The Bub in the Belly

Hello friends,

A quick post today to respond to one of the comments on my post on Rachel's new meal plan. I felt that the commenter probably represented a good number of parents in Singapore so I hope that by posting my response here for everyone, it might provide some additional insight into our choices for Rachel.

This was the comment:

It is a whole new idea to skip formula milk during the day at any caregiver's place and on milk (bm) at night. Your PD gives a different perspective from what other PDs mention with respect to milk is a must for calcium needs.
Have you considered full cream fresh/UHT milk?
Sippy Cup vs Straw Cup - any difference on dental hygiene?

Anonymous


Hi Anonymous,

Thanks for your comment, which I very much appreciate.

I'm flattered that you may have thought that I'm such an innovative person but really, it is not a whole new idea to rely on breastmilk and solids at this stage when Rachel is coming to 16 months. In fact, the World Health Organisation recommends exclusive breastfeeding up till 6 months and then breastfeeding with other food up till two years. The plan is to progress from (1) breastmilk to (2) breastmilk and solid foods then (3) to solid foods by the time she is two. This plan is, in no way at all, a whole new idea and it is in no way an idea that I came up with. Believe me, I won't do something like this unless I have researched the hell out of it. You can do some reading on this. Weaning, nutrition, there's so much information readily available.

I acknowledge it's not the norm in Singapore not to buy formula milk but to me, it's more of a cultural habit. Our son, Ryan, is on breastmilk and formula milk, so we are very much adopting the habit in his case and we are certainly not rebelling against the cultural norm, although I will say that, if Ryan was more interested in solids, we would definitely be relying less on formula milk. We just didn't have much of a choice in his case.

Having said that, I have to disagree when you say milk is a "must" for calcium needs. The "must" is the calcium and the vitamin D, not the milk itself. Milk is a good source of calcium but it is not the only source available. Not everyone is able or happy to take milk so it can never be a "must" otherwise these people would be severely malnourished! Milk is a convenience, because milk is so readily available and such a rich source, but again, not a "must". There are many other sources of calcium in food - yoghurt, cheese, soy, bread, fortified orange juice, etc. and for older children, supplements can be considered. Again, you can do some reading on this. Lots of information available.

My PD is not the only PD with this view, I'm sure, because it's a scientific fact which is undeniable - milk is not the only source of calcium. I'd be interested to know who the other PDs you mentioned are who believe that milk is a "must" for children of Rachel's age because they would be misinforming the parents and, frankly, scaring them. I wouldn't be consulting such PDs on anything - who knows what other misinformation they are disseminating.

Incidentally, my gynae also shares the same view as our PD. My gynae goes one step further to say that dairy milk is actually harmful to humans, whether infants or adults. He even removes the samples of formula milk from the free goodie bags that promoters leave at his clinic for his patients! Heh heh. 

As for fresh milk/UHT, yes I considered it and ruled it out.

As I mentioned previously, I'm not against milk or dairy products. My son, Ryan, is on formula milk (and breastmilk). I myself enjoy a milky cup of Milo and, when I have tea, it is always with milk. It was simply that, in Rachel's case, for various reasons which I outlined in my post, we felt that this arrangement would be best. It compels us to move forward and to progress, whereas Ryan has truly hit a brick wall in terms of his diet. Your child may be different, your circumstances may be different and I am in no way saying that all parents should do the same. I do, nevertheless, want to clarify that this plan of ours not to rely on formula milk is supported by tons of nutritional research and is, in fact, the norm in many countries. It takes a little more effort, given our usual Asian diet, but I don't mind that.

With regard to sippy vs the straw, both are only temporary measures until the child learns to use a regular cup, so in terms of dental hygiene, I would not be worried if I clean her teeth regularly. If you need to compare, straw cups are better than sippy cups for dental hygiene and for teeth development. Rachel is currently using a straw cup for water at her nanny's and at home. We are training her at home to use a regular cup as well so once she is good with it, she can use a regular cup if she wants milk (or other beverages) at her nanny's place. 

First, the bottle. It is recommended that children progress from the bottle/nipple to the cup from one year onwards. The goal is to reduce reliance on the bottle and on sucking and to encourage more reliance on solids and chewing.

Some parents may choose to make the transition gradually by using a sippy cup in between. I did come across some articles saying that sippy cups do not promote good oral hygiene but I think that can be countered with brushing your child's teeth regularly.


Next, the milk. What I understand from my various discussions with Dr Ngiam and my own research is that milk is not a must. If milk is part of your toddler's diet, it should not be the main part after your child turns one. In Dr Ngiam's words, milk should be like coffee and tea - just a beverage. At this stage we should be looking to nutrient-packed solids for our child's dietary needs.

The general recommendation, mostly from Western sources, is to start weaning the child off milk during the period between one and two years old. The rationale is that this is an important window to get the children to eat solids and chew their food. If their diet still consists mainly of milk when they are between two and four, there is a risk that they will prefer to stick to milk and become picky with food. I found this to have proved true in Ryan's case. Before he turned two, I could still offer him chicken rice and fried rice; now he only takes white rice.

Having made such progress, it did not make sense to "go backwards" and put Rachel on formula milk. I did not want to start a habit which we would eventually have to wean her off of. I note that the culture in Singapore seems to be to rely on milk for as long as possible and to wean the child off it when he/she is much older. I guess Rachel crossed the finish line ahead of most of her Singapore peers and presented her nanny with a novel situation which makes her nanny a little concerned and uneasy.


So, should we give Rachel any milk at all? Well, milk is still a rich source of certain nutrients - Ryan is as healthy as can be. Plus I knew that her nanny would be more at ease to have something to offer Rachel between meals.

Since I was looking into it, I decided to check up the nutritional pros and cons of different types of milk (formula milk, fresh milk, goat's milk, non-dairy milk). In the end, I decided on almond milk and I managed to pick up some organic unsweetened almond milk (original) from Pacific Foods. I will ask Rachel's nanny to serve it in a sippy/training cup, and only if she feels that she has no other option.

I should say that I'm not against dairy products for Rachel. Rachel takes a helping of whole milk yoghurt every morning, and she gets an extra helping if she's hungry in the afternoon.


I should also point out that almond milk is not perfect because it has very little protein and fat. Our little ones do need protein to grow and fat is absolutely crucial to build up their amazing brains. Sources of protein and healthy fat (other than milk) include oily fish (such as tuna and salmon), eggs, soy, meat, peanut butter, tofu and avocados. The recommendations for toddlers around Rachel's age is to consume 30 to 40 per cent of their daily calories from fat. A little sidenote - never restrict your toddler's calories or dietary fat please! Dieting is an absolute no-no at this stage!

Some significant updates this week. Firstly, babydoll is standing up without assistance! I ticked it off after I caught her standing on her feet for about half a minute (after which she got distracted by something and crawled off). From a squatting position, she can push up into a stand entirely on her own, and from a standing position, she can lower herself into a squat and then a sit.

It's very strange to see her standing on her own! It's almost as if something is missing. I still worry that she's vulnerable and I still feel the urge to provide physical support. I have to consciously restrain myself from reaching out to her. She doesn't seem particularly amazed that she is standing up, so I don't want to make it seem like a big deal and risk stressing her.

I've been digging up the hair accessories that I've accumulated for her, although I don't have many - now I have good reason to collect more!

In very-important-to-me news, Richard and babydoll have moved back into our master bedroom! I mentioned a few weeks ago that we paired up and slept in different rooms. I put Ryan to bed while Rachel went with Richard. It was part of an effort to wean Rachel off night latching and to give her the chance to consistently sleep through the night. I felt that I was actually preventing her from getting a good night's rest because, if she woke up during the night the first thing I did was to put her on the breast. It was the fastest way to quiet her and put her back to sleep. If I didn't do that, Rachel would fuss and search for the breast herself and then Ryan would wake and, realising that the buffet line was open, he would want his share. Rachel would wake a few times and she would wake Ryan up at least once of those times. It was physically shattering on me, to be honest.

The tipping point came when I was so ill and not recovering because I was not getting sufficient rest. Richard put his foot down and split us up. I was horrified at the idea but Richard didn't waver. He took care of Rachel throughout the night while I continued our existing routine with Ryan. I recovered after a couple of good nights and Richard reported good progress with Rachel so we continued on for a bit, and last week, we re-united everyone under one air-conditioner. I'm pleased to record that we are all doing very well now.




That's all for now. Till next time, then.

Look at the way her eyes lit up! That's some cherry tomatoes and some rocket on Christmas Day. Next, she had some chicken...

... and carrot slices for snacking.

More carrots and rocket, plus some big tomatoes.

Steamed carrot sticks.

At a Vietnamese restaurant in KL with Terri and Vincent. Enjoying a salad of raw vegetables - bean sprouts, tomatoes, cucumber and water cress.

Sweet potato sticks!

Steamed broccoli!