Even before he or she is born, your baby can respond to external stimuli. And the research shows that not only does this help you bond with your baby, it can even help with their development.

As your baby’s brain begins to develop nerve connections, that stimulation can really help them awaken their senses.

In the fifth episode of Selalu SIGAP, our host Andrea Lee chats with dr. Ardiansjah Dara Sjahruddin, Sp.OG., M.Kes, or dr. Dara, an obstetrician-gynecologist, talks about the significance of stimulating babies in the womb and how you can do it.

This episode covers:
  a. Why stimulation is important for unborn babies
  b. The stages of pre-birth stimulation
  c. What you need to remember

Prenatal Development

Proper nutrition rightly gets a lot of focus, but having a healthy pregnancy also requires providing stimulation to the baby in the womb.

Prenatal sensory experiences can shape a baby’s brain, and its development has long lasting effects on the baby’s abilities. These experiences can also be the start of an emotional bond between the infant and the mother that will continue for life.

In the early days of pregnancy, expectant mothers often caress or touch their stomach even though they are not showing yet.

According to dr. Dara, the gesture mostly comes naturally and the mothers can do so unconsciously. “That is considered good and it can be a form of stimulation,” he said.

He emphasized that stimulation during pregnancy must be those that generate positive moods. When an expectant mother talks to her unborn child with joy, that feeling will do wonders in minimizing childbirth risks such as postpartum depression.

“Sometimes a patient’s husband would jokingly say of the expectant mother, ‘She talks to herself, doc’. But that’s no problem at all, I even encourage her to do so. Talking to the baby would make the mother feel less stressed. And mentally, she’d be stronger from pregnancy until labor,” dr. Dara said.

Exciting the Senses

Dara said that as the baby’s brain develops, each trimester requires different stimulation.

The first trimester is where expectant mothers can begin to have an emotional attachment or relationship with their babies. Talking to them may help in feeling closer, and it is considered a great way of bonding. Reading or talking to babies also allows them to be familiar with the parents before birth and encourages cognitive development.

“During this time, expectant mothers are suggested to talk about positive things [to their babies], which can also benefit her well-being, such as ‘Be good, baby, help me to feel less nauseous’. It may sound silly for some people, but don’t worry at all,” dr. Dara explained.

In weeks 18 to 24 of pregnancy, the baby’s ears begin to be able to detect noises. “At that age, a baby can hear the sounds around it, such as the mother’s heartbeat or the blood flow,” said dr. Dara.

As the baby grows, he recommended that music therapy can be introduced from week 24 of pregnancy. Citing the popular notion that babies are stimulated by classical music in the womb, dr. Dara said that expectant mothers can listen to any type of music they favor, as classical music may not be everyone’s cup of tea.

“We don’t want the mother to feel stressed from listening to something she feels uncomfortable with. So go ahead with pop, jazz, gospel songs, anything she finds soothing. That way, she’d have good blood circulation and that’s an excellent thing for the baby,” he said.

In the third trimester, stimulation is mostly done by touching. As the belly grows bigger, parents can see the baby’s movements more clearly. They are encouraged to touch the belly and talk to the baby whenever it moves or kicks, as it can help the baby to feel relaxed and reassured.

During this time, expectant mothers are also suggested to do exercise. dr. Dara said that doing routine exercise will improve the mother’s mood and blood circulation, which in turn will benefit the baby as well.

“People often forget that sport is also a form of stimulation,” he said. “And it doesn’t necessarily have to be any sport, doing house chores is also good for pregnant women.”

The ideal sports that can provide stimulation during pregnancy are those with minimal risks such as speed walking, jogging or swimming.

Know by Heart

As we’re going through a pandemic, dr. Dara shared three key things expectant mothers need to remember in terms of giving stimulation at home.

Giving stimulation must not present any harm for you and the baby. Keep away from doing things over the top and try to minimize any risk.

Secondly, personalize any sound stimulation to the mother’s liking, be it music or reading out a story. Mothers should feel happy and relaxed when stimulating their babies.

Finally, stimulate your baby regularly. dr. Dara emphasized continuity as it directly affects the emotional bonding with your baby.

If there is any question concerning stimulation, dr. Dara said that it should always be discussed with a health practitioner.

“Nowadays, it’s very easy to receive information that might seem tempting to you, but always remember to consult with your doctor and don’t follow blindly,” he said.

Get to know more https://bit.ly/PentingnyaStimulasiBagiJanin

It seems like everyone has an opinion on pregnancy. And while generally well meaning, the advice is often contradictory, and sometimes flat out wrong.

Especially for first time parents, this can all add to the stress of pregnancy as you try to work out fact from fiction.

In the fourth episode of Selalu SIGAP, our host Jill Van Diest talks with Dr. dr. Lucy Widasari, M. Si, of the Acceleration Team of Stunting Prevention (TP2AK) about how to spot pregnancy myths and how you can be fully informed of the facts.

This episode covers:
a. Myths commonly found during pregnancy
b. The facts you need to know
c. How to verify the information you get

Works of Imagination

When you’re pregnant, you may find that suddenly everyone around you is a health expert who provide tips about what is and isn’t safe for you. But although they mean well, these advices can also be confusing, conflicting, or even wrong.

Dr. Lucy described the sheer number of pregnancy myths she found during the research she conducted on expectant mothers.

These myths can encompass foods and drinks to avoid, to whether or not you can have your hair colored while you’re pregnant.

Popular myths say that foods to avoid during pregnancy include crab, calamari, pineapple, and cucumber. Consuming crab, for instance, might cause the baby to have 11 fingers. Pineapple is considered dangerous as some believe it may cause miscarriage or bring on labor. Drinking iced water is also frowned upon, as some believe it can enlarge the baby’s head.

“As I mostly work in nutrition, I found so many myths in the sector, including that delivery should be aided by a witch doctor or respected figures in the community,” Dr. dr. Lucy said.

The Hard Truth

Having a healthy pregnancy requires eating a balanced diet to provide what the mother and the baby need.

Noting the pineapple myth, for instance, Dr. dr. Lucy said that eating one when you’re pregnant is perfectly fine, as long as you keep a healthy and balanced diet.

Another item people like to warn about is coffee. But far from being a myth, research shows that high levels of caffeine have been linked to pregnancy complications. Per Dr. dr. Lucy’s suggestion, expectant mothers can have one cup of coffee or around 100 miligram each day.

“Caffeinated drinks can have a diuretic effect, meaning it may cause someone to urinate more often than usual. Caffeine is also a stimulant, which means it can increase heart rate, and can reduce iron absorption. So I suggest expectant mothers to limit their caffeine intake. If possible, don’t drink coffee at all,” she said.

Another food source on the myth list is instant noodles, which some believe can be harmful to pregnant women and their growing babies. According to Dr. dr. Lucy, there is yet to be a proper recommendation on instant noodle consumption, but she suggested expectant mothers to limit the intake as it is high in sodium.

She said that although some brands have added micronutrients to their instant noodles as recommended by the World Health Organization, they still contain preservatives, flavor enhancers and food colors.

“If you really crave one, try to use just half the seasonings or make your own. Secondly, add meat, chicken or vegetables. And always remember that all ingredients must be fully cooked,” she said.

One of the things expectant mothers should avoid eating is raw or undercooked food, such as sushi and salad. Eating raw fish can expose your growing baby to bacteria such as salmonella and listeria that can lead to infections and can be potentially harmful. Furthermore, although fish or seafood is actually a great source of protein, it can contain high levels of mercury, which is toxic.

The same goes for vegetables. Though they are good sources of vitamins and minerals, expectant mothers need to be more wary as fresh salad can contain bacteria.

“Vegetables need to be properly cleaned and cooked,” said Dr. dr. Lucy. “Based on research, cooked vegetables only lose about 5 to 15 percent of vitamin C compared to fresh ones. So it’s no problem at all.”

Another common myth says that pregnant women should avoid getting hair treatments, such as dying or straightening. On this, Dr. dr. Lucy said that there are no studies on the effect of such treatments.

“But if you believe that doing something during pregnancy is unsafe, then you should avoid it altogether,” she said.

Filtering Information

With so much information coming from all around us, it can be difficult to know what the truth is.

Dr. dr. Lucy shared that it is a family’s duty to separate the facts from the myths, including during a pregnancy. For instance, try to get your news from reputable media companies and gather information that is grounded in medical science.

“Along with having the right knowledge, having a support system from the family and the presence of an obstetrician-gynecologist who provides the right information will help immensely,” she added.

She also emphasized the importance of going to the same doctor or prenatal care provider for examinations during pregnancy, for the sake of having a thorough medical record. That way, should you have any concern in any stage of your pregnancy, the doctor can help you in offering the related facts.

“Don’t hesitate to ask and consult your worries with a health practitioner,” Dr. dr. Lucy said.

Get to know more https://bit.ly/MitosdanFaktaSoalKehamilan

Through its leadership development programmes, Tanoto Foundation empowers our leaders of tomorrow. In Singapore, Tanoto Foundation supports a variety of promising individuals in their pursuit of higher learning. Tanoto Scholar Ms Chia Yi Mian, a final year medical student from the National University of Singapore Yong Loo Lin School of Medicine, is one of them.

The following is her reflection of her journey as a recipient of the Tanoto Foundation Scholarship and her experiences with Project Sukacita, a Tanoto Scholar-led community service project that uplifts the lives of underserved communities in Pangkalan Kerinci. This is reproduced with the permission of the Singapore Medical Association (SMA), which published her reflections in the April 2021 edition of their SMA News.

2020 was a rough year not just for Singapore, but for the whole world. As measures were put in place to curb the spread of COVID-19, community involvement projects (CIP) could not carry out their usual activities. As part of the organising team of Project Sukacita VII 2019, an overseas CIP in Indonesia, I was dismayed that we would not be able to follow up with the villagers that we had interacted with previously in person.

The team and our goals

A flagship community service project under the Tanoto Scholarship, Project Sukacita is a platform where Tanoto Scholars work together to volunteer and contribute towards enhancing the quality of health and education of the underprivileged communities. The annual CIP has been running since 2012. Our team comprises Tanoto Foundation scholars from the National University of Singapore Yong Loo Lin School of Medicine, Singapore Management University and Nanyang Technological University. With strong support from the Tanoto Foundation and the three schools, a total of 33 volunteers took part in Project Sukacita in May 2019.

Our project aims to encourage the locals in Pangkalan Kerinci, Indonesia, to adopt a healthier lifestyle by improving health awareness, achieved through conducting health screenings and health education. In Indonesia, one out of four children under five years old face the threat of stunting. Stunting is the result of malnutrition and a lack of physical and social stimulation. This can impact a child’s development, resulting in lower cognitive ability and, on a larger scale, impact economical productivity. Of note, the SMERU Research Institute projected an increase in the poverty rate in Indonesia as a result of the COVID-19 pandemic, further perpetuating the risk of stunting in children.

Serving the community

During our two-week long trip, we held multiple educational activities with the children which taught them the importance of hand and oral hygiene. Targeting our concerns of stunting in the region, we also engaged the children with interactive play to educate them on food nutrition and the importance of a balanced diet. Separately, we held two sessions of health screenings for the children and their parents. The health screenings focused on identifying existing ear and oral conditions for the children and the measurement of body mass index and blood pressure, and addressing any acute concerns, of the adults. 143 children and 122 adults underwent our health screening programme.

During the health screenings, our volunteers shared advice tailored for each participant based on findings during the sessions, and provided educational pamphlets. Participants with alarming complaints or conditions requiring medication were directed to local doctors who volunteered their time with us. As our project only spanned two weeks in an entire year, it was important to ensure that the locals were directed back to the local healthcare system for follow-ups. Having local doctors volunteering on-site was the first step towards sustainability and ensuring long-term follow-up.

We also launched a longitudinal programme with the local childcare to track the children’s height, weight, diet and dental hygiene monthly. The collected data is reviewed by our team such that early identification of children who are not growing adequately or require more nutrients in their diet will receive prompt intervention. With this, we hope to alleviate the problem of stunting faced by the children we serve. The Tanoto Foundation, which oversees our project, is also actively engaged with the Indonesian government in efforts to prevent stunting. To find out more, visit https://www.tanotofoundation.org/stunting.

Looking to the next trip

Although Project Sukacita 2020 was cancelled, I hope that the local children will be reminded of us when they practice hand hygiene frequently during this pandemic. I also hope that the locals will be as excited to see us again as we are to serve them again!

© Singapore Medical Association. This article was originally published in SMA News April 2021 issue