From getting pregnant and fertility struggles to pregnancy and postpartum recovery, here’s what you can anticipate as an expectant or new mum here in Singapore – and the specialists who can help you at every step of the way.
Prepping for pregnancy
Your current state of health plays a significant role in your chances of getting pregnant and having a healthy pregnancy. It also sets the foundation for your child’s health later on down the line, explains DR FIONA CHANG of Complete Healthcare International (CHI). So, if you’re thinking about trying for a baby or are already actively trying, you’ll want to improve your health in any way you can.
You can begin the process by going for a pre-pregnancy health check-up, says Dr Chang.
“A pre-pregnancy check-up will help you understand what you should be expecting and how to get yourself ready for pregnancy. It’s also an opportunity to identify any measures you can take to reduce your risk of problems with fertility and during pregnancy.”
In addition to a discussion about your chances of conception, you can expect a detailed conversation with your doctor about any current or past health problems, your immunisation history and your periods, as well as any family histories of genetic problems.
Additionally, Dr Chang says that a preconception check-up may involve a PAP smear test, a blood test to screen for various antibodies and conditions, and an ultrasound to evaluate your pelvic structure.
Getting your mind and body ready for pregnancy
In addition to visiting your doctor for a preconception check-up, there are other important things you can do to encourage a safer and healthier pregnancy for all parties involved.
And, it’s not just about physical health. In fact, a big part of preparing yourself to get pregnant is making sure your mental health is in good working order, explains Dr Chang.
To get your mind and body pregnancy-ready, and boost your chances of conception, she recommends:
- making sure any chronic medical conditions are well controlled;
- avoiding high-risk activities that can contribute to reduced fertility for both men and women, including smoking, substance abuse and drinking alcohol;
- following a healthy diet;
- getting regular exercise;
- maintaining a healthy weight; and
- getting your stress levels under control.
How long does it take to get pregnant?
According to Dr Chang, “Most pregnancies occur during the first six menstrual cycles of attempted conception.” In fact, she says that approximately 85 percent of couples will get pregnant within the first year of trying if they are having regular, unprotected sexual intercourse.
Complete Healthcare International
#08-00 Shaw House, 350 Orchard Road
6776 2288 | chi-health.com.sg
When you need some help getting pregnant
While some couples get pregnant quickly, others may face difficulties for a number of reasons. So, when is the right time to seek professional support? Here, Alpha IVF Centre weighs in.
When should a couple visit a fertility clinic?
We recommended that couples try to get pregnant naturally for six months before seeking help at a fertility clinic. To help increase their chances of getting pregnant, we suggest frequent sexual intercourse near the time of ovulation, and encourage couples to lead healthy lifestyles when trying to get pregnant.
Couples should seek help earlier, however, if there are other issues such as menstrual pain or irregular periods.
If you have been trying for a baby for more than six months, and are above the age of 35, we advise you to consult a fertility specialist. A fertility specialist can arrange the necessary tests based on the individual’s medical history and current health conditions.
What are the main causes of female infertility?
Female infertility can be caused by several factors that include problems with ovulation, blocked fallopian tubes, poor egg quality, low ovarian reserve (low egg quantity), and uterus abnormalities such as fibroids, polyps, adenomyosis and endometriosis. It’s best to visit a fertility specialist to diagnose the cause of infertility and provide available treatment options.
What are the main causes of male infertility?
Male infertility can be caused by low sperm production, poor sperm quality, blockage of the ejaculatory duct, and non-obstructive azoospermia (no sperm production) due to genetic abnormalities, illness and cancer treatments like chemotherapy and radiotherapy.
What kinds of treatments do you recommend to couples having problems getting pregnant?
There is no “one treatment fits all”. We strongly believe in tailoring fertility care and leveraging on technologies to optimise the treatment outcome. Alpha IVF Centre offers fertility treatments such as Intrauterine Insemination (IUI), In-vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI). We recommend that couples have a discussion with a fertility specialist on the best suited treatment option.
What is the difference between IUI and IVF?
IUI is a procedure in which sperm is inseminated into a woman’s womb during ovulation, with fertilisation occurring within the body.
IVF involves fertilisation outside of the body, in a culture dish under controlled laboratory conditions. The embryo is then transferred back into the womb. Pregnancy occurs when the embryo implants on to the lining of the uterus.
Are there any new developments in fertility treatment we should know about?
IVF technology plays an important role to achieve positive outcomes. IVF technology such as Intracytoplasmic Sperm Injection (ICSI), Time-lapse Culture System and Blastocyst Culture, Artificial Intelligence (AI) Embryo Selection and Cryopreservation technology are used here at Alpha IVF Centre.
Alpha IVF Centre & Alpha Women’s Specialists
#12-12 Royal Square at Novena, 101 Irrawaddy Road
6860 8888 | alphaspecialists.com.sg
Seeking fertility treatment
The first step to understanding why you’re not getting pregnant is a consultation with a fertility specialist, and fertility health screening to determine any factors that could be affecting your ability to conceive, explains DR ROLAND CHIENG, medical director at Virtus Fertility Centre Singapore (VFCS). He adds that 50 percent of all infertility cases involve a “female factor”, and 50 percent involve a “male factor”, highlighting that both partners play an even role in getting pregnant.
Fertility screening for women involves a combination of tests. This includes a blood test to measure the Anti-Mullerian Hormone (AMH) level, which helps determine a woman’s ovarian reserve, as well as ultrasound tests to look for any cysts in the ovaries, fibroids or polyps in the inner lining of the uterus. These test results help your fertility specialist to understand your total fertility picture.
For men, fertility screening usually entails a sperm analysis to check the sperm health – specifically the number of sperm, and the sperm’s motility and morphology. Data from VFCS has shown a significant decline in sperm quality over the last three years, with as many as eight in 10 men suffering from issues in sperm morphology.
Your fertility specialist will discuss your test results and advise on possible treatment options for your individual situation. IVF is among the different fertility treatments, but every couple is different; again, your fertility specialist will advise on the most suitable treatment protocol with the best chance of success. Assisted conception provides a higher chance of starting a family. That’s why it’s important to select a fertility clinic that optimises the chances of a successful pregnancy after embryo transfer.
Selecting an IVF specialist
If your journey requires IVF, there’s a lot to consider when choosing the right clinic, explains Dr Chieng. Here are three factors to factor in when making this important decision.
#1 The success rate of the fertility clinic
When looking at a clinic’s success rates, there are two main considerations: pregnancy rates after embryo transfer, and live birth rates when compared across age groups.
To optimise the chances of successful pregnancy after embryo transfer, VFCS has a “freeze all” approach. This involves freezing all embryos to be used later in a natural cycle, or in a cycle with hormonal replacement to prime the endometrium. This approach has shown good pregnancy outcomes in all age groups, says Dr Chieng.
“Beyond successful pregnancy rates, it’s also important that couples look at the clinic’s success rate of IVF cycles that result in live births, particularly with patients who match your profile. At VFCS, our success is measured by the baby you carry in your arms.”
#2 Lab technology and expertise
Every fertility clinic utilises different technologies, which play an important role in impacting the treatment outcome.
“Fertility clinics in Singapore use Intracytoplasmic Sperm Injection (ICSI) treatment to fertilise eggs by selecting good quality sperm and directly injecting it in the egg, as part of the IVF process,” says Dr Chieng.
“For the past five years, VFCS is the only clinic in Singapore that has adopted Intracytoplasmic Morphologically Selected Sperm Injection (IMSI). This is a refined version of ICSI, and has produced much improved outcomes. IMSI enlarges the sperm to over 1,200 times its actual magnification allowing our experienced scientists to choose the best sperm for fertilisation. In comparison, standard ICSI treatment only offers 200 to 400 times the magnification of sperm.”
Additionally, like any other field of medicine, the training experience of the fertility team is paramount. The expertise and experience of the embryologist and scientists in the laboratory is essential for success, as they are the ones creating, nurturing and freezing the embryos.
#3 Holistic approach to fertility care
No two couples are the same when it comes to fertility issues. So, no two treatment plans can be either. Therefore, every couple’s fertility treatment should be designed for their specific fertility challenges, explains Dr Chieng.
“VFCS offers a holistic approach to fertility treatment utilising the four pillars of care – physician, scientist, nurse and counsellor – so that couples are fully supported on their journey.”
He says that IVF can be a mentally and emotionally straining journey for couples. So, choosing an IVF clinic with counselling support services is key. In addition to offering counselling sessions with fertility counsellors, VFCS also provides counselling with embryologists for couples to have a thorough understanding of their embryo quality and transfer process.
“We put our patients at the centre of their care, so they are a part of the process right from the start. The partnership between the specialist, the laboratory and our patients is key to this patient-centric approach, which we believe is essential in alleviating the couple’s fear and anxiety.”
Virtus Fertility Centre Singapore
#09-01-05 Scotts Medical Center at Pacific Plaza,
9 Scotts Road
6460 4555 | virtusfertilitycentre.com.sg
TCM before, during and after pregnancy
Whether you’re trying to get pregnant, are already pregnant or have just given birth, here’s how you may be able to benefit from the natural, restorative practices of Traditional Chinese Medicine (TCM) every step of the way.
What is TCM?
TCM is an ancient form of Eastern medicine that dates back thousands of years. It looks at the body holistically, focusing on maintaining good health and boosting the immune system to enhance the body’s natural abilities to fight off disease. Emphasising energy and balance, TCM treatments may include herbal medication, acupuncture, cupping therapy, and the massage and scraping techniques known as tuina and gua sha, respectively.
Kin Teck Tong is a homegrown Singapore TCM brand that provides all these treatments and more across 10 locations in Singapore. This includes a just-opened clinic at Sengkang Grand Mall. The bilingual team of Traditional Chinese Medicine practitioners and Board- certified physicians provides healthcare services for the entire family.
Physician YEO WEI LING says that more and more couples are incorporating TCM treatments into their routines when starting a family. Here, she shares three ways it can help when trying for, carrying and caring for a baby.
#1 Fertility-boosting benefits
Many couples facing fertility issues seek TCM treatments to regulate their bodies and improve their chances of getting pregnant.
From the TCM perspective, three internal organs are crucial for fertility: the liver, spleen and kidney.
“These organs produce, store and regulate the reproductive essence, qi, and the blood in our bodies. These are important factors in reproductive function. An imbalance in these energies can prevent the body from ovulating, destabilise hormonal fluctuations and make it more difficult to conceive naturally.”
Performing acupuncture on the body’s acupoints is a way to release this blocked energy and restore its natural balance, explains physician Yeo Wei Ling. “We advise patients to go for weekly follow-up TCM treatments for at least three months to regulate ovulation and balance their hormonal activity.”
For women undergoing fertility treatment such as IVF, acupuncture can play a role in improving the outcome by “decreasing blood flow impedance and increasing the uterine blood flow, and modulating the immune factors.”
More importantly, she says that acupuncture helps reduce stress and anxiety during the whole process, thus increasing a couple’s chances of conceiving.
Besides acupuncture, Physician Yeo says that Chinese herbal medicine may be recommended, particularly if individuals show underlying hormonal imbalance.
What’s more, Chinese herbs can be used to “enhance sperm quality, motility and volume.”They even help improve a man’s libido and stamina. Of course, this “requires a careful diagnosis for each individual.”
#2 Acupuncture while pregnant
“Throughout pregnancy, acupuncture can be beneficial, particularly for women undergoing IUI or IVF,” says Physician Yeo. “To stabilise the pregnancy, acupuncture is safe and advised up until the end of the first trimester.”
She says that regular acupuncture treatment can help alleviate symptoms of the not-so-pleasant side effects that can come along with pregnancy, including:
- morning sickness, which may include appetite loss, episodes of nausea and vomiting;
- body aches and pains; and
- fatigue and loss of energy.
#3 Natural postpartum healing
According to Physician Yeo, the natural harmony between yin and yang is disrupted after childbirth. Acupuncture, she says, aids in restoring this balance by nourishing the qi and blood.
“Acupuncture and specialised massages can help postpartum women with symptoms like exhaustion, lower back discomfort, poor appetite and insufficient breast milk supply.”
In fact, she says that from the TCM perspective, the first month after giving birth is crucial to the immediate and future health of both mother and baby. A new mum’s diet should focus on “nourishing yin, blood and qi to support postpartum nutrition.” This can make a significant difference to the experience a mother has in her fourth trimester, and her ability to recover well.
EL readers can use the code “EXPATLIVING” to enjoy a physician consultation and acupuncture treatment for $48 at any Kin Teck Tong branch.
Kin Teck Tong
Once you’re pregnant (congrats!), you can anticipate a whole lot of prenatal visits, particularly in your first trimester. The initial antenatal tests include blood work to check your basic and health and immunity, and scans to ensure that your baby is well, and without genetic or physical issues. Your doctor will also discuss with you the routine screening tests that are done at different milestones – for instance, a combined blood test and scan done at 10 to 12 weeks to screen for chromosomal abnormalities, and testing for gestational diabetes at 28 weeks.
Once you hit the 12-week mark, prenatal visits will become monthly. You can expect regular blood pressure checks, urine tests and ultrasound scans to ensure baby is growing properly, and to look out for any signs of distress. And, at around 36 weeks, your visits will become weekly as you gear up to give birth!
Planning your delivery
Choosing the right obstetrician to guide you through one of life’s major milestones can be daunting. Expats in Singapore whose maternity costs are covered by health insurance usually give birth in private hospitals and see obstetricians for prenatal check-ups. However, public hospitals also provide quality care and can be a more affordable option.
Also, obstetricians normally only work at one hospital, sometimes two, so if your insurance doesn’t cover all hospitals, then your choice of doctor will be limited to those who work with a particular hospital.
Since every woman has different preferences for childbirth, it’s a wise idea to do plenty of research and meet with different obstetricians until you find one who you feel comfortable with. With this in mind, don’t be shy about asking questions: everything from birth plans, pain management (yes, epidurals are very common here, if that’s what you’d like!) and foetal monitoring, to a doctor’s rates of caesarean sections, inductions and episiotomies is fair game.
Managing your mental health while pregnant
The changes that come with having a baby are far more than physical. The stress, hormones and emotions involved are very real, and may require some extra support, explains certified coach and counsellor, TANJA FAESSLER-MORO. She and the team at Counsellingconnectz provide pregnancy, birth and postpartum counselling, as well as fertility, IVF and donor counselling. Here, she shares how counselling can benefit couples at every stage of their journey on the road to parenthood.
How can getting pregnant affect a woman’s mental health and wellbeing?
In many different ways! In a positive way, it can release lots of “happy hormones”, making her feel “complete”, and confirm her motherhood aspirations and her blossoming into “mum-me” identity.
However, many women experiencing physical challenges during pregnancy may not enjoy being pregnant and feel deeply ashamed to admit it. Some women become very anxious and stressed, then embark on the vicious cycle of becoming even more fearful and anxious by the possibility of “damaging” baby’s health with their stress hormones.
When is it time to seek professional support?
We can clearly see how the state of mental health during conception can impact a subsequent pregnancy. This means that if a woman experienced depression when trying to get pregnant, there is a high possibility of her experiencing depression either during pregnancy or postpartum if not treated throughout.
Do seek help if you are experiencing dark thoughts while pregnant, increased anxiety for longer periods of time, feelings of unhappiness about a pregnancy when you “should be” happy or feelings of isolation.
Concerned husbands are also encouraged to reach out. In fact, we have lots of husbands who initiate the first meeting and share their worries about their wives. This approach can be very helpful!
How can counselling help?
First of all, counselling can help women to feel “not alone” with their challenges as it all gets “normalised” by a counsellor. We as counsellors see so many cases each day and week, and can help to make the client feel, “Hey, it’s absolutely normal to feel that way.”
Counselling is a non-judgmental and a safe place for a woman to share thoughts that she usually wouldn’t share with anyone else. This can be a relief to finally have a place to release that weight she’s been carrying!
What about husbands?
It’s important for men to manage their mental wellness, too. A number of husbands going through fertility journeys lasting more than six months, for example, often start witnessing changes in their wives’ thinking and behaviours. Many husbands share thoughts and worries like, “I’m looking at the woman sitting next to me, and it’s clearly not the one I got married to five years ago,” “I miss the relationship we once had,” and “I’m worried about seeing my wife suffering, but I can’t show it because I need to be the strong one and stay hopeful.”
What about after baby is born?
After pregnancy (postpartum), counselling can help with everything from postpartum depression to breastfeeding to finding her new identity after birth.
For many women, planning to go back to work can be a major challenge. Just when they feel like they’ve got a handle on things, they must leave it all behind to go back to work. They start grieving the loss of time they’ll be spending with their newborn and have zero awareness of that grief. They reach out to us because they feel primarily fearful and sad. Our team has expertise in helping women going through transitions – from pregnancy to birth, from birth to work.
New dads can benefit greatly from counselling too. In fact, a UK study found that 70 percent of new dads experienced an undiagnosed depression. Many new dads feel disconnected from their partners, and even a sense of grief over the loss of the relationship they once had. Others feel unimportant, as everyone only asks about the wife and baby, or they feel constantly criticised for doing everything “wrong”.
Keep in mind that no matter what stage you’re at in your journey, you are not alone! There is plenty of support surrounding you, and we’re all here to help you every step of the way.
#09-01 Scotts Medical Suites,
9 Scotts Road
Home from the hospital: What’s next?
Heading home from the hospital is exciting, but it can be overwhelming for new parents. The good news is, you’ll be seeing the baby’s paediatrician often, with the first appointment scheduled just days after leaving the hospital. So, any concerns or questions can be addressed immediately!
At baby’s first appointment, your paediatrician will conduct a full-body check, assess the baby’s jaundice level and weigh baby without clothes to ensure that he or she hasn’t lost more than 10 percent of his or her birthweight, explains DR MEGHA JASM, a paediatrician, specialised in neonatology, based at IMC Children’s.
“This first week is especially important to establish adequate breast or formula feeding. Some babies need assessment by lactation consultants to optimise their latch and maternal milk flow,” she says. “Babies should be fed on demand, and this usually comes to once every two to three hours, through the day and night. Once they regain their birth weight, they should show steady weight gain of almost 200 grams per week through the first three months of life.”
Following baby’s initial well check, visits to the paediatrician are usually scheduled at one, two, four, six, nine, 12, 15 and 18 months to monitor your child’s growth and ensure he or she is meeting the appropriate milestones. At IMC Children’s, these baby well checks include:
- physical examination by a paediatrician;
- identification and discussion of any new issues;
- developmental assessment;
- growth screening including height, weight, head circumference and BMI measurement;
- discussion about your child’s diet, sleep, hygiene, behavioural patterns and bowel habits;
- vaccine review and updates; and
- referrals, if necessary.
What is jaundice?
Jaundice refers to the yellow discolouration of a baby’s skin or whites of the eyes. It occurs as a result of excess bilirubin, a yellow pigment that comes from breakdown of red blood cells in the bloodstream, explains Dr Jasm.
“Physiological or ‘normal’ jaundice is common, often starting by day three after birth, peaking around day five of life, and clearing by two weeks of age” she says.
“However, a small percentage of babies need phototherapy if their jaundice is high. In some situations, this can be done by admitting the baby to a hospital, or by home phototherapy machines. At IMC, we have a facility to do blood tests to quantify bilirubin levels, and we can also arrange for phototherapy in the comfort of your home, if needed.”
Babies are at an increased risk of high jaundice, she says, if they:
- are premature;
- are deficient in G6PD (glucose-6-phosphate dehydrogenase) – an enzyme that protects red blood cells from breakdown;
- had significant bruising or accumulation of blood in their scalp during birth;
- have an A or B blood type but their mother’s blood type is O; or
- have excessive weight loss, and are not passing enough stools as a result.
“Breast milk jaundice is a very common type of jaundice that can persist for up to two months in fully breastfed, healthy babies,” says Dr Jasm. “These babies may need monitoring of their jaundice levels until it normalises. Parents should look out for red flags namely pale stools and dark urine. If those are present, an immediate assessment by a paediatrician to rule out liver diseases is warranted.”
Other common concerns
Here are two more things to pay attention to once your newborn is at home.
#1 Umbilical cord care
A newborn’s umbilical cord stump normally falls off within two weeks of birth. In the meantime, it’s important to keep an eye on it to make sure it’s healing properly. It does not need any alcohol or antiseptic wipes or any other applications. See a doctor if there is any sign of infection such as yellow, foul discharge or the skin around the belly button starts to turn red.
Spitting up is normal and usually occurs when food backs up from a baby’s stomach though the food pipe. Usually a sign of infant reflux, this occurs even in healthy babies and is not often a cause for concern.
However, do seek medical attention if your baby:
- spits up green or deep yellow fluid;
- is not gaining weight;
- refuses food;
- is unusually irritable after eating;
- is persistently spitting up forcefully (projectile vomiting);
- is having difficulty breathing or has a chronic cough; or
- has a temperature higher than 38 degrees Celsius, measured by an ear thermometer.
International Medical Clinic
IMC Camden, IMC Children’s, IMC Jelita and IMC Katong
6733 4440 | imc-healthcare.com
The postpartum period: What to expect after pregnancy
“The postpartum period, also known as the ‘fourth trimester’, is the immediate period after childbirth when a woman’s body physiology returns from pregnant to non-pregnant state,” explains DR TSIN UIN FOONG, a British-trained family GP at Osler Health International.
In Singapore, it’s typical for a six-week postnatal check to be performed by either a family doctor or obstetrician. If you’ve had a caesarean section (C-section), you will have a scheduled review of the wound within the first week as well, says Dr Foong.
Postpartum need-to-knows (so you’re not surprised later)
There are lots of things that happen after pregnancy and childbirth that just aren’t talked about enough. Here are three realisations you might not want to come to on your own later, so we’re cluing you in now!
#1 Breastfeeding may be hard
Despite how some women make it look, breastfeeding can be a challenging journey. You also may find yourself visiting your doctor for common concerns such as breast or nipple pain, breast engorgement, mastitis (infection of the breast) and supply worries.
“Support is essential for both mum and baby to achieve the most optimal goal for each parent and baby,” says Dr Foong. “Getting this support from a lactation consultant at home or in hospital can be helpful. Talk to your doctor to get the guidance you need. Your doctor can also refer you to who you need to see for further support.”
You may also want to consider attending antenatal classes during your antenatal period, as they may be useful when it comes to breastfeeding, too.
#2 You’ll bleed for about six weeks
Vaginal bleeding after birth is normal and usually stops by six weeks, says Dr Foong. However, a doctor’s evaluation is required if:
- the bleeding is sudden or very heavy;
- there has been an increase in bleeding;
- significant clots are passing;
- there is an unpleasant smelling discharge; or
- you experience any of these symptoms and feel unwell or have a fever.
#3 You might leak urine
Urinary incontinence is a common pelvic floor dysfunction that affects nearly 47 percent of women in the first 12 months after childbirth. It involves loss of bladder control, usually prompted by exertion such as laughing, sneezing or coughing.
The good news is that it does improve over time, says Dr Foong. “Regular pelvic floor muscle exercises, especially if started prenatally, help with reducing postpartum urinary incontinence. Occasionally, some women may require referral to a women’s health physiotherapist or a urogynaecologist for further evaluation.”
“In the first two years of life, infants start to experience the world and the people surrounding them. They begin to communicate and to move around, they learn how they can influence objects or trigger reactions in people. In other words, they develop a tremendous number of new skills,” says DR NICOLE PLESKO-ALTERMATT, a dedicated children’s doctor at Osler Health International’s Star Vista clinic.
“Some of these skills, like grasping an object, taking the first steps or waving ‘bye bye’ serve as developmental checkpoints called ‘milestones’. Each milestone is expected to be achieved by a child at a certain age. Once you have settled into life as a family, you’ll get to know your little bundle of joy better and will be attuned to his or her needs – and you can start tracking these milestones.”
Tips for tracking milestones at home
Your child’s development should be checked regularly by a paediatrician or family doctor starting from the one-month mark. And, as a parent, you can also observe and take notes of the most important milestones – both for monitoring purposes and to celebrate your child’s achievements, explains Dr Plesko-Altermatt.
“Parents should observe their infants’ growth and learning regularly. Make notes of your child’s newly acquired skills and bring these notes to medical check-ups. They will serve as a reference and can help to identify peculiarities or concerns early.”
Some of the most important milestones, she says, are:
- social smiling (usually around two months);
- head lifting (also normally around the two-month mark);
- grasping an object (this is expected at around four months);
- use of basic gestures (typically occurring around nine months);
- crawling on hands and knees, or other efficient means for getting around (you expect this major feat somewhere around the nine-month mark);
- use of first specific words (this commonly occurs closer to 12 months);
- taking their first independent steps (also expected at around 12 months); and
- combining two or more words (you can anticipate this game- changer at around 24 months).
Every child is different
What happens if your child doesn’t reach a milestone at the expected age? First, breathe easy knowing that every child is different, and will develop and grow according to their own unique pattern, says Dr Plesko-Altermatt.
However, if you do have any questions or concerns regarding your child’s development, she strongly encourages reaching out to a children’s doctor without hesitation.
“As a doctor with extensive paediatric experience, I know that early identification of an issue is best for the ongoing development of a child. Do come in for a screening so that your child’s development can be evaluated and we can discuss the ways in which you can help your child to grow and learn.”
This article first appeared in the April 2023 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!