centre, Clomid
(Clomiphene Citrate) is the most
common and most useful drug for
treatment of ovulation problems in
women. However, it is not useful for
women who are already ovulating
and when the infertility is related
to other problems. Clomid is safe
provided its use is monitored because
some women do develop cysts after
taking Clomid. “The cysts are usually
benign and the result of an underlying
problem of the ovary. It is not directly
due to the medication itself,” Dr Koh
added.
4.Artificial insemination or IUI
The purpose of the Intra Uterine
Insemination (IUI) programme is to
place some of the good quality sperms
into the uterus at the time the wife
releases her eggs. Hence, to ensure
optimum chances at IUI, the woman
must have a normal uterus and patent
fallopian tubes. Her husband’s sperms
must also be of sufficient quality and
quantity.
“Chances are also higher if she
is below 37 years of age and the
treatment is performed together with
super-ovulation, i.e. medications to
induce more than one egg,” said
Dr Loh. Average success rate is about
12-15% per attempt.
5.IVF
IVF is the general term covering all
the various programmes that involve
the help of a scientist to fertilise the
eggs in the laboratory.
A couple needs this treatment if they
have blocked or damaged fallopian
tubes, severe endometriosis or if the
doctor suspects a fertilisation problem
e.g. older women, women with
fewer eggs or failed IUI treatment.
This treatment is also suitable if the
husband has poor sperm quality.
IVF outcome is most dependant on
the egg quality. Dr Loh stressed that
although IVF has a much higher success
rate, at an average of 30-40% per
attempt, this must be weighed against
its risks - more injections, more stress,
higher complication rate of multiple
pregnancy and ovarian hyperstimulation
syndrome (where the woman gets very
bloated with water retention and in rare
situations, breathlessness). IVF is also a
more lengthy and expensive treatment
when compared to IUI.
IVF is used for severe infertility factors
or as a last resort if simpler treatments
HN
fail.
Male Infertility
Studies have shown that male
infertility is on the increase because of
declining sperm quality and counts.
According to Dr Fong Yan Kit, Specialist
in Urology at Raffles Surgery Centre,
factors that can affect sperm health
include:
a. Varicocele (an abnormal enlargement
of the veins in the scrotum draining
the testicles) as it elevates the intrascrotal temperature
b. Drugs, smoking and alcohol
c. Previous infection of the testis and
prostate
d. Exposure to strong radiation
e. Stress
Even if you are facing male fertility
issues, all hope is not lost.
Dr Thong Pao Wen, Specialist in
Obstetrics & Gynaecology at Raffles
Women Centre, shares with us the
following ways to improve their sperm
quality:
a. Stop smoking
b. Take a regular supplement containing
essential vitamins, minerals and
anti-oxidants
c. Prevent overheating of the scrotum by
avoiding tight underwear or long
stays in the sauna
d. Avoid excessive pressure on the
scrotum (e.g. long distance cycling).
e. Learn to relax and prevent excessive
stress. Eat well and sleep well
f. Maintain a healthy weight as being
over or under-weight can influence
estrogen and testosterone levels
g. Stop using recreational drugs and
alcohol
h. Stop using body building anabolic
steroids as it can cause testicular
shrinkage
i. Avoid over intensive exercise which
can cause a testosterone
deficiency
j. Avoid environmental hazards like
radiation, pesticides, heavy metals,
lead or paint
Feature Raffles HealthNews
Health Screening
for
My Babe
Pregnancy is an amazing thing. Inside your body is
a growing foetus that will, in months, come into
this world. This process is incredible and usually straight
forward. However, there are times when things may
go wrong and your baby may not develop
the way he/she should.
Raffles HealthNews Feature necessary to ensure that the unborn child is
of good health and not affected.
When would the second trimester
screening need to take place and what
is it for?
Foetal screening is important as doctors
can detect abnormalities in the unborn child
early. If there is a defect that is incompatible
with life, the parents can be counselled. Early
detection also allows for safe termination of
the pregnancy.
In the second trimester, the foetus is
screened around 20 weeks for common
structural abnormalities that can be
detected by ultrasound, placental
localisation and cervical length. This is
an important scan as it allows parents to
be reassured that there are no structural
abnormalities in the majority of cases. It
also allows the identification of structural
abnormalities that may need to be treated
during pregnancy or soon after delivery.
Certain abnormalities necessitate the
baby to be borne by a certain method (like
induction for early labour or Caesarean
section). Sometimes, babies with certain
abnormalities require immediate specialised
medical attention at birth and this could be
arranged in anticipation if the abnormalities
are detected during foetal screening.
Foetal screening can be conducted
during the first, second and third
trimester. We speak to Dr Tony Tan who
has special clinical interests in foetal
medicine and therapy on the various types
of screening and their purpose.
If the placenta was low-lying, the
obstetrician would have to take note
of symptoms like vaginal bleeding and
check the location of the placenta later in
the third trimester to determine whether a
Caesarean section is required for delivery.
A short cervix at 20 weeks increases
the risk of premature delivery before 33
weeks. For those with a short cervix, your
doctor may treat you with progesterone to
reduce the risk of premature delivery.
What is the first trimester screening about
and who needs it?
What is the third trimester screening about?
Is it necessary?
2
Tests to set your mind at ease
Understanding Screening
1
Babies can be abnormally formed
or be affected by poor development
while in the womb of the mother. With
modern science, assessing your unborn
child’s health is no longer a dream.
Foetal diagnostics allow doctors to screen
your unborn child for potential health
problems and physical defects. Parents are
thus better able to cope with the potential
stress involved. Your doctor can also better
manage your pregnancy to ensure that you
can have a smooth delivery.
According to Dr Tony Tan, Specialist in
Obstetrics and Gynaecology, Raffles
Women’s Centre, about two to five per cent
of babies are born with some type of birth
defect. “This may be due to chromosomal
abnormality, genetic disease or structural
abnormality in the baby.”
Women of all ages, and not just those aged
35 and above, should consider screening
for ease of mind as many abnormalities in
the babies are random events and may not
be easily identified by factors such as age
or family history.
“All pregnant mothers, to a certain extent,
must receive some basic form of foetal
screening,” advised Dr Chow Kah Kiong,
Specialist in Obstetrics and Gynaecology,
Raffles Women’s Centre. “The most usual
one is a routine blood test. The next almost
universal test is an early ultrasonogaphy on
the foetus.”
However, depending on the risk factors
in the pregnancy, more tests may be
The First Trimester Screening combines
historical data, high resolution ultrasound
scans with the mother’s blood. It is
conducted earlier than most other
prenatal screening tests, between the
11 to 13 weeks of your pregnancy. As a
routine prenatal screening test, it is safe
and poses no risk of miscarriage or other
pregnancy complications.
It has, over the years, developed into
an improved version as it screens for
common chromosomal abnormalities
such as Down syndrome, early structural
abnormalities, and the risk of early preeclampsia (a condition which manifests
as high blood pressure with proteins in
the urine during pregnancy that requires
delivery before 34 weeks).
I recommend this test to all pregnant
women regardless of age, as it is now
recognised as the best screening test
for Down syndrome. It is better than
screening for Down syndrome just
by maternal age alone. Knowing the
risk of severe pre-eclampsia early in
pregnancy also allows the identification
of those at high risk to benefit from the
use of medications such as calcium
supplementation and low dose aspirin
early in pregnancy. This may reduce
the risk of pre-eclampsia.
Our clinic has a very good performance
record in the First Trimester Screen, with a
very high detection rate of Down syndrome.
In the third trimester, the foetus may be
screened for growth disorders. In five per
cent of cases, the foetus is growing below
the normal range. Such foetuses should
be monitored closely so as to determine
the best time for delivering the foetus. A
3D or 4D scan, purely for bonding between
parents and the foetus, may also be
performed at this time if you wish.
HN
3D/4D scan
Unlike traditional 2D ultrasound scans,
3D scans send sound waves at different
angles. The returning echoes are
processed, resulting in a reconstructed
three dimensional volume image of the
foetus's surface or internal organs. 4D
ultrasounds string together frames of 3D
ultrasounds to see movement.
10 Feature Raffles HealthNews
Updates on
Old Wives Tales
There is a whole range of stories surrounding the topic of pregnancy. These myths or old wives tales as some
would call them, ensure that you are kept on your toes throughout the entire pregnancy period.
Hear from our experts to ascertain those that you can simply dismiss.
You can’t take medication during
pregnancy.
NOT TRUE: Many women refuse to take
medication during pregnancy for fear of
possible adverse effects. Often, they would
rather “endure” the symptoms. Common
examples include “flu” and “vomiting”.
While it is generally agreed that vomiting
is a common symptom of early pregnancy,
severe vomiting may lead to dehydration,
which can be harmful to the general
health of the woman. In certain cases
of upper respiratory infection, a course
of antibiotics may be necessary. If left
untreated, it may occasionally lead on
to chest infection (pneumonia). Similarly,
bladder infection should be treated.
Untreated bladder infection may result in
infection to the kidneys, and may increase
the risk of premature labour.
Women may also stop medication on their
own for an underlying condition once they
are pregnant, without the doctor’s advice.
Examples include asthma, thyroid and
high blood pressure medication. If the
underlying condition is not controlled,
it may have a negative impact on the
pregnancy such as increased risk of
miscarriages and poor growth.
Therefore, don’t play doctor and consult
your healthcare provider to find out what’s
safe to take.
— Dr Watt Wing Fong, Specialist in
Obstetrics & Gynaecology, Raffles Women
Centre
Raffles HealthNews Feature 11
It is unsafe to undergo hair colouring
during pregnancy.
NOT TRUE: Hair colouring is generally
safe for pregnant women. There have
been no known harmful effects of dye or
chemicals entering the pregnant mother's
body through the skin or hair due to hair
dyeing.
However, do take note of the following:
• Wear gloves when handling the hair
dye
• Clean off any dye that gets onto the
skin immediately
• Do not leave the hair dye on longer
than the recommended duration
• Wash off the hair dye thoroughly with
water & shampoo
• Opt for natural hair dyes if possible
In addition, stick to the brand of dye that
you have used before. This is to minimise
the possibility of developing an allergic
reaction, which would require treatment
with drugs such as steroids. You should
also read the instructions that come with
the dye and ensure that there is no warning
against its' use during pregnancy.
the pelvis, throughout the flight.
• A
void gas producing food and airline
food. Try to bring your own food if
your airline allows.
Epidurals are dangerous as the
mother may suffer long-term damage
like paralysis, rheumatism and
backache.
— Dr Mohamed Faizal, Family Physician
at Raffles Medical’s Terminal 3 Medical
Centre
NOT TRUE: The use of epidural analgesia
for pain relief in labour is very safe, and
the risk of any complications from it is
very low.
Your gums bleed easily during
pregnancy. Bumps or swellings on
the gums are mainly due to hormonal
changes and not something you
should worry over excessively.
If a woman in labour is unable to cope
with the labour pains using other methods
of pain management, then having an
epidural is an effective method to relieve
her pain. The pain relief it provides can
last throughout labour, however long the
duration of labour is.
NOT TRUE: The change that affects
women the most is pregnancy gingivitis.
This is a condition whereby the hormones
in the bloodstream cause the gums to
become more sensitive to food and
bacteria that naturally live in the mouth.
This makes the gums more inflamed
and bleed easily upon brushing. In some
women this is quite mild and they may
not notice it. However, in others, the
inflammation can be quite marked and
become painful if left unchecked. This
can lead on to benign growths known as
pregnancy tumours.
— Dr Chow Kah Kiong, Specialist in
Obstetrics & Gynaecology, Raffles Women
Centre
Overwhelming clinical evidence has also
shown that gum disease during pregnancy
can lead to premature, low birth weight
babies.
You shouldn’t fly.
During pregnancy, it is ideal to visit your
dentist, especially in the second trimester
to ensure that your routine has been
adequate. A cleaning and gum treatment
at this time is ideal to prevent pregnancy
gingivitis.
NOT TRUE: Generally, commercial air
travel poses no special risks to a healthy
pregnant woman or her baby. The main
concern for the airline is the likelihood of
the pregnant woman going into labour
whilst flying as this would potentially require
a costly diversion and inconvenience to
other passengers.
Most airlines are willing to accept
pregnant passengers up to 35-36 weeks.
Most also require a doctor’s letter from
28 weeks onwards. These two criteria
vary amongst the different airlines.
Further evaluation is required if there have
been complications during the pregnancy,
before the journey.
It is also prudent to find out what health
care facilities are available at the
destination and whether your travel
insurance would cover for the cost of any
complications of the pregnancy requiring
medical input or evacuation.
Some tips on the aircraft:
• Take short walks along the aisles
every 30mins if it is safe to do so.
• Do stretches and isometric leg
exercises.
• Drink plenty of fluids.
• Sit closer to the lavatory.
• Seatbelts should be worn low around.
— Dr Rachel Chan, Specialist in Dental
Surgery, Raffles Dental
The leakage of water is a signal
that you would go into labour soon.
However, the labour process could
be very long and you should
only go to the hospital if you
experience contractions.
NOT TRUE: Some women think that
they should only go to the hospital if
they experience contractions. They fail to
realise that it is possible for the water bag
to be leaking without going into labour.
The danger of that is that there is an
increased risk of infection once the water
bag leaks. Once infection sets in, the baby
may be affected. Sometimes women may
not know if it is urinary leakage or amniotic
fluid leakage.
When in doubt, one should always confirm
with their doctor.
— Dr Karolyn Goh, Specialist in Obstetrics
& Gynaecology, Raffles Women Centre
— Dr Lee I Wuen, Specialist in Obstetrics
& Gynaecology, Raffles Women Centre
Post delivery, you are not to take
a bath for one month (i.e. during
your confinement period).
NOT TRUE: In my opinion, you can take
a bath as long as there is no open wound.
Since hygiene is the reason for bathing,
do take note of the following:
• Bathe when necessary i.e. not too
frequently
• Bathe with warm water at 37 degrees
Celsius i.e. similar to our body
temperature
• Use some herbal water to bath to
avoid catching the cold and damp. It
could also help with blood circulation
• Keep the bathing process short, within
five to ten minutes
• Dry and dress up immediately to avoid
catching a cold
If the wound is still healing, it is
recommended to use a warm damp
towel to freshen up instead of bathing, to
prevent infection.
— Ms Jin Jinhua, Consultant Acupuncturist,
Raffles Chinese Medicine
You should not breastfeed a toddler
during pregnancy, as that would
affect the new baby who needs all
the nourishment it can get.
NOT TRUE: As long as a woman is
healthy, breastfeeding during pregnancy
won't harm her, the foetus, or her toddler.
However, a doctor may recommend that a
pregnant woman not breastfeed, if she has
a nutritional deficiency, is underweight, or
is at risk for pre-term labour.
HN
— Dr Jazlan Joosoph, Specialist in
Obstetrics & Gynaecology, Raffles Women
Centre
12 UpClose Raffles HealthNews
UpClose
Ms Phan Nhung
with
Manager, Hospital Marketing, Raffles Hospital
3
7-year-old Vietnamese, Ms Phan Nhung, is a blessed woman. Besides having two adorable
girls (six and two years old) and a supportive husband, she is in her dream job - one that
allows her to combine her interest in marketing and her desire to help others cope with
health problems. She speaks about how her role as manager for hospital marketing in Raffles
Hospital, helps the unwell find hope in a foreign land.
Raffles HealthNews UpClose 13
How long have you been with Raffles?
What is it about healthcare that
attracted you?
I joined Raffles Hospital four years ago.
Before that, I was a Senior Marketing
Executive in charge of marketing in a
training and consultancy business.
I always thought it would be meaningful
to contribute to the health of others. With
my interest in marketing, I realised I could
help market the hospital. Hence I wrote in
to the Human Resource department for a
job opportunity.
With that, I now directly market the
services of Raffles Hospital to foreign
patients who are seeking medical help for
their ailments.
So, what does the hospital marketing
department do that makes it different
from other marketing departments?
Raffles Hospital’s hospital marketing
department has several units focusing
on the international markets and local
markets. I belong to the International
team where we bring in foreign
patients.
In addition, we service foreign patients
who require assistance in languages.
Being native speakers, we are able
to provide personalised service to our
patients, especially in bridging the
language gap, which is one of the most
challenging factors that foreign patients
face.
What’s a typical day for you like?
A typical day for me starts with visiting
the Vietnamese inpatients in the
Hospital. I believe providing personalised
service is the most important aspect of
a healthcare business that outweighs
all other marketing efforts. If we are
unable to deliver our promise to our
patients while they are here, no amount
of marketing events or advertising
campaigns will help.
What skills do you need to have to be
in hospital marketing? Are there any
specific character traits that you need
to have?
As a woman working in healthcare (and
having two kids), what would be your
best tip for fellow women, especially
those who are planning to have kids?
To be effective in hospital marketing,
you would require marketing sense;
that includes a sense of urgency when
you receive patients’ enquiries.
If you have not made plans for kids, start
planning today! Kids are an incredible
source of joy. While it’s easier said than
done, working mothers must find ways
to strike a balance between their family
and career. Sacrificing one for another
may not bring you fulfilment in the long
run though it may give you temporary
relief.
Since healthcare is a service industry, you
must genuinely care for patients. Serving
foreign patients can be burdensome
if you are unable to relate to patients’
circumstances, since many come with
complex medical conditions. Compassion
is also important as patients depend on
you for information and support.
What do you enjoy most about your
work?
Working with a team that relentlessly
cares for the patients as well as growing
the market energises me. I also find it
personally fulfilling to be able to make
our foreign patients’ experience at Raffles
Hospital complete through our assurance
that we are here for them 24 hours every
day. In a way, we are like their family
away from home.
I remember a patient from central Vietnam
who came to Raffles for the treatment of
tongue cancer. As it was his first time
to Singapore, he had made several
appointments with other hospitals in
Singapore prior to the visit. After I received
him from the lobby and accompanied him
through his visit at Raffles, he asked if I
could help him cancel his appointments
with the other hospitals as he found our
care comforting. A sense of peace could
be seen on his face after a long search for
medical treatment overseas.
At times when I have to work beyond
office hours or when I have to travel for
work overseas, my husband and my
helper would support me.
That’s no easy task - balancing
between family and work
commitments. So what drives you
on to do what you do everyday?
Since I joined Raffles, I am happy that
more Vietnamese patients are choosing
to come to Raffles Hospital. In fact, the
Vietnamese have moved up to be one
of the top groups among the foreign
patients in Raffles Hospital.
Seeing how our foreign patients recover in
the hands of our medical team and getting
their positive feedback motivates me in
my work. I look forward to each day as a
chance to contribute to the growth of the
hospital and to support the medical team
to nurse patients back to health.
HN
The main part of my day job is to
work closely with our Patient Liaison
Offices, and Associates from regional
countries. I also coordinate with clinics
and doctors to answer patient enquiries
and provide support to foreign patients
who need language translation services
while they are at Raffles.
ir
nd the
ang) a
).
(Jeff T Annie Tang
d
n
a
b
er hus a Tang and
h
h
it
(Ann
ung w
an Nh princesses
Ms Ph
two
m
a
I
,
e
m
a
I
m
,
e
m
e
su use ant
c
n
t
n
a
g
n
x
EE xc
14 Feature Raffles HealthNews
g
e
e
r
r
PP
The joy in pregnancy lies in
the fact that you are now
in the best position to make
excuses, and the people
around you would not dare
to call your bluff.
Raffles HealthNews Feature 15
Every possible situation can be blamed on pregnancy.
Forgot somebody’s birthday? – I’m pregnant!
Slept the afternoon away and had no time for chores? – Pregnant!
Craving for that sinful dessert? – Pregnant!
Good mood? Bad mood? In the mood? No mood? – Excuse me, I’m pregnant!
Much has been said about the trials
and tribulations of pregnancy. While it is
undeniably a trying and difficult time for
women who have to put up with certain
unpleasant symptoms, there’s no reason
why you should not have fun during this
period now that you have the perfect excuse
for everything you do (and don’t do).
Pregnancy is the time for self-indulgence.
Enjoy it while it lasts.
All Hail the Queen
The changes in the hormonal levels in
pregnant women are truly profound. Most
men find it difficult to fully comprehend what
is causing all these changes from mood
swings to the need for extra sleep to food
cravings. If he really wishes to understand,
get your doctor to explain the details. All
he really need to know is that as this is a
demanding time for you, the least he could
do is to give in to your requests.
In addition, it’s important that you do not tire
yourself too much when you are pregnant.
Make full use of this fact to your best
advantage. If anything, now is the time
your partner should relieve you of certain
household chores. He should have been
doing his share of the work prior to this.
However, if he had not been helping
out previously, now is the best time to
start. With nine months of training, your
husband would no longer be able to cite
ignorance as the reason for not helping
out.
The Dream Diet
Most women, at some point of their life,
would go on a diet. At least many would
claim to be. Whether they keep strictly to
their diet plan is another issue altogether.
The point is, many women have to forgo
some of their cravings due to weight or
health issues.
Diets are not for pregnant ladies. The
baby needs all the nutrients it can get. At
the same time, a bit of junk food won’t hurt
either. After all, you are now entitled to
have ‘cravings’ and indulge in them fully.
In addition, women should not forgo
this opportunity to consume the famous
Chinese delicacy - bird’s nest. Said to
give one good skin and health, now is the
time for you to fully pamper yourself with
such expensive treats.
Remember, what’s good for you is good
for your baby (and vice versa of course).
Big And Beautiful
Some of us suffer from negative selfimage from time to time. The plethora
of airbrushed images in the media can
be depressing even for people in the
healthy weight range.
As mentioned, every woman, when she
becomes a mother, gets some time off
from the dieting cycle. This is a great
relief for many. When you are pregnant
or holding a baby in your arms, people
seem to forgive you more readily for
carrying the extra weight. After all,
babies are much more important than
looking like a supermodel. You are big
and beautiful.
Pregnancy is the best excuse for carrying
extra weight. However, if your reason to
be overweight is pregnancy, make sure
you use this excuse only for up to a year
after your child’s birth. HN
16 Feature Raffles HealthNews
Morning sickness, heartburn
and constipation are common
symptoms you may encounter during
your pregnancy. Ms Nehal Kamdar,
Senior Dietitian at Raffles Internal
Medicine Centre, shares some tips on
how to handle them with the right diet.
Eat Away Your
Pregnancy Symptoms
Morning Sickness
Constipation
Heartburn
While this is usually experienced in the
morning, the feeling of nausea or vomiting
can also be experienced in the afternoon or
evening. Morning sickness occurs in 50 to
90% of pregnancies. It sometimes continues
beyond the 1st trimester. However, it usually
ends by the 14th week of pregnancy.
You may also experience constipation
as the muscles of the gastrointestinal
tract are relaxed during pregnancy. As a
result, food stays in your intestines for a
longer period of time.
Heartburn is usually experienced during
the last stage of pregnancy. As your baby
grows larger, it can push up against the
stomach. As such, the acid content in the
stomach is forced up into the oesophagus.
Relieve the symptoms by:
Control of the symptoms by:
You can relieve the symptoms by:
aking something light, such as
• T
crackers or dry toast 10 to 15mins
before you get out of bed, followed
by a light breakfast soon after rising.
• Having smaller and more frequent
meals/snacks.
• Avoiding foods which you find
nauseating, such as oily and
spicy foods.
• Wearing loose and comfortable
clothing.
• Drinking lots of fluid to avoid
dehydration.
• Increasing fibre intake. Eat more
wholegrain cereals, fruits and
vegetables.
• Increasing fluid intake by taking
a minimum of 10 glasses of fluids
a day.
• Increasing physical activity
(in accordance to your
doctor’s advice).
• Taking prune/apple juice or dried
prunes. These can act as natural
laxatives.
voiding spicy, fried food and coffee.
• A
• Having smaller and more frequent
meals or snacks.
• Drinking fluids between meals
rather than together with the meals.
• Sitting upright for one to two hours
after meals.
Raffles HealthNews Feature 17
S
Happy Labour Day
o it’s D-Day. You are going into labour.
Understand the labour stages and
what you need to look out to have an
unforgettable delivery experience.
18 Feature Raffles HealthNews
You should contact
immediately if:
your
doctor
• your water bag breaks, or if you
suspect you’re leaking amniotic fluid
• your baby is moving less than usual
• you have vaginal bleeding (unless
it’s just a small amount of bloodtinged mucous)
• you have fever, severe headaches,
changes in your vision, or abdominal
pain
These may signal an emergency and
would require immediate medical
attention.
Labour Is Painful
We have all heard stories of how painful
the labour process is. Thankfully, with the
help of modern medicine, mothers can
get pain relief.
“In my practice”, shared Dr Tan Yew
Ghee, Specialist in Obstetrics and
Gynaecology, Raffles Women’s Centre,
“epidural analgesia is the most common
method, accounting for 70 to 80% of
all deliveries and showing an upward
trend over the years. This trend is
largely due to the safety record and by
word of mouth recommendations”.
Every labour experience is unique - an
unforgettable experience that you can
proudly recount to your child when he/
she grows up.
According to Dr Koh Gim Hwee, a
Specialist in Obstetrics and Gynaecology,
Raffles Women’s Centre, childbirth can
take just a few minutes or many hours.
“The signs of labour can be unique
to different individuals,” said Dr Koh.
According to him, the simple pre-labour
signs you should learn to recognise
before rushing down to the hospital
are:
1.Persistent lower back or abdominal
pain, often accompanied by a
crampy premenstrual feeling
2.A vaginal bleeding called “show”
(a brownish or blood-tinged mucus
discharge). If you pass out the mucus
plug that blocks the cervix, labour
could be imminent or days away
3.Painful contractions that occur at
regular intervals, each lasting only
30 seconds
4.Clear water flowing from the vagina
(broken water bag), but you’re in
labour only if it is accompanied by
painful contractions
As with every procedure, including
epidural analgesia, there is a one to
two per cent risk. Serious risks from
the use of epidural include possible
infection, severe headache and drop in
blood pressure. The medical team will
adjust the dosage such that there is no
complete numbness and you can push
naturally under close supervision for a
natural vaginal birth.
TENS
Transcutaneous Electronic Nerve
Stimulation uses electrical current to numb
areas of the body, blocking pain signals
to the brain and stimulating endorphin
production.
Acupuncture
You will require several treatments in the
last few months of pregnancy, and this may
result in a smoother, less painful birth.
Acupressure, Massage and
Counterpressure
These specific touch techniques help relieve
pressure or pain and enhance relaxation
and release endorphins.
Hot and/or Cold Compresses
Applied to the lower back, these help
relieve back pain.
Aromatherapy
The use of aromatic substances can
trigger other chemical responses in the
body to help relax.
Music
Sound can help reduce our perception of
pain and enhance relaxation. Different types
of music are useful at different stages of
labour. Music masks the distracting sounds
in the hospital environment to create a more
personal atmosphere to labour in.
Movement, Positioning, and Position
Changes
There are many alternative pain relief
methods. Here are some of them:
Your baby’s position contributes directly
to the pain and length of labour. You
should follow your body’s cues to move
and change positions frequently. Some
helpful movement and position changes
for labour include walking, swaying,
slow dancing, squatting, lunging, and
hand-knee positioned pelvic rocking.
Breathing and Relaxation
Companionship and Support
Use learnt breathing patterns to aid
your relaxation. You would consciously
release tension in your body, allowing
your uterus to do its work without
additional effort or energy wastage. To
be able to relax during labour would
require some practice though.
Hydrotherapy
Some studies have shown that
hydrotherapy, when used correctly during
labour, can be safe, reduce pain, enhance
progress, and reduce the likelihood of
tearing in your perineum (the area between
your vagina and anus). A shower is
beneficial almost anytime during labour.
Labour support provided by a professional
Doula, or birth companion, may improve
birth outcomes, reduce the numbers of
Caesarean sections, epidurals and other
medical interventions, while promoting
bonding and successful breastfeeding.
Delivery Stages
Childbirth can be divided broadly into
three main stages. Dr Cordelia Han,
Specialist in Obstetrics and Gynaecology,
Raffles Women’s Centre, explains what
happens during the three stages and
what you need to do during each stage.
Raffles HealthNews Feature 19
The first stage begins with contractions.
Contractions are regular painful uterine
tightening that causes progressive
changes in your cervix and ends when
your cervix is fully dilated. This stage
is divided into two phases: latent and
active phase of labour.
During the early latent stage of labour,
your cervix gradually effaces (thins
out) and dilates (opens). During active
labour, your cervix begins to dilate
more rapidly. During the active phase
of labour, contractions are stronger,
closer and more intense. This last part
of active labour is also referred to as
the “transition stage”.
The second stage of labour begins once
you’re fully dilated and ends with the birth
of your baby. It is sometimes referred to as
the “pushing” stage. This is where mothers
are encouraged to push when contractions
are present. An episiotomy may be required
for the majority of first-time mothers. This
is where your doctor makes a small cut to
widen the outlet for an easier delivery. This
will subsequently be repaired.
The third and final stage begins right after
the birth of your baby and ends with the
separation and subsequent delivery of
the placenta.
The length of labour can vary from
individual to individual. “First-time
mothers may experience longer labour;
sometimes as short as six hours and
others as long as 20 hours,” said
Dr Han. Usually, the duration of labour
gets shorter with each subsequent
birth,” she added.
Post-delivery
After birth, your doctor will check your
pulse, blood pressure, and uterus
contraction to ensure everything is
fine. Your baby may be given a dose
of Vitamin K and will have an APGAR
test (covering your baby’s appearance,
pulse, grimace, activity and respiration).
You should check with your doctor on a
regular basis to understand what you
can or cannot do.
“Breastfeeding mothers will notice that
abdominal cramps similar to those
experienced during menstruation occurs
after breastfeeding,” said Dr Han. “This
is due to the oxytocin released during
breastfeeding in the first few days.”
A final word of advice from Dr Han:
“every mother has an inborn strength to
deliver and nurture a child. Use it and
enjoy this beautiful experience.”
Surviving Your Wife’s
Delivery
Nowadays, wives expect their
husbands to be in the delivery
room, and for good reasons. Dr
Jazlan Joosoph, Specialist in
Obstetrics
and
Gynaecology,
Raffles Women’s Centre, shares
tongue-in-cheek advice on how
you can stand by your wife, and not
faint, as you welcome your little one
to this world.
• Be prepared. When your wife
announces that she’s pregnant, it
also means that you are going to
be a dad. Denial will not help.
• If it’s going to be a caesarean
birth, do not peak over the green
flap unless you are sure you can
handle it.
• Even if you see little value in
your presence, it can greatly
boost your wife’s morale. Just
cheer her on and be around to
support her. And don’t faint. The
medical team already has their
hands full.
• Birthing is not usually a medical
emergency, so do stay calm and
don’t get all hysterical at the
sight.
• When your wife screams at you
“this is all your fault…” recognise
that it is a routine result of a
hormonal change during the
•
•
•
•
•
final stage of the birth process. And
if you think about it, she’s probably
right. Avoid screaming back. It’s not
the right time.
Should you see a pair of scissors
emerge or hear the word
“episiotomy”, be very engrossed by
anything else you can find in the
room. Turn away. This is important to
your future well being.
Seeing your little one come out from
the love of your life is one of life’s
beautiful miracles. Show extreme
pride and admiration for your wife’s
pain threshold and be secretly
grateful that you will never ever
have to go through her suffering.
The cord cutting ‘ceremony’ is an
unforgettable moment for many
fathers. When cutting the cord, be
extremely gentle and careful. It is
much tougher and more sausagelike than you will expect.
If you have not taken biology classes
in school, you may be surprised by
the birth of a second, less attractive
baby. It looks like a plastic bag of
frozen meat and is large. This is the
placenta that played a big role in
protecting and nurturing your child.
After the hospital stay where you
have nurses fussing over you and
your wife, be prepared for the
many adventures when you are
home. Getting experienced hands
to help is advisable but learn fast
from them. HN
20 Feature Raffles HealthNews
Bagging the Delivery
Pack your hospital bag ahead of time to reduce unnecessary stress. Ensure
the bag is roomy enough to contain all the items that you, your husband
and your baby will require during the hospital stay. Below are some
suggestions on what you ought to pack.
Mother
Extras
____ Comfortable robe
____ Electric heated massager
____ Nightgown
____ Massage oil
____ Nursing bra and nursing pads
____ Personal stereo and headphones
____ Warm socks
____ Favourite tapes or compact discs
____ Slippers
____ Books and magazines
____ Comfortable outfit to wear home
____ Camera or video camera
____ Sanitary pads
(with fresh batteries)
____ Toiletries
____ Extra pillow
____ Hair clips, scrunchies, barrettes
____ Gift for sibling
____ Brush or comb
____ Hard candy to suck on during
Father
____ Change of clothes
labour
____ Lanolin, if nursing
____ Cell phone
____ Book or magazine
____ Toothbrush, toothpaste and
other basic toiletries
____ At least $20 in cash and loose
change for snacks, phone calls, etc
____ Watch with a second hand for
timing contractions
Notes
__________________________________
__________________________________
__________________________________
__________________________________
Baby
____ Car seat
__________________________________
____ Newborn hat
__________________________________
____ 2 receiving blankets
____ 2 “onesies”
__________________________________
____ 2 pairs of socks
__________________________________
____ “Going home” outfit -- including
__________________________________
sweater or bunting
____ Diapers and diaper bag
Documents
____ Birth plan
____ Insurance cards
____ Address book with phone
numbers
__________________________________
:
y
c
n
a
l
l
o
e
r
R
n
C
l
a
o
n
a
o
ster
i
t
o
g n Em
Pre
Raffles HealthNews Feature 21
A
P
regnancy is an exciting time when a new member is added to the household.
However, it is also a stressful and worrying period coupled with many emotional
and physical changes. Not surprisingly, many pregnant women develop depression.
“Depression is more than just feeling
blue,” explains Dr Clarice Hong, Specialist
in Psychiatry, Raffles Counselling Centre.
“Depression is a mood disorder that causes
an extreme dip in your mood so much so
that it interferes with your daily activities.
While depression is not uncommon, it is a
source of concern during and immediately
after pregnancy as it can affect the health
of both the mother and the baby.”
According to studies, one in five women
would experience some depression
symptoms during their pregnancy, while
as many as one in ten would develop
full-blown clinical depression.
Depression usually results from a
combination of factors. These range
from family history of depression,
hormonal and physical changes during
pregnancy to stressful life events.
Pregnant women with untreated depression
are more likely to experience pre-term birth,
spontaneous abortion and gestational
hypertension or pre-eclampsia.
Baby Blues
Feeling down after childbirth is common.
Hormonal changes post-delivery coupled
with the stress and fatigue from baby care
are all triggers for one to feel blue.
There are three levels of depression
that’s associated with post-delivery. The
most common but the least severe of
them is baby blues. Symptoms include
moods swings, feeling sad, anxious or
overwhelmed, loss of appetite and trouble
sleeping. Such feelings usually go away
naturally within a few days to a week.
Postpartum depression is a more
severe level of depression. It can hit
anytime within the first one year after
childbirth. Sufferers will have thoughts
of hurting the baby, themselves and
lose interest in the baby. Postpartum
depression usually lasts longer and
will require treatment by a doctor. Early
intervention can speed your recovery.
A severe but rare condition affecting only
four in 1000 births, postpartum psychosis
occurs in the first two weeks after childbirth.
Sufferers see things that aren’t there, feel
confused, have rapid mood swings and will
actually attempt to hurt themselves or their
baby.
Sufferers of postpartum psychosis should
get immediate medical help. Don’t wait and
hope for improvement as it may lead to lifethreatening thoughts or behaviours. HN
22 Feature Raffles HealthNews
Depression Che
cklist
Are you:
• Feeling res
tless or moody
• Feeling sad
_______
, hopeless, and
overwhelm
• Crying a lo
ted _______
• Having no e
_______
nergy or motiva
tion
• Eating too
_______
little or too mu
c
h
• Sleeping to
_______
o little or too m
uch
• Having trou
_______
ble focusing or m
a
king decis
• Having mem
ory problemsions _______
• Feeling wor
_______
thless and guilt
y
• Losing intere
_______
st in activities yo
u
used to enjoy
• Withdrawin
_______
g from friends a
n
d
family
• Having ache
_______
s and pains that
don’t go away
______
_
Enjoying the Roller Coaster Ride
Dr Hong shares eight tips to help you enjoy your pregnancy and post-delivery.
1.
Get as much rest as you can. Sleep when the baby is sleeping.
2.
Do what you can. There’s no need to be perfect.
3.
Seek help from your husband, family, and friends.
4.
Make time for yourself, to go out, meet friends or just spend time with your husband.
5.
Talk about your feelings with your husband, family, and friends.
6.
Talk to fellow mothers and learn from their experience.
7.
Avoid making major life changes during pregnancy or right after giving birth to reduce unnecessary stress.
8.
When big changes can’t be avoided, arrange for support and help in your new situation ahead of time.
Raffles HealthNews Feature 23
Guidelines
for Sanity
Surviving the first 3 months of parenthood
T
he journey of parenthood is often emotionally charged. On one hand, you
will be rejoicing the addition of the newest (and cutest) member to the
family. On the other, the new challenges may leave you tired, frustrated,
and often a little frightened. Here is your guide to surviving the first three months
of parenthood.
24 Feature Raffles HealthNews
Self-Care after Childbirth
During the first two weeks at home,
you should focus only on caring for
yourself and the baby. Let your friends
and relatives who are willing to help do
the cooking, cleaning, shopping and
laundry. Adequate help and rest can
make a great difference in how quickly
you feel strong and well.
Therefore, all new parents can benefit
from assistance at home after childbirth.
For a woman who has had a caesarean
birth, such help is essential at least for
the first week.
In addition, during the first few days,
mothers should:
• Do some leg exercises to reduce the
chance of deep vein thrombosis.
• Ensure adequate water intake and
eat well.
• Avoid carrying heavy objects (i.e.
anything heavier than their babies),
and strenuous activities.
• Get help with household chores.
Having a confinement lady may help.
• Look after the wound by ensuring
personal hygiene i.e. take a shower,
but keep the wound dry and clean.
Eating right
Nutritional foods and beverages are
just as important after birth as during
pregnancy. A woman’s body has just
completed one of the most physically
draining tasks it ever has to do, and
needs time and help to return to its
normal state.
Eating right after delivery isn’t that
complex. Just continue eating a goodquality diet as you did during pregnancy.
If you are not breast-feeding, your nutrient
and calorie needs are the same as they
were before you became pregnant. If you
are breast-feeding or recovering from a
caesarean delivery, you will have special
nutritional needs.
According to Ms Nehal Kamdar, Senior
Dietitian at Raffles Internal Medicine
Centre, it is easier for breastfeeding
mothers to lose weight as breastfeeding
use up to 500 calories per day. If you
are breastfeeding, avoid cutting down
on portion size as it will reduce the
amount of breast milk you produce.
However, you can reduce your intake of
oily food and sugars like cakes, pies,
pastries, fried chicken, roti prata etc.
Raffles HealthNews Feature 25
If you are not breastfeeding your baby
or have stopped, the following tips from
Ms Kamdar may be of help:
• Focus on Do’s rather than Don’ts
For example, rather than thinking of all
the yummy foods that you may need
to cut down or avoid, think of the sexy
dress that you can buy once you have
lost weight or the pre-pregnancy clothes
that you could fit into.
• Establish FAST goals
Keep your goals flexible, attainable and
short-term (FAST) and work towards
them.
• Eat regular meals
Do not skip meals in your attempt
to lose weight. Breakfast is a very
important meal of the day as it jump
starts your metabolism.
• Include foods that are high in fibre
Fibre adds bulk to food and helps
you feel fuller for a longer time.
If you are breastfeeding your baby,
going on a restrictive diet will reduce
the amount of breast milk you produce.
“Environmental contaminants are stored
in body fat and losing weight rapidly can
cause these contaminants to be released
in the blood stream and passed to the
baby via breast milk. Trying to lose weight
drastically by following severely restricted
diet will leave the mother nutritionally at
risk, with low energy levels and low level
of immunity,” added Ms Kamdar.
Most doctors will advise new mums to
continue with their pre-natal vitamins in
addition to extra calcium. So talk to your
doctor about your eating habits and what
kind of vitamins he or she recommends.
Nursing mums can also be anaemic, so
your doctor may also recommend that
you take an iron supplement.
Putting an exercise plan in place
Too many of us are familiar with the negative
body-image issues that come along after
childbirth. Although the baby is out, you
may still look pregnant. Wearing maternity
clothes when pregnancy is over just isn’t
fun, and being offered a seat in MRT in such
circumstances is no longer a relief.
“You must be realistic with your weight loss
goals after pregnancy. It took you nine
months to gain all that weight, therefore, give
yourself at least a year to get back to your
pre-pregnancy weight,” said Ms Kamdar.
So, when should you start exercising
again? “Generally, it is recommended that
women wait about six weeks after they have
given birth to start exercising, eight weeks
if they have had a caesarean. However,
some women can start exercising before
this,” said Dr Watt Wing Fong, Specialist
in Obsterics and Gynaecology at Raffles
Women Centre. Therefore, do discuss
with your doctor if you are planning to start
an exercise regime.
If you are breastfeeding, there are a few
things you should keep in mind when you’re
exercising. “First, make sure your breasts
are well supported when you exercise.
Also, try to breastfeed your baby before you
exercise. It will be more comfortable as your
breasts won’t feel so full,” said Dr Watt.
Post delivery, do you often feel overwhelmed and drained? You are not alone. Here are some tips from Dr Lim
Yun Chin, Specialist in Psychiatry at Raffles Counselling Centre, to keep you on top of the situation.
Take care of your own needs
Rather than count on someone else to take care of you, it’s actually your job to take good care of yourself. This is one thing
you simply cannot and should not delegate.
Learn to cut corners on things that don’t matter
Alternatively, learn to delegate them to someone else. Instead of trying to do all the household chores, leave more time for
the things that really matter to you, such as spending time with your loved ones.
Have a support team in place
Your family members, friends, or co-workers could all be members of your support team. There should be someone waiting
to cheer you on after a tiring day.
Don’t lose your sense of humour
It’s the ultimate weapon against the madness around you. Hanging on to it will keep you sane.
26 Feature Raffles HealthNews
Operation Breastfeeding
Contrary to what many believe, a mum’s
role in breastfeeding is really to hold the
baby close and wait for the baby to do his
job. While you may wish to talk, pat or stroke
him and encourage him to feed, ultimately,
all you really have to do is to be patient.
Never insist that a baby “has to be hungry”
just because it’s been a while since he had
been fed. Likewise, you can’t assume that
he can’t be hungry because he just ate, for
example, one hour ago.
“Babies are unpredictable and no two babies
follow the same feeding schedule. Some
babies will finish feeding in 15 minutes;
some may need an hour,” said Dr Watt.
Fathers are powerful partners who can
contribute to the success and failure of
breastfeeding by actively supporting and
helping their wives. A dad’s assistance is
key in this project. Here are some pointers
for our super-dads in the making:
Learn to read signs
Babies won’t hesitate to show you their
true feelings. However, their actions
can be so subtle that many of us will
not be able to second-guess what they
are trying to convey.
Remember, when a baby is under stress
(i.e. hungry, cold, wet or dirty diapers,
pain and loneliness) he will show you
some very predictable signs. He’ll curl
up his hands and feet and bring them
to the center. He’ll bend his knees and
cross his feet or put his heels together.
He’ll start to turn his head and may suck
on his hands or fingers. Eventually he’ll
start to fuss and finally cry.
Tips for New Dads
Basically, your baby is asking you to pick
him up and tend to his needs through the
above actions. Learning to read his body
language will save you and your wife lots
of heartache and tears.
The first time alone with your burden
of joy need not be a nightmare. By
taking some simple steps, your
first time alone with the baby will
be a pleasant and enjoyable one.
Remember, practice makes perfect.
Be helpful
The joy of diaper changing
If your wife is breast-feeding, she will
probably feel sleepy just after nursing.
Encourage her to take a nap while the
baby is sleeping.
Make sure you are familiar with
the steps in diaper changing. It is
recommended to have practical
experience beforehand. Having to
change a loaded diaper without
some experience could get you and
your baby in a very messy situation.
In addition, relieve your wife from
as many of her usual roles and
responsibilities as possible. Unless
she genuinely wants to, she shouldn’t
have to do any chores, deal with her inlaws or anything else except caring for
herself and the baby.
A well-rested mum is less likely to feel
cranky and the whole family benefits
from this.
Ensure that your wife feels
appreciated
Surprise your wife with your thoughtfulness
and get her out of the house once in a
while. Even brief breaks can be relaxing.
Help her realise that she is an incredibly
important person in the household through
your words and actions. HN
Assembling milk bottles
Make sure you know where all
bottles are kept and learn how to
assemble and disassemble one. Do
some test runs under the guidance
of an expert. Never feed a newborn
without first testing how hot the
formula is.
Distraction tools
Ensure you have age appropriate
toys, DVDs and other such stimuli
on hand. Babies are easily distracted
and these tools might help ease their
anxiety when Mummy is not around.
Raffles HealthNews Supplements 27
PREGNANCY
and the use of
Nutritional Supplements
During pregnancy, hormone secretion changes radically, causing the physical
and emotional changes experienced by most women fairly early in the first
trimester. These hormonal changes can lead to "morning sickness" or nausea
in the first trimester, especially when there are nutritional deficiencies.
Nearly all pregnant women can benefit from nutritional and multivitamin
supplementation one year before and throughout pregnancy, labour, delivery
and breast-feeding.
Promotions
Now buy 1 at S$16.90*
Buy 2 at S$29.90*
.......... S
tudies have shown that deficiencies of folic
acid have been linked to low birth weight
and neural tube defects (in infants). It is thus
recommended that all women of childbearing
age take daily folic acid supplements to reduce
their risk of congenital birth defects.
Raffles Pregnancy Support 60’s
(U.P. S$18.90)
Vitamin B6
.......... Supplementation
of Vitamin B6 has been linked
to relieve nausea and morning sickness.
Raffles DHA (U.P. S$20.30)
Vitamin B12
.......... R
equired for proper homocysteine metabolism
and may also help in the prevention of anaemia.
Folic Acid
Calcium
Omega 3
.......... C
alcium supplements may reduce the risk of
pre-term delivery, often associated with preeclampsia. They can also help to ease leg
cramps during pregnancy.
.......... Maternal levels of omega-3 fatty acids,
especially DHA, decrease during pregnancy.
In nursing women, the material levels and
essential fatty acids (EFAs) in breast milk may
be reduced further. For the foetus, a deficiency
of EFAs, particularly Eicosapentaenoic acid
(EPA) and Docosahexaenoic acid (DHA),
may lead to a poorly developed central
nervous system.
* Prices are not valid in conjunction with other discounts and promotions.
* Only valid at Raffles Health Retail Pharmacy at Raffles Hospital.
585 North Bridge Road | Level 1 | Raffles Hospital | Singapore 188770
Now buy 1 at S$17.90*
Buy 2 at S$31.90*
28 FoodNotes Raffles HealthNews
Chicken
Herbal Soup
1 serving per recipe
Ingredients
•
•
•
•
50g chicken leg, boneless
5 red dates
15g dang sen (codonopsis)
8g kei chee (wolfberries)
• 5g dang gui (Angelica)
• 500ml chicken stock
• Salt and pepper to taste
Preparation
1. Cut the chicken to cubes and blanch in hot water.
2. Add in red dates, dang sen, kei chee, dang gui and chicken stock.
3. Bring to boil with slow fire. After that, to simmer for 3 hours.
4. Add salt and pepper to taste.
Nutrition Information per Serving
Calories Fat Carbohydrate Protein Fibre 50g
2g
10g
4.3g
0.5g
“A simple, easy to prepare, nutritious soup for the new mum!”
Ms Nehal Kamdar, Senior Dietitian,
Raffles Internal Medicine Centre
Ease of preparation:
Nutritional level:
Raffles HealthNews Q&A 29
What are the effects of 'cooling' food on females? Is it
true that eating 'cooling' foods, such as pineapple and
cucumber will induce more discharge in females? Can
the consumption of 'cooling' food cause miscarriages?
Vaginal discharge is sometimes due to hormone changes or mild infections that can be the result
of pH (acidity) changes in the vagina. It is quite possible that certain foods alter the pH and thus
induce more vaginal discharge. Such mild discharge is harmless. There is no scientific proof that
miscarriages are caused by 'cooling' foods.
Dr Tan Yew Ghee, Specialist in Obstetrics & Gynaecology, Raffles Women Centre
Cold foods in Traditional Chinese Medicine (TCM) are a type of food which may stimulate the cooling effects
in your body and reduce the “yang” energy, as our body needs to counter the cooling effect with yang energy
in the body. Prolonged period of taking these kinds of food without balancing them with other warm or hot
food may cause yang energy and kidney yang deficiency. This interferes with the normal function of the
reproductive organs and leads to irregular periods and abnormal discharge.
If the woman’s constitutional type is cold and damp, then she has a deficiency of spleen and kidney in TCM
terms. Taking too much cooling food will induce more discharge. For pregnant woman with a history of
miscarriage, and weak kidney yang, the consumption of cooling food may cause miscarriages.
Ms Jin Jinhua, Senior Acupuncturist, Raffles Chinese Medicine
Why do some women put on so much weight after giving
birth while others less?
There are several factors that contribute to some women retaining pregnancy weight or gaining
additional weight during confinement.
In the Asian culture, women are supposed to observe a one-month confinement period to nurture
the women’s health back to prenatal state. During this month women are to eat fatty and oily food
like internal organs, fried chicken, fish and food cooked with a lot of ginger and sesame oil. Some
Asian cultures encourage eating 30 chickens, 12 bottles of rice wine and 15 kilos of old ginger
root. ‘Cooling’ vegetables are not given; physical activities like walking around the house or going
out for walks are restricted. This high-calorie diet coupled with lack of exercise contributes to
weight gain, more so if the woman is not totally breastfeeding her baby.
Ms Nehal Kamdar, Senior Dietitian, Raffles Internal Medicine Centre
PROMOTIONS
30 MarketPlace Raffles HealthNews
Your TCM Specialist Centre
Traditional Chinese Medicine (TCM) has been used for centuries
to relieve many symptoms and complications of pregnancy.
Acupuncture and certain Chinese herbal treatments are safe
and natural alternatives for mums and babies to stay healthy,
and for mums to restore their bodies after birth.
Sign up for a TCM package that meets
your needs.
Antenatal TCM Care Packages
February - March 2010 Promotion
1. Raffles Lifestyle Package at S$244.80
2. Enjoy Wellness vaccination(s) at the following prices
for every Lifestyle Package sign up:
•
•
•
•
•
Hepatitis A vaccination S$72.20
Hepatitis B vaccination S$28.85
Hepatitis A & B vaccination S$90.50
Influenza vaccination S$23.40
Gardasil (cervical cancer) vaccination S$144.45
3. Get the following health supplements at:
• Raffles Glucosamine (1500 mg) (40's) S$34.10
• Raffles Adult Multi (60's) S$25.60
• Raffles Women's Multi (60's) S$31.40
April 2010 Promotion
1. Lipid screen, glucose check and doctor's review at
S$32.10
2. Travel kit at S$26.95
For more information, please call 6311 1111.
Terms and conditions:
* All credit card promotions are not valid with the above packages.
* Packages are only valid for the promotion period.
* Packages are only valid at RafflesMedical panel of clinics
in Singapore. Packages are not available at
Raffles Health Screeners, Raffles Executive Medical Centre
and Changi Airport Medical clinics.
* Prices inclusive of GST.
•
•
•
•
eneral Well Being (4 sessions of acupuncture)
G
General Pain Management (6 sessions of acupuncture)
Headaches and Migraines (6 sessions of acupuncture)
Skin Care (6 sessions of acupuncture)
S$190
S$287
S$287
S$377
Postnatal TCM Care Packages
•
•
•
•
Post Delivery Care (5 sessions of acupuncture)
Weight Management (10 sessions of acupuncture)
Full Body Slimming TuiNa (6 sessions of acupuncture)
Local Area Toning TuiNa (6 sessions of acupuncture)
For more information or to book an appointment,
call us at 6311 2388 / 2322.
Email [email protected] or visit us at
www.raffleschinesemedicine.com
* Terms and conditions apply
* Valid till 31 March 2010
* Prices inclusive of GST
S$375
S$642
S$492
S$321
PROMOTIONS
Raffles HealthNews MarketPlace 31
New Mum Rejuvenation Programme
Restore your glow and regain your figure with a whole range
of services specially designed to meet your unique needs.
Maternity Wellness Package S$963
Hormonal changes in pregnancy causes three in five women to
suffer from pregnancy gingivitis (inflammation of the gums).
If left unchecked, this can progress to periodontal (gum)
disease which has been linked to pre-mature, low birth weight
babies. Pregnant women with chronic gum disease are four to
seven times more likely to deliver prematurely than mothers
with healthy gums.
The good news is that clinical trials have shown that gum
treatment and therapy can significantly reduce this risk. It is
therefore recommended that you include a dental check-up as
part of your pre-natal routine.
This package comprises 10 Pre or Post Natal massages
which may be utilised during or after pregnancy.
Glowing Complexion Package S$637
This package is excellent for the treatment of fine lines,
wrinkles, mild acne scarring, keratosis, orange peel skin and
uneven pigmentation.
Skin Renewal Package S$1,563
This helps get rid of unsightly freckles and skin pigmentation,
while stimulating collagen to produce a firmer skin tone that
looks revitalised and rejuvenated.
Cosmetic Surgeries and Treatments
Raffles Dental Maternal Health Package
at S$107*
• First dental GP consultation
• Scaling and polishing
Sign up now and receive a complimentary pre/post natal
massage worth $130 at Raffles Aesthetics in Raffles Hospital.
Complimentary massage to be redeemed within 3 months of
purchase of the Dental Maternal Health Package.
Choose something for yourself from our range of cosmetic
surgeries and treatments to bring out your confidence and
radiance after childbirth.
Weight detox programme
Hair loss treatment
Hair transplantation services
Breast augmentation (breast implants or breast reduction)
Liposuction (for arms, thighs and tummy for a slimmer
silhouette)
• Abdominoplasty (tummy tuck to reduce excess skin)
• Fat transfer (for facial and buttocks enhancement)
•
•
•
•
•
For appointment, please call 6311 2360 /2365
or email us at [email protected].
For more information or to make an appointment,
call 6311 2340 or email [email protected]
* Terms and conditions apply
* Prices inclusive of GST
* Terms and conditions apply
* Prices inclusive of GST
1 tertiary hospital
72 multi-disciplinary clinics
35 medical specialties
34 years of quality health care
1 Trusted Medical and Wellness Provider
Raffles Medical Group offers a complete continuum of care through its network of clinics and hospital.
At Raffles Hospital, we go the extra mile to provide the highest quality medical care and services through
personalised team-based care and patient centric services that are tailored to your needs.
Raffles Medical provides a comprehensive range of family medicine and corporate wellness services,
including vaccinations, health screening, travel health, emergency and housecall services through
our islandwide panel of clinics.
Our medical facilities at the Singapore Changi Airport also provide family medicine, health screening, emergency
and dental services. Our medical centre at Terminal 3 is available 24 hours for your healthcare needs.
With us, your health is in good hands.
This is our promise.
Services
24 Hour Emergency / Aesthetics / Ambulance / Cancer / Children / Chinese Medicine / Counselling /
Corporate Healthcare / Dental / Dialysis / Ear, Nose & Throat / Eye / Family Medicine / Fertility / General Surgery /
Health Screeners / Heart / House Calls / Internal Medicine / International Patient Services /
Japanese Clinic / Orthopaedics / Physiotherapy / Skin / Travel Health / Women
To Our Patients Our Best
For more information on our services or for an appointment, please call +65 6311 1111 (24-Hour)
www.rafflesmedicalgroup.com