Breast milk is best for your baby

It is common for children to have viral illnesses several times a year, some of which will be associated with abdominal pain and occasionally diarrhoea, vomiting or both. If this is a viral gastritis or a case of gastroenteritis, the use of probiotics helps in regulating the good and bad bacteria in the gut after an episode of infection. Colimix would be helpful in management of abdominal discomfort for the child through relaxation of the muscles of the intestines as well as reduction of gas production.

The normal intake of a dairy in a 2-year-old child ranges from 300-400 ml of full fat cow’s milk daily. This can be served as 3 drinks of about 120-150 ml serving in a cup rather than a bottle. Dairy products such as cheeses and yogurts can be served in place of milk if preferred. A serving of cheese is approximately 20g (a small matchbox size) and a serving of yogurt for this age group is around 60 ml of full fat yogurt (e.g.. Greek yoghurt) or 125 ml (a small pot) of other types of yoghurt. Always remember to check the label for added sugars on yoghurt pots, many marketed to children have a lot of sugar added. A yoghurt with more than 15g sugar added per 100g is a high sugar-containing food. A better option is to use plain yoghurt and flavour it with homemade fruit puree or fresh fruit.

Other tips that are useful for parents: Avoid flavoured milk with added sugar. Other unsweetened fortified milk drinks such as soy or almond milk can be used, but milk alternatives are lower in energy than full-fat cow's milk so care needs to be taken that the rest of the diet provides adequate energy. Rice milk is not suitable as a main milk drink for children under 4 years. This is due to concerns about its naturally occurring arsenic content. Children should be discouraged from drinking too much milk if this means they have less appetite for a good range of foods at meal times.

A 1-year-old child should be drinking at least 2-3 servings of dairy (500-700ml) which contains at least 500mg of calcium. If she is allergic to dairy, there are two main types of specialised formulas:

• extensively hydrolysed formulas (where the cow’s milk protein is broken down into small pieces)
• amino acid formulas (this formula is not based on cow’s milk and the protein is completely broken down).

These specialised milk formulas has a different taste and smell to ordinary infant formula so babies over 6 months of age may be less willing to change to this type of milk substitute. Soy infant formulas may also be suitable for some babies with cow’s milk allergy. Partially hydrolysed formulas that are available over the counter are NOT suitable for the treatment of cow's milk allergy.

You should always discuss the most appropriate type of milk substitute with your paediatrician or health care practitioner before you make the decision to stop breast feeding. The formula recommended for your child may need to be changed depending on your child’s age, dietary intake, growth and severity of reactions to cow’s milk. Your child will need regular assessments by a paediatician or dietitian to make sure they are on the most suitable formula until 2 years of age.

Calcium can come from sources other than dairy, especially for a dairy allergic child. Recommended alternatives for calcium other than from dairy sources include the following:

• calcium fortified cereals and bread
• calcium fortified orange juice
• crushed ikan bilis, canned salmon/ sardines with the bones that are soft and edible
• broccoli and green leafy vegetables

It is equally important for the child to have an adequate supply of vitamin D. This can be in their natural exposure to the sun for the child or via vitamin D supplementations as calcium will not be well-absorbed in the absence of vitamin D. You can consider vitamin D supplementation if the child does not have adequate amount of vitamin D in the diet. A supplement containing 8.5mcg/340IU vitamin D is recommended in UK for babies under the age of 1 year. Everyone over 1 year of age should take 10mcg/400IU vitamin D, including pregnant and breastfeeding mothers. Formula fed babies are likely to obtain enough if drinking 600ml of infant formula daily. If drinking less than this, a vitamin D containing supplement may be required.

It is acceptable for your 6-year-old child to continue with 2 glasses of either GROW formula milk or pasteurized reduced-fat cow milk, as part of a well-balanced diet.

Fresh milk can be introduced into the child’s routine diet as early as after 1 year old. The choice of continuation of a formula is really a matter of convenience and availability.

At his age, 1 serving of dairy foods are recommended daily as part of a well-balanced diet. This is equivalent to 2 glasses of low-fat milk.Other examples of dairy foods include yoghurt and cheese.

The composition of the partially hydrolyzed whey is such that the whey from cow milk protein has been broken down to smaller proteins, which helps to facilitate protein digestion and absorption. The green colour of the stools maybe caused by the reaction of bacteria in the intestines. This is normal in formula fed babies.

The volume of paediatric oral nutrition supplement used should be tailored for a child who requires it based on the age of the child, the clinical condition that the child has and the target improvement of weight gain expected on starting the oral nutrition supplement. This assessment may need a more holistic overview of the child's diet so that the paediatric oral nutrition supplement does not become a replacement for a well-rounded diet that we will encourage most children to achieve.

If your baby has been rejecting formula milk or fresh milk after 1 years old, you can introduce dairy in the forms of yogurt or cheese into his diet. He can still aim to achieve his intake of dairy in diet with 2-3 servings a day or any combination of fresh milk of 1 servings a day (250ml) or yogurt (200g) or cheese (20g).

Type 2 diabetes, the most common type of diabetes, is brought on by age, genetics (seen in the family history) and environmental influence - the biggest of which is overweight or obesity. Understanding this, Type 2 diabetes is reversible when overweight and obesity play a large contributing role. Take for example a person who gets diabetes at a weight of 120 kg. If he can half his weight to 60 kg by lifestyle or through bariatric (weight loss) surgery, his diabetes may very well be reversed. However, for most others with the condition, it is not reversible but can be controlled to prevent future complications.

Control of blood glucose requires a 3-prong approach of:

• watching your diet,
• reducing weight if overweight through diet and exercise and
• following your doctor's advice in taking medication.

Generally, the recommended diet for diabetes is to be mindful of the food that can raise blood glucose levels. These are in the form of sugary food, fruits and starchy carbohydrates. The idea is not to stop taking carbohydrates or fruits but to reduce the amount, choose low glycemic index carbohydrates, incorporate fibre and combine with vegetables and protein in the diet. Sugary food should be avoided when blood glucose levels are high and not well controlled, but they can be incorporated into the diet when the control is better. Diet is to be balanced with physical activity and regular exercise. Seeing a dietitian for individualised advice is important.

Besides genetics and age, Type 2 diabetes is driven by being overweight which is the biggest environmental influence on the condition. Being overweight makes the body less efficient in its use of insulin which is the hormone that lowers blood glucose levels. Regular exercise and losing weight increases the body's efficiency in using insulin to lower blood glucose levels. Both actions help a person to reduce reliance on medication to control the condition. Diabetes-friendly meal replacements like Glucerna can be used in conjunction with a doctor's or dietitian's advice to substitute a higher calorie meal or snack. If done regularly and consistently, together with an overall diet plan and regular exercise and physical activity, this can help a person lose weight.

Casein and whey are the two major protein groups of cow’s milk. Casein is digested more slowly than whey, resulting in a more prolonged release of amino acids into the bloodstream. Both casein and whey are complete, high-quality proteins, which support muscle tissue building. There is no conclusive evidence to show that casein intake is linked to any disease condition (e.g. cancer).

Ensure contains cow’s milk protein (which includes both casein & whey) and soy protein. Do note that Ensure should not be confused with regular milk powder, as it is an oral nutrition supplement which is specially formulated to deliver complete and balanced nutrition.

Both Ensure powder and the ready-to-drink packet can be stored at room temperature. Once the powder is reconstituted or the packet is opened, the beverage should be consumed within 4 hours. If the beverage is refrigerated, it can either be consumed chilled or warmed gently (but not boiled) prior to consumption.

It is not a matter of which one is better but which one is more appropriate for the elderly in question. Using supplement which provide 1 kcal/ml means that the elderly must consume more in order to achieve the same caloric intake compared to when they consume the 1.5 kcal/ml preparation. Those who are looking after older people will know that one of the main challenges facing them is that the older people don’t eat or drink enough. So, in such situations, it is better to serve them with smaller volumes, yet packed with all the nutrition they need. Using Ensure Plus as an example, it provides 1.5 kcal/ml of calories and therefore, 1 can will provide 50% more calories compared to equal volume of the Ensure Life, which provides 1 kcal/ml. It also provides more protein (13 g instead of 9 g), higher daily values for Vitamin D (80% instead of 60%) and higher daily values for omega-3 fatty acid ALA (40% instead of 20%). However, both provide 26 essential vitamins and minerals and 15% of daily value for choline which is vital for nerve and muscle function as well as for normal liver metabolism. The 1.5 kcal/ml Oral Nutrition Supplement is ideal for the elderly who have poor appetite and do not eat and drink enough or have involuntary weight loss.

Ensure Plus is a unique blend of prebiotic fiber to help promote digestive tract health and a good source of fiber (3 g scFOS^®†/serving) to help maintain regularity. These fibers reduce the risk of either diarrhea or constipation.

ProSure is designed for cancer patients who are losing weight or at-risk of weight loss. It is a complete nutrition formula that is higher in calories and protein than a standard product (e.g. Ensure). ProSure also contains a special fatty acid called EPA, which may help address weight loss caused by certain cancers.

For individuals who do not have cancer and are trying to gain weight, there are other complete and balanced oral nutritional supplements which may be more suitable, such as Ensure Plus.

If you have concerns about your weight, please seek a personal consultation with your doctor.