Monday, March 30, 2015

Children saving accounts with very low interest rate p.a. in Singapore

We wanted to start a bank saving account for our kid and I searched for reviews pertinent to best interest rate saving accounts.
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In Singapore, saving by adults and children will give near zero interest rate (hence zero motivation to save).
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What I gathered from these reviews (without the latest up-to-date reviews), OCBC is okay in terms of interest rate while DBS/POSB is the lowest.
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When we visited OCBC, we found out that the interest rate for children saving account is at 0.05% per annum (p.a.). That's equivalent earning 4 cent per month for a SGD 1000 deposit.
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There are other plans available, such as those associated with insurance/assurance scheme.
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Alternatively, there is also the arrangement that earns higher interest rate for saving accounts, e.g. zero-withdrawal criteria with minimal monthly deposit of SGD 1000. This arrangement will allow earning of 0.48 % p.a. or 0.88 % p.a. (for child who holds OCBC child development account).
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We opted for the basic saving account that earns the 0.05 % p.a. interest rate.
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Visiting the bank today made me realize that saving in the bank is not a wise decision for saving money for our children's future. I need to find prudent investment options in the near future.

OCBC saving plans.

Rashes

My kid developed eczema and we suspected it was due to contact allergy. The allergen was still an enigma but most probably came from outside the house, e.g. playschool.
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We have visited the clinic twice. The first one was at a polyclinic and the pediatrician prescribed anti-histamine syrup and steroid cream. The thing about steroid cream was that it didn't help alleviate the itch. Our kid scratched and broke the skin. We tried calamine and it was better than steroid cream. Calamine with menthol that gives off cooling sensation is the best. However, doctors would warn against over-usage of calamine because it will dry off the skin and aggravate the eczema. To prevent that from happening, we would also apply moisturizer intermitently.
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It didn't work. After more than three weeks of itchiness, we decided to bring our baby to see a skin doctor (dermatologist). 
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The doctor asked about our history of allergies and came to the conclusion that our kid's eczema is due to genetics. Although he was right, we know that genetics is not the only factor. Environment and habits are also involved in the development of eczema in children and adults.
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A study on urban versus rural suggested that habits, lifestyle and environment play important contribution to discrepancies in rural versus urban susceptibility to eczema or autoimmune disorders.
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We are currently giving our kid another antihistamine oral medication, steroid anti-inflammatory oral medication, and topical steroid creams for body and face (the distinction is due to the potency of steroid, where the face will have lesser steroid content as compared to body cream). Hope this week will see a better improvement.
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There is a great reference about skin rashes and type of rashes with their associated probabilities. Read "Rashes" by AskDrSears.
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For persistent/chronic eczema, I wouldn't suggest using steroid cream long-term because the side-effects are bad for developing kids. I would use calamine for most time and try to reduce steroid usage. I am willing to try traditional chinese medicine (TCM) or Ayurveda approach.
 

Kuih bangkit recipe

Our baby loved kuih bangkit. Unfortunately, lunar new year was over and it was difficult to get find stores selling one. Bengawan Solo has kuih bangkit and I bet it would be very delicious but a little pricey for me. Furthermore, I wanted to learn how to bake kuih bangkit so that I can make some for my kid whenever there is demand in the house.
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There are two main recipes that I consulted.
I followed the latter (Nasi Lemak Lover).
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It wasn't difficult to get tapioca and sago flours from Singapore. I could easily get them from NTUC Fairprice. I used the packed coconut cream and the outcome was okay. I was having difficulty finding the classic mould for kuih bangkit with bunny, tortoise etc., so I simply got one for other purposes and it worked just as well.
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Home made kuih bangkit as according to Nasi Lemak Lover recipe.
 
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The outcome was delicious.


Steroid cream will get into body for adults and children (inevitably)

I have received plenty of reassurance that topical cream with steroid will not cause any problem because the steroid will not get into the body (or at least at a predetermined rate of skin absorption), i.e. steroid will stay on the skin longer while absorption rate is controlled.
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I asked, "what about accidentally ingesting it from fingers or hands"? The same reassurance of negligible amount.
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I asked "what about scratching and breaking the skin"? The same negligible amount.
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However, steroid such as hydrocortisone will be absorbed by the body. It is important to know how much is considered hazardous (or detriment). I hope the clinical or toxicological studies on steroid cream toxicity considered the above accidental means of introducing steroid into the body (e.g. increased "absorption" due to skin tear made by scratching or ingestion by toddlers).
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Our 3 yo toddler got prescribed the following medicines:
  • Elosone 0.1% (w/w) mometasone furoate which is a synthetic corticosteroid with anti-inflammatory, anti-pruritic and vasoconstrictive properties used on face. Precaution includes adrenal suppression more prone in infant and children (I had a look at a similar disorder adrenal insufficiency in children). In children, other complications are Cushing syndrome and probable stunted growth (no study on it thus far).
  • celestroderm/diprocel (aka Betamethasone dipropionate) 5g is a body topical steroid cream.
  • Prelone syrup taken orally. Synthetic steroid with anti-inflammatory and anti-itch effect.
  • Polaramine (aka DEXCHLORPHENIRAMINE MALEATE) taken orally. It is an antihistamine.
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We never felt confortable giving steroid cream but had to give in after seeing how unbearable the itch was. Unfortunately, the steroid cream is not as effective as Calamine solution with menthol (soothing and cooling effect). We are using these two medication alternately and prefer the Calamine over steroid cream.
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As for the oral medication, we are hoping that the anti-histamine will neutralize the histamine produced by the body.
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It's been three weeks now and any sign of recovery would be a relief.
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I hope there is no "urbanized eczema" caused by exposing children to overly clean and sterile environment. After this, we are planning to bring our kids to more outdoor activities with lots of earth, soil, and sand. Physical interaction with leaves, grass, and crawlies will be good. Some gardening will be super.
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References

Monday, March 23, 2015

What to expect in newborn prolonged jaundice

There are many reasons (multifactorial) for newborn baby jaundice. Some are normal events (for Asian babies), whereas in rare cases they are due to insidious reasons.

First week
After given the green light to go home (especially with acceptable jaundice level), baby will still be susceptible to increased bilirubin (biological product that causes jaundice), especially when he/she drinks just mother's milk. There are two main means to remove bilirubin, i.e. urine and stool. If baby's urine is pinkish/reddish, it is an indication of blood/hemoglobin in urine (e.g. hemoglobinuria as experienced by our baby) which can indicate ABO incompatibility (e.g. mother's antibody is attacking baby's blood cells) which is common for parents with different blood type (see below). After discharge from hospital, parents are required to visit polyclinics to monitor their babies' bilirubin level (every two days). The result mostly will show an increase in bilirubin level (if it reaches a threshold, hospitalization and phototherapy will be required). To minimize the chance of going back to hospital, babies should be given sufficient amount of milk for him/her to pass both yellowish urine and stool. Some doctors don't encourage sun-bathing babies (but morning sun should be harmless). Alternatively, getting a portable photo-therapy assembly is good (if ABO incompatibility is suspected; good hospitals will check baby's blood type and compare it with mother's).

ABO incompatible arises when mother, father and resultant baby's blood types.

Second week
After second week when the bilirubin still persist on the high (even after healthy amount of passing urine and stool), it is still normal considering that baby's liver is still not fully functional. Visit to the clinic is still at two days intervals. There is nothing much the doctor can do except prescribe the next visit.

Third week
If the jaundice level is still high. It is time to add milk with formula. Although we wanted fully breast milk, but jaundice and re-visiting the clinic is not permitting that ideal. The best way to beat baby jaundice is to add milk with formula for the day-feeds and fully breast milk during the night-feeds. You will realize that the amount of stool will increase tremendously. Giving our baby fully breast milk at night prevents constipation (milk is mild laxative whereas formula can cause constipation). 

Normally if jaundice is still high, doctor will prescribe liver function test. Our baby has normal liver function.

Subsequently
After introducing formula at 1/3 part of daily feed, our baby's jaundice stabilized. The jaundice still come-and-go but by the look of the skin and white eye, our baby is getting better.

What we wished our hospital provided
  • Blood type test on baby (we had to ask for it)
  • Portable photo-therapy assembly for rent (when required)
  • Step-by-step expectation if jaundice level persisted. Although the hospital encourages fully breast milk for babies, persistent jaundice is an indication that breast milk is not enough and a compromise is needed.
 
 

Good Gift Vouchers


What makes a good gift voucher?

  • Discount should be more than 10 % off listed price. If the gift voucher can't provide an equivalent of 10% discount of the listed price, then it is useless.

I got this voucher with terms & conditions stating "a minimum purchase of 12 packets of Pampers/Merries diapers". There is an ambiguity in the term "packet". If it meant a pack of diapers (e.g. Pampers New Baby Diapers size S 46 diapers cost SGD 18.20), then 12 packs would be SGD 218.40! That would translate to a  3.7 % discount which is not attractive.
 Anyway, there is also Pampers New Baby Diapers (24 pieces) that cost SGD 8.80 per pack. At 12 packs, they cost SGD 105.60 and an SGD 8.00 off would translate to a 7.57% discount. Well, it's still less than 10% discount.

However, if you compare with Dutch Lady promotion of SGD 3.00 off for every SGD 8.00 spent. That translate to 37.5% discount! Way better than the first example. However, practically, I would have to buy approximately SGD 9.00 of Dutch Lady product to qualify for the SGD 3.00 off, which is still better at 33.3% discount.

This is how voucher/promotion supposed to be! At more than 30% discount. Great buy Dutch Lady!
Another good example is Old Town White Coffee SGD 5.00 off for minimum SGD 20.00 spent in the restaurant. That is a 25% discount! Although it's not possible to have exactly a SGD 20.00 bill, the voucher is still better at more than 10% discount.

Old Town White Coffee voucher worth SGD 5.00 for every SGD 20.00 spent (equivalent to 25% discount).

  • Ubiquity to redeem the voucher. If the voucher requires the holder to travel to far region of Singapore just to spent it, then it will not be a favourite.
  • Free-means-free vouchers. Sometime back, a friend received a free facial treatment voucher and went to redeem it. The outlet provided free facial treatment to half of the face (as a comparison for "before-and-after effect" of treatment). However, the other half of the face will require payment! That's a deceitful tactic (even if there is fine prints on it).
  • Reasonable time/duration to redeem voucher.
  • Privacy protection voucher. A voucher that requires filling in personal particulars with name, address, phone number, spouse name, children's name etc. can sometimes be an uncomfortable feeling, especially when we don't know how the personal data will be protected/safe-guarded.i
That is my list of good voucher criteria. I'll add more if I can think of any.

Just to share.

 

Engagrow A plus LeapFrog AlphaPup Learning Playset (worth SGD35)

With minimal spending of SGD200 on participating Enfa A plus products.

  • Enfamama A+ 0.9 kg, 
  • Enfamil A+ Stage 2 0.9/1.8/1.95 kg, 
  • Enfamil A+ Gentlease Stage 2 0.9 kg, , 
  • Enfagrow A+ Stage 3 0.9/1.8/1.95 kg, 
  • Enfagrow A+ Stage 4 0.9/1.8/1.95 kg, 
  • Enfagrow A+ Stage 5 0.9/1.8 g

Send NTUC Fairprice receipts (in single receipt dated 1 Mar to 31 Mar at >SGD200 of participating products) to Mead Johnson Nutrition (S) Pte Ltd by 7th April 2005 (deadline). A redemption slip for collection of LeapFrog free gift will be sent via direct mail (while stock lasts) two weeks after the deadline (expected date would be around 20 Apr 2015).

Redeem LeapFrog AlphaPup Learning playset with Enfagrow purchases (see participating products).
I sent mine and hope to receive the redemption slip soon (after March).

Wednesday, March 18, 2015

Noisy foldable bathroom door wakes baby

Foldable plastic door that you slide to open and close in the bathroom has a "clickable" catch, i.e. spring catch (I called it springy latch). It is used to fasten the foldable door in place and it makes a clicking loud noise that startle my baby.
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Going to the bathroom will have a fail-proof baby-waking effect in our household, especially when our baby sleeps in the master bedroom with a bathroom.
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There are different types of spring catch out there, with some that comes like ball bearing. I think they make clicking sounds too but I'm not sure how subtle these better quality designs are.
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The easiest to fix way would be to do away with the door catch. I removed two of them (bottom and upper ones). These catches will not affect the locking mechanism of the foldable door.
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It is much better now with the catches gone. The only difference to the door is that if you don't lock the door, a strong wind/draft will move the door.

Monday, March 2, 2015

Child height prediction

Sometimes back, I read an article about height prediction for the son or daughter of basketball player Yao Ming and his wife We Li. Note that both are 2.26 m and 1.90 m, respectively. Based on the formula given, e.g. for daughter’s estimated height = (father’s height x 0.923 + mother’s height)/2 produces 1.992 m, whereas for a son’s estimated height = (father’s height + mother’s height) x 1.08/2 produces 2.246 m. The average height of a man is 1.74 m.

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The above calculation is easier than the online version where you have to convert meter or centimetre to foot. In addition, you will have to input the child’s age and weight (in kg or pound). Fortunately, Google can help with the conversion, e.g. typing “180 cm to foot” will produce 5.9 foot.

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Online height predictor

  • BabyCenter height predictor. You will have to produce child’s current age, height (in inches), weight (in pound), and parents’ height. The minimal age of child is 2 yo.

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Sometimes, abnormal growth (gigantism) could be due to benign (or malignant) tumour to the pituitary gland, in which case, there is an over-production of the growth hormone. However, the reverse is true for under-development (hypoplasia) of pituitary gland in which lesser amount of the growth hormone is produced, and thus causes dwarfism. Read more about the treatment for dwarfism (MayoClinic). Growth hormone therapy can be expensive and it is required daily for several years until the targeted height is achieved.

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An example of synthetic growth hormone therapy is Protropin from Genentech. Yearly treatment cost is estimated at USD 20,000 to USD 40,000 or more (as quoted in NYTimes dated 1994). There are other drugs out there nowadays, e.g. Nutropin by Genentech. It is best to consult paediatrician/doctors.