Diarrhoea 101

About 1.5 months back, DD had a bout of diarrhoea. It wasn't too serious initially and I continued to feed her what she normally eats, sans dairy. However, I found out that it wasn't enough just cutting out dairy and she would feel worse after every meal. I quickly googled (thank goodness for Google!) what she should or shouldn't be eating and here's what I found.

Foods to avoid:
- Diary
- Oily foods
- Sugary foods
- High fibre vegetables and fruits

Foods to eat:
Bland foods, follow the BRAT diet.
B - Bananas
R - Rice (or porridge for those of us who live in Asia)
A - Applesauce
T - Toast
Other food items which can be taken during diarrhoea include chicken without skin on. The chicken should be cooked without oil (eg baked or steamed). Eggs are also fine.

Hylands Teething Tablets Update

Just a quick update to the post about Hylands Teething Tablets which I wrote in December 2007.

There was finally a recall of the tablets in October 2010. Finally!

From the FDA website:

"Hyland's Teething Tablets are manufactured to contain a small amount of belladonna, a substance that can cause serious harm at larger doses. For such a product, it is important that the amount of belladonna be carefully controlled. FDA laboratory analysis, however, has found that Hyland’s Teething Tablets contain inconsistent amounts of belladonna. In addition, the FDA has received reports of serious adverse events in children taking this product that are consistent with belladonna toxicity. The FDA has also received reports of children who consumed more tablets than recommended, because the containers do not have child resistant caps."

You can read the full recall from the FDA website here.

What You Need to Know About Mercury in Fish and Shellfish

I thought I should post this since I was just telling someone about this. Back in the good old days in Singapore (and many parts of Asia), babies who were weaning on to eating solids at around 4 to 6 months old were frequently fed porridge cooked with fish. So it'll be fish for lunch and dinner, almost 7 days a week. No doubt, fish contains high-quality protein and Omega-3 fatty acids, needed for physical growth and brain development respectively. However, in light of our highly polluted waters nowadays, the benefits of eating lots of fish are negated by the amount of heavy metals contained in these fish. Not only that, but high levels of heavy metals in the body have been linked to behaviour problems, learning difficulties and reduction in IQ levels in children.

And some studies have shown that it doesn't matter whether the fish is farmed or from the sea. Both types of fish can contain heavy metals, with the amounts differing depending on various factors.

Here is the link to the advisory from FDA on mercury in fish and shellfish:

What You Need to Know About Mercury in Fish and Shellfish

The Past 2.5 Months - Part 1

Everytime I think that that will be the longest time I go without blogging, it just gets longer! This time, I haven't blogged for 2.5 months. Unbelieveable. Where has the time gone?!?

The past 2.5 months have been pretty exciting, to say the least. DH took a weeks' leave in the first week of June with the intention of having a holiday right here in Singapore. Yep, that's right, to save some money, we decided to tour Singapore instead since there were so many places we have yet to visit in Singapore. Unfortunately, the night before DH's leave started, DS came down with a fever. And as usual, the bug spread to me and DD too. Just when I thought things couldn't get worse with DH's leave ruined and us spending time sick at home instead of enjoying our holiday, DH came down with sore eyes! Yep, he must have picked up the bug from work. It was a really nasty bug with each eye being infected for 2 weeks. DH says he has never seen sore eyes so bad, even though he sees patients with sore eyes fairly frequently at work. Well, it spread from DH to me, then to DD and finally DS. And guess what? DS spread it back to DH again!!! It took us a grand total of 7 weeks before we got rid of the bug from our household. I started reading up about sore eyes and from our personal experience with it, this was what I learnt:

- Sore eyes can be bacterial or viral.

- The eye drops prescribed for sore eyes are anti-bacterial so they wouldn't work if yours is viral. But doctors usually prescribe them anyway, possibly as prophylaxis. But really, if they are viral in nature, even if you do nothing, it'll eventually go away anyway. Some literature suggests that using the eye drops as prophylaxis on the good eye (assuming only one eye was initally infected) would, in fact, make the good eye more susceptible to picking up the virus.

- If it's bacterial, it'll respond to the eye drops within a few days and you'll see the eyes getting much better. If it's viral, it may not respond and the sore eyes can continue for 2 weeks.

- If it's viral, just drop breastmilk into your eyes a few times a day. Breastmilk contains antibodies which do work against viruses. So there, go befriend a few lactating mothers. You'll never know when you need their help. :P We used only breastmilk in the eyes later on in our infection and that seemed to have cut down the infection time from 2 weeks to 1 week.

- Change pillow cases and towels (bath and hand towels) daily. Change sheets twice a week if you have kids who love to bury their faces into their sheets. Throw away all eye make up or any other make up which goes near the eyes. Wash all makeup brushes if they are too expensive to be replaced. No face towels, just use tissue paper.

- If you have more than 1 kid, put most of their toys away, leaving only those which can be washed or wiped down easily. Towards the end of our infection, we disinfected everything (toys, furniture, doors, etc) nightly with a diluted bleach solution. Door knobs and other common household items like telephones and remote controls were disinfected twice a day.

- And contrary to what many believe, you can't get sore eyes by simply looking at someone with sore eyes! The bug, however, spreads really easily. For instance, if I have sore eyes and I unknowingly rub my eye and later open a door, the next person who touches the door knob will get the bug on his hands. If he proceeds to touch his face, he may transfer the bug to his eyes.

- Oh, and one more, you don't develop any immunity to sore eyes just because you've just recovered from it. DH's eye doctor warned him that he could catch it again anytime. And he did! DS spread it right back to him!

LEAD Found in Vitamins for Women and Children

A recent survey by the FDA on vitamins labeled for women and children found elevated lead levels present in most of the vitamins.

Full report by FDA can be found here. The brand name of all the women and children's vitamins are included in the report, and sorted according to population group (young children, pregnant and lactating women, and adult women) and decreasing estimated exposure.

Do check out the report if you are taking vitamins or if you are feeding your child vitamins. Out of the 324 products sampled, only 3 products for children and 1 product for pregnant or lactating women had no lead levels detected. They are:

- NF Formulas Liquid Pediatric (for children 0-6 years old)
- Natrol Liquid Kids Companion (for children 0-6 years old)
- Twinlab Infant Care (for children (for children 0-6 years old)
- After Baby Boost 2 (for pregnant and lactating women)

On a side note, even though all 324 vitamin products sampled were labelled for women and children, I would imagine that vitamins labelled otherwise (ie for general consumption, not necessarily only for women or children) would also contain lead. My opinion on this is that if you are eating a healthy diet, skip the vitamin! All vitamins and minerals needed by the body can be easily found in the foods we eat daily. Furthermore, absorption of these vitamins and minerals are better from food, rather than from supplements.

(This article was edited on 15 September to include the names of specific samples of vitamins which had no detected levels of lead in them)

Tupperware Plastics Information

I'm a huge fan of Z Recommends. They review products and discuss what is "safe" for babies and children. Recently, they spent quite a number of hours chasing down information on the plastics used to make Tupperware products.

Almost everybody I know uses Tupperware. I'm a big fan of Tupperware storage containers myself. Tupperware containers provide convenient storage solutions for anything and everything - food, drinks, toys and even toiletries. They even have a lifetime guarantee to boot!

So I think it's a huge welcome that Tupperware has decided to release its plastics information. This will allow concerned customers to check if a certain Tupperware product contains Bisphenol-A.

With thanks to Z Recommends, here's a direct link to their blog entry "Tupperware Releases Complete Plastics Information to Z Recommends".

Re: Toys and Lead

With all the recalls of toys in recent months, I hesitate to buy toys for DD and DS. Lead is a toxic substance that is very worrisome, but frequently found in recalled toys. In toys, lead can either be found in the paint on the toys or in the plastic. This is something that I wasn't aware of previously, but lead is added to plastics to soften the plastic and to make it more flexible. The use of lead in plastics is not banned yet.

So what's the problem with lead? The neurotoxicity of lead poisoning is not reversible. That is, any brain damage or learning disability caused by lead poisoning is not reversible. According to the National Center for Environmental Health, children who are at risk of lead poisoning are those below the age of 6, because they tend to put toys, other objects or their hands into their mouths.

While most of the recalled toys involve China-made toys, this is simply because 75% of the world's toys are made in China. Buying a toy that is made in America, for instance, doesn't make the toy any safer than those made in China. Considering the small market share of toys that are made in America and looking at the number of made-in-America toys that are eventually recalled, America may have as high a percentage of recalled toys as China! This is according to data from the Consumer Product Safety Commision (CPSC).

So what to do? We can't possibly avoid toys altogether and have the children run amok at home from boredom. Well, we've just been trying to look at this whole issue rationally and taking a common sense approach to it. If the toy is really cheap, brand unknown, of poor quality (e.g. wood has splinters or plastic has sharp edges) and looks flimsy, then most likely it IS cheaply made. We natually tend to or want to believe that a branded toy (e.g Fisher-Price, Hasbro, Haba, Plan Toys) has better quality control than an unbranded one. Although, having said that, branded toys haven't been spared of recalls either.

Some of you might be aware that there are lead testing kits available for us to test for the presence of lead in toys at home. But according to consumerreports.org, these kits, though "useful", have limitations. For instance, some kits were able to test "surface lead" or "accessible lead", but not lead that was embedded below the surface.

I found a website (http://www.healthytoys.org/home.php) which tests toys for lead and some other toxic substances. This is a project of the Ecology Center, which is a non-profit organisation, so it's good to know this project has no vested interest in any particular toy company. For now, since this has the most information about "safe" toys available on the market, I will try to buy DD toys that are listed as "safe" on this website. At this point in time, I'm more concerned about DD because she puts everything in her mouth!

References:

http://www.cdc.gov/nceh/lead/default.htm

http://english.peopledaily.com.cn/200602/17/eng20060217_243653.html

http://www.usatoday.com/money/industries/retail/2007-10-04-toy-fear_N.htm#open-share-help

http://blogs.consumerreports.org/safety/2007/10/testing-the-lea.html


http://www.healthytoys.org/home.php

BPA-Free Drinkware for Babies and Toddlers

Yes, I admit that I'm a bit obsessed about Bisphenol A (BPA). I recently found more information about BPA in drinkware for babies and toddlers.

In case anyone is interested, this page contains a review of BPA-free sippy cups:
http://tinyurl.com/2anx4r

And this page has recommendations for BPA-free baby bottles:
http://tinyurl.com/2f9wrh

And finally, this page has a directory of BPA-free bottles and sippy cups. This is such a fantastic resource!
http://tinyurl.com/22wxra

Hyland's Teething Tablets - Important Info

Prior to today, I was a big fan of Hyland's Teething Tablets. (http://www.hylands.com/products/teething.php) Most mothers I have "met" in online forums both in Singapore and internationally sing praises about this wonderful product, which does wonders to relieve the crankiness and irritability of a teething infant or toddler. I have given this homeopathic product to DS when he was teething (he was horrible everytime he cut a tooth) and would always be amazed at how his crankiness would miraculously disappear. As such, I have recommended this product to quite number of mummies. I have even bought a new bottle of Hyland's Teething Tablets in anticipation of DD cutting her first tooth, just in case she doesn't take very well to teething, like her brother.

Well, after reading what one mother posted on the Baby Center board, DH and I discussed it and we decided NOT to give our children anymore Hyland's Teething Tablets. We're going to throw away the bottle that we bought for DD. Here's a summary of what the mother wrote on the Baby Center board, for those of you who do not wish to read it - essentially, this mother gave her infant son the recommended dose of Hyland's Teething Tablets and he got anticholinergic poisoning from it. In anticholinergic poisoning, the person may, for example, get delirious, hallucinate and have urinary retention. If medical care is not administered, death may result in severe poisoning.

For the record, I would like to say that I am a skeptic. I usually read what others write with a pinch of salt, especially if it's related to personal experience and not evidence-based. However, DH has read what this mother wrote and he says her description of her son's symptoms does accurately fit a case of anticholinergic poisoning. Some of you will know that DH is a medical toxicologist-in-training (that's why we're here in Denver!).

The reason why Hyland's Teething Tablets work is because they contain a substance called Belladonna. According to DH, Belladonna causes numbness, hence the tablets work to ease the discomfort caused by teething. However, in large doses, Belladonna can cause anticholinergic poisoning. Now, do note that the dosage stated on the product label of Hyland's Teething Tablets is NOT high enough to cause any sort of problems. However, there is no guarantee that there will not be any mistake in the manufacturing process, hence resulting in a higher amount of Belladonna present in the tablets. Hyland's Teething Tablets are manufactured in the US, and the FDA (Food and Drug Administration) in the US does NOT regulate homeopathic products, Hyland's Teething Tablets being one of them. There is really no guarantee that the tablets contain the substances in the proportions stated on the label.

In addition, infants/toddlers may accidentally be overdosed on Hyland's Teething Tablets. I know that I am guilty of having given DS slightly more tablets than recommended on the bottle.

For those mummies who have used or are still using Hyland's Teething Tablets, it is really up to you whether you will continue to use it. I just wanted to highlight the hidden dangers of using this product, which I didn't give much thought to before. DH and I have decided not to use it anymore, even though it worked very well to ease DS's crankiness when he was teething.

I will follow up the case posted on the Baby Center board and post if the laboratory test results are out. I am also curious to know if the tablets in that bottle did contain more Belladonna than they were supposed to.

Bisphenol A, Plastics and Baby Bottles

I looked up this information for a friend (she just gave birth a week ago!) and since I know so many other mummies who are due soon or have infants, thought I'll post this on my blog too.

Bisphenol A (BPA) is a compound commonly found in plastic containers/bottles. More specifically, they are found in polycarbonate plastic (hard plastic containers) and can leach into the food and liquid that we store in these containers. To put it simply, BPA is cancer-causing, but is commonly found in unacceptable levels in our bloodstream and even in umbilical cord blood and in the placenta.

Here's a link to a good article about plastics and kids. This article also recommends safer alternatives: http://www.healthobservatory.org/library.cfm?refid=77083 . Here's another similar article: http://tinyurl.com/23595a

For those of you in Singapore, here are your options if you want to use BPA-free bottles for your baby:

1. Pigeon glass bottles (if breakage is not so much a concern to you) http://tinyurl.com/2a79ku

2. Bfree bottles (sold at bigger Kiddy Palace stores, Baby Hypermart and Pharmaplus at Camden Medical Centre)

3. B-free bottles from Dr Brown (I believe I saw this at The First Few Years at KKH before)

4. Soft plastic bottles like those from Medela

During the first 4 days of DD's life, when I had to supplement her with special milk formula for low birth weight babies, I just used the glass bottles from formula samples they provided at the hospital. But do note that if you are feeding expressed breast milk (EBM) in the glass bottles, there are suggestions that nutrients from the EBM may cling to the side of glass bottles (more so than to plastic) and hence, not get ingested by baby. I can't seem to find references at this point in time that support that claim (although I know that I've read it somewhere before), so if anyone reading this can point me to the references, I would appreciate it if you could send them to me for posting on my blog. Thanks!