Dr Thomas - Baby and Children Specialist Kemena Pacific Hospital Bintulu

04/09/2025

30/08/2025

28/08/2025

Are you familiar with this situation?

Your child is asked to redo a simple correction, and instead of complying, he bursts into tears, shouts at the parents/teachers, and refuses to listen. He/she will be frustrated over tiny little things such as: losing a game, being told to turn off the TV, or being asked to tidy up. The entire household begins to feel like they are “walking on eggshells,” never knowing when the next explosion might come.

For many families, the daily stress of raising a child with ADHD is not just about inattention or hyperactivity. What causes the greatest strain is often the emotional dysregulation — the sudden mood swings, irritability, and explosive reactions. Unfortunately, this aspect of ADHD is frequently misunderstood. Instead of being recognized as part of the condition, children are sometimes labeled as “spoiled,” “defiant,” or “disrespectful.”

Understanding the link between ADHD and emotional dysregulation is vital. It not only validates parents’ struggles but also points the way to effective strategies — from teaching children how to recognize and label their feelings, to equipping families with coping tools that can reduce stress at home.

Recommendations/guidelines/diagnostic criteria:
-5 & -11: emotional dysregulation is not a diagnostic criterion but recognized as common in ADHD.

& guidelines: highlight the importance of assessing and managing it, often overlapping with oppositional defiant disorder, Disruptive Mood Dysregulation Disorder, anxiety, or mood disorders.

Apart from treating the hyperactive/inactivity symptoms of ADHD with medication, it is also very important to address the emotional dysregulation component. This is where clinical psychologist comes into play. One of the first steps in cognitive-behavioral therapy (CBT) is teaching the child to recognize and label emotions. By learning to name feelings — “I am angry,” “I feel disappointed,” “I am frustrated because I lost the game” — children begin to create a pause between the feeling and the reaction.

26/08/2025

Did you know?

Dengue cases in Malaysia continue to rise every year, especially during rainy seasons. Bintulu has three hotspot zones this month - Kampung Baru, Kampung Sinong, and Pasar Lama.

There are 4 different dengue virus serotypes — meaning a person can get dengue up to 4 times in their lifetime.

A second dengue infection often carries a higher risk of severe complications such as dengue haemorrhagic fever or dengue shock syndrome.

💉 The New Dengue Vaccine – Qdenga®
Qdenga® is a tetravalent (4-in-1) live attenuated vaccine, designed to protect against all four dengue virus strains. It is available in Malaysia since February 2024.

What makes it important?
✅ Can be given regardless of previous dengue infection history.
✅ Shown to reduce symptomatic dengue and hospitalisation risks in clinical trials.
✅ Adds a strong layer of protection alongside mosquito control efforts.

⚠️ Dengue prevention: COMPLEMENT - do not replace other preventive measures.
1) Eliminate stagnant water—and remove breeding sources like tins, tyres, plant trays weekly.
2) Participate in community clean-up campaigns and support fogging operations.
3) Seek immediate medical attention for dengue symptoms: high fever, severe headache, eye pain, joint aches, or skin rash.

When used together, vaccine and vector control strategies can significantly protect Bintulu communities from dengue.

23/08/2025

Relaunching ceremony of Kemena Pacific Hospital - this marks an important milestone for our hospital. This is not just a change in ownership - it is a change in direction. It reflects confidence in Sarawak's own ability, and determination to build institutions that serve our people in ways that fits our needs.

Our rebranding signifies far more than a name change. It represents our promise to deliver exceptional healthcare at a more competitive price – ensuring good quality medical services become increasingly accessible to every family in Bintulu. We believe a high quality medical care should be a right for every family.

11/08/2025

🚨 When Bullying Turns Deadly 🚨

No parent should ever have to bury their child because of violence at school.

No child should feel unsafe in a place meant for learning and growth.

Among my patients, I have encountered cases of bullying in primary school. It is very common nowadays. As a paediatrician and a concerned father, I shall also learn practical steps to prevent, detect, and respond to bullying – before it escalates.

🧠 Know the Signs
Children often hide bullying out of fear or shame. Watch for:
1) Unexplained injuries or damaged belongings
2) Sudden fear of going to school
3) Changes in appetite, sleep, or mood
4) Drop in academic performance

🗣 Create a Safe Space to Talk
1) Ask open-ended questions: "How was recess today?" instead of "Did anyone bully you?"
2) Listen without interrupting or blaming
3) Assure them it’s not their fault

🛑 Take Immediate Action
1) Document incidents (dates, names, details)
2) Inform teachers, school counsellors, and administration
3) Request for a clear safety plan at school
4) If physical harm or threats occur – report to police

🤝 Teach Assertiveness and Empathy
1) Role-play scenarios with your child on how to say “Stop” confidently and seek help
2) Encourage kindness – bystanders can be powerful protectors

📢 Push for School-Wide Prevention
1) Advocate for anti-bullying policies and awareness programs
2) Support peer mentoring and safe reporting systems

Zara’s tragedy must be a turning point.
Let’s ensure no other child suffers in silence.
Bullying is not “kids being kids” – it is a serious public health and safety issue.

💬 Share this to raise awareness. Together, we can make schools a safe place for every child.

04/08/2025

🍼 The Pacifier Dilemma: A Parent’s Real-Life Struggle

This scenario is no stranger to new parents: A 2-month-old baby cries to sleep every night. Exhausted parents, they try a pacifier — it calms him instantly. But then the doubts creep in:

❓ “Will this hurt breastfeeding?”
❓ “I heard pacifiers cause dental problems…”
❓ “Is it safe for sleep? What about SIDS risk?”

Sound familiar? You’re not alone.

Pacifiers are one of parenting’s most debated tools — praised for soothing, feared for risks. So what’s the truth?

Let’s go through the evidence-based guidance from the American Academy of Pediatrics (AAP) and American Academy of Pediatric Dentistry (AAPD).

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Key Recommendations Simplified:

1. ✅ YES to Reducing SIDS Risk
- AAP Priority: Use for all sleep (naps + night time) in the first year.
- Reassurance: Even if it falls out after your baby sleeps, it still helps!

2. ⏰ Timing Matters
- Wait until breastfeeding is solid (~3-4 weeks old).
- Parents/ mother can relax: Once established, pacifiers DO NOT shorten breastfeeding duration.

3. 🦷 Wean by Age 3 (Earlier = Easier)
- AAPD Warning: Dental risks (open bite, crossbite) spike after age 3.
- AAP Tip: Start weaning at 6-12 months when SIDS risk drops.
- Dental fear? Valid — but preventable with timely weaning.

4. ⚠️ Safety First
- Never attach to neck (strangulation risk).
- Use 1-piece pacifiers + clean like bottle ni***es.
- No honey/sugar!(Botulism + cavities).

5. 🚫 When to Avoid
- If baby gets frequent ear infections (post-6 months).
- If he clearly doesn’t want it.

Pacifier is not "monster" to be feared of. Wish all new parents can be happy and chill parents. Some clear benefits of pacifier are:
👉🏻 soothing effect
👉🏻 prevent overfeeding
👉🏻 temporary relieve for tired parents
👉🏻 reduce incidence of SIDS

02/08/2025

“𝐃𝐫 𝐋𝐨𝐰, 𝐤𝐞𝐧𝐚𝐩𝐚 𝐚𝐝𝐚 𝐯𝐚𝐤𝐬𝐢𝐧 𝐌𝐑 𝐭𝐚𝐦𝐛𝐚𝐡𝐚𝐧 𝐬𝐞𝐤𝐚𝐫𝐚𝐧𝐠 𝐬𝐞𝐥𝐚𝐢𝐧 𝐣𝐚𝐝𝐮𝐚𝐥 𝐛𝐢𝐚𝐬𝐚 𝐤𝐢𝐭𝐚?”Ada ibubapa selalu tanya saya dan ini penjelasannya.
(华语版本请往上刷）

𝐏𝐞𝐫𝐭𝐚𝐦𝐚, semasa pandemik, ada anak-anak berumur 6–59 bulan yang terlepas suntikan MR rutin. Dos tambahan ini memastikan setiap kanak-kanak mendapat perlindungan yang mereka perlukan.

𝐊𝐞𝐝𝐮𝐚, kita perlukan sekurang-kurangnya 95% kanak-kanak berimun untuk menghentikan penularan campak. Peratusan itu menurun semasa pandemik—kempen ini menguatkan semula “imuniti kelompok” kita.

𝐊𝐞𝐭𝐢𝐠𝐚, pada 2024 Malaysia mencatatkan kes campak tertinggi dalam lima tahun. Dengan menutup jurang imuniti dengan cepat, Aktiviti Imunisasi Tambahan MR membantu menurunkan kes.

Campak sangat mudah berjangkit dan boleh menyebabkan jangkitan paru-paru dan otak yang serius; Rubela semasa kehamilan berisiko menyebabkan kecacatan seumur hidup (Sindrom Rubela Kongenital)

𝐕𝐚𝐤𝐬𝐢𝐧 𝐢𝐧𝐢 𝐩𝐞𝐫𝐜𝐮𝐦𝐚, 𝐬𝐞𝐥𝐚𝐦𝐚𝐭 dan melengkapkan jadual NIP anak anda. Untuk membuat temu janji:
1️⃣Pergi ke MySejahtera dan pilih “Imunisasi”
2️⃣Buat temu janji di mana-mana Klinik Kesihatan KKM
3️⃣Terus walk-in ke klinik KKM terdekat

Mari kita lindungi anak-anak dan komuniti kita. Tempah dos MR tambahan hari ini.
————————————————————————————————————

“刘医生，为什么卫生部现在在平常全国免疫计划之外，还要额外加打一次麻疹（Measles)–德国麻疹(Rubella),简称MR疫苗？”下面给大家一个简单明白的解释：

一，在疫情期间，一些6–59个月的孩子错过了例行接种。多打一剂可以确保每个孩子都获得所需的保护。

二，我们需要至少95%的儿童具备免疫力，才能阻断麻疹传播。疫情期间这个比例下降了——这次活动就是要重建我们的“群体免疫”。

三、2024年我国出现了五年来最多的麻疹病例。迅速填补免疫空缺，能够有效降低病例数。

麻疹传染性极强，可导致严重肺炎或脑炎；孕期感染德国麻疹则可能引发先天性风疹综合征（CRS），给宝宝带来终生影响

这剂疫苗免费、安全，并且是对儿童现行NIP接种日程的补充。预约方式：
1️⃣在MySejahtera“免疫接种”模块预约
2️⃣在任一KKM健康诊所预约
3️⃣或直接到最近的KKM诊所即到即打

让我们一起守护孩子和社区的健康。今天就为孩子预约额外的MR疫苗吧。

02/08/2025

Meet 6-year-old Mia (not her real name):
For months, Mia complained of tummy pain almost daily. Her worried parents rushed her to clinics, did X-rays (showing mild constipation), and ultrasounds—all normal. Even after treating constipation, her "on-and-off" pain persisted, especially before school. Her parents felt helpless... until they learned about functional abdominal pain.

💢What IS Functional Abdominal Pain?
Mia’s story is classic:
- 🔍 Normal tests (scans/bloodwork show no disease)
- ⏰ Pattern: Pain around the belly button, lasting minutes to hours, often triggered by stress (school, routines)
- 💡 Key Insight: It’s REAL PAIN linked to gut-brain miscommunication— NOT "just in her head."

💢Why Traditional "Fixes" Fail?
Like Mia, many kids get stuck in a cycle:
1. Pain → Miss school/get rewards (TV/games) → Pain increases due to reinforced attention
2. Parents’ anxiety → More doctor visits → Child feels "something not right"

💢Breaking the Cycle
Mia’s family succeeded by:
✅ Validating her pain while reducing "sick-day rewards" (no screens/play during absences)
✅ Keeping her in school/routines unless severely ill
✅ Teaching her deep breathing during pain flares
✅ Discovering her triggers: separation anxiety at drop-off

Within weeks, Mia’s pain episodes dropped by 80%

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💢Key Takeaways for Parents💢
🔹 If tests are normal but pain continues → suspect functional causes
🔹 Stress is fuel: School pressure, peer pressure or bully, family changes, anxiety
🔹 Stop rewarding pain
🔹 Focus on resilience: "This pain won’t harm you—let’s breathe through it!"

⭐️Functional pain isn’t fake—it’s a misfire between gut and brain. Healing starts when we treat the system, not just the symptom."

23/07/2025

Great news for Bintulu community. Ms Tasia is experienced in providing tailored interventions for children with autism or ADHD. Her expertise in psychology will definitely help parents and children to cope better with their unique challenges.

We are pleased to welcome Ms. Tasia Khairunnisa Azzahra, Clinical Psychologist, to our team. She holds a Master of Clinical Psychology from Universiti Kebangsaan Malaysia (UKM) and a Bachelor of Psychology (Hons) from Taylor’s University.

Her prior experiences include serving as a Trainer at the Malaysian Institute for Debate and Public Speaking in 2019, working as an Applied Behavioural Analysis (ABA) Therapist and Shadow Aide at SP Autism Behavioral Center from 2020 to 2021, and volunteering as a Listener and In-house Viber with PlusVibes in 2022. She underwent clinical training as a Postgraduate Clinical Psychology Trainee at Klinik Psikologi Kesihatan (KPK-FSK), UKM in 2023, with further placements at PERMATA Kurnia and Hospital Canselor Tuanku Muhriz (HCTM) in 2024.

Ms. Tasia provides psychological services based on established clinical approaches for individuals across different age groups and presentations.

𝐂𝐥𝐢𝐧𝐢𝐜 𝐇𝐨𝐮𝐫𝐬:
𝐌𝐨𝐧𝐝𝐚𝐲 - 𝐅𝐫𝐢𝐝𝐚𝐲: 𝟖.𝟎𝟎 𝐚.𝐦. - 𝟓.𝟎𝟎 𝐩.𝐦.
𝐒𝐚𝐭𝐮𝐫𝐝𝐚𝐲: 𝟖.𝟎𝟎 𝐚.𝐦. - 𝟏𝟐.𝟎𝟎 𝐩.𝐦.

To book an appointment with Ms. Tasia, you may contact us at:
Tel: +6086-251 888
Email: customercare.bintulu@kemenapacific.com

16/07/2025

Restricted eating in children refers to a child having a limited and repetitive food profile and being at risk of developing nutritional deficits and/or poor weight gain. It can cause considerable parental anxiety and significantly impact family life.