SPEECH BY DR JANIL PUTHUCHEARY, SENIOR MINISTER OF STATE, MINISTRY OF HEALTH AND MINISTRY OF COMMUNICATIONS AND INFORMATION, AT THE 7TH APMCHC AND IPRAMHO INTERNATIONAL MEETING 2024, 23 FEBRUARY 2024, 8.50AM, KK WOMEN’S AND CHILDREN’S HOSPITAL

Good morning everybody. It is nice to be back at KK Women's and Children's Hospital (KKH) again, and at the same IPRAMHO conference again, so I feel a very warm welcome, and a sense of familiarity, not least because of the friends that I have in the front row as well. So, good morning to everybody and thank you for inviting me to join you here, for this year’s Asia Pacific Maternal and Child Health Conference (APMCHC) and the Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children (IPRAMHO) International Meeting.

2. I am very glad that this platform has spearheaded further collaboration across agencies to improve the health outcomes of children and women, supporting the efforts of our Child and Maternal Health and Well-being (CAMH) Strategy and Action Plan. Today, I will speak a little bit about two areas under Singapore’s maternal and child health efforts. First, the importance of nutrition and the impact on health, especially in the first 1,000 days of life. Second, the need for upstream efforts to provide support to healthcare professionals, parents and caregivers of infants and young children in guiding them around healthy nutrition.

Nutrition and its impact on maternal and child health

3. Singapore has made great strides in improving maternal and child health over the last few decades. Today, we have one of the lowest infant and maternal mortality rates in the world, thanks to the efforts of our team of healthcare providers in providing good care for both mothers and their newborns. Since 2021, we embarked on developing the CAMH Strategy and Action Plan to provide more support, to drive better health outcomes for children and their families. All these efforts signify the strong commitment to improve support for the mother and child, our healthcare colleagues’ dedication to advance care, as well as individuals’ efforts to keep healthy and well.

4. So in conjunction with CAMH efforts, KKH launched the SingHealth Duke-NUS Maternal and Child Health Research Institute (MCHRI) in 2021. This is the Centre of Excellence for maternal and child health research. Taking a life-course approach, MCHRI aims to tackle population health challenges, implement evidence-based initiatives and foster a learning ecosystem. IPRAMHO is one of the key programmes of the MCHRI which seeks to develop an integrated model of care and the implementation of effective population health efforts for women and children. 

5. Over the years, a series of national guidelines has been developed under IPRAMHO to improve the metabolic health of women and children – through encouraging physical activities, addressing gestational diabetes, and tackling weight management and health issues arising from sedentary lifestyle. For example, the Guidelines on Perinatal Mental Health was launched last year and the Singapore Integrated 24-Hour Activity Guidelines for Children and Adolescents in 2022. 

6. This year’s theme, ‘Optimising Perinatal Nutrition for Population Health’ focuses on improving clinical care for better maternal and child nutrition. Nutrition plays a pivotal role in one’s health –it exerts a profound influence on both short-term and long-term health outcomes and development outcomes. Adequate maternal nutrition during pregnancy is crucial for healthy foetal development. It can help to prevent complications during delivery, and having a child with low birth weight. Similarly for the child, good and optimal nutrition in early childhood is essential for physical and cognitive development; and malnutrition poses risks of stunted growth, impaired immune function and many other challenges. So, we need to support mothers and children in having good nutrition through healthy eating. 

Guidelines for Feeding and Eating in Infants and Young Children 

7. Today, I am happy to launch the Singapore Guidelines for Feeding and Eating in Infants and Young Children. Jointly developed by KKH and the College of Paediatrics and Child Health, Singapore, in collaboration with representatives from healthcare agencies, these Guidelines provide useful information to healthcare professionals, parents and caregivers, to help children form healthy eating habits starting right from infancy, with specific nutrition goals and feeding milestones –a holistic approach to address the need for both modifiable factors on body weight management, i.e., physical activity, as well as diet and nutrition.

8. Habits forged in one’s early years can last for a lifetime. In fact, healthy eating habits that are forged during early childhood might have longer-term effects. These habits tend to stay with us even when we grow older. Our local study on Growing Up in Singapore Towards Healthy Outcomes (GUSTO), suggests that good eating behaviour can mitigate a child’s risk of obesity, even for children with risk factors, such as having parents who are overweight. Children’s eating behaviours such as perception of portion size, the speed of eating, food choices and nutrition, are key risk factors for childhood obesity. We will need to better understand and address these factors to continue tackle the childhood obesity issues that we face as a population.

9. For an individual child, healthy eating naturally starts at home. Simple actions like the portion sizes that parents pick for their children will influence the portions the children serve themselves later in life. Parents and caregivers can also influence a child’s diet through introducing age-appropriate food types and textures, such as introducing soft food that can be easily chewed and swallowed, as well as finger food that encourages self-feeding for toddlers aged 12 to 24 months. Parents and caregivers are also encouraged to look into reducing the child’s intake of sugars and salt commonly found in drinks like juices and snacks. They could and should optimise feeding practices and establish a regular, family-centred mealtime habit, and all of these will help to cultivate healthy eating habits and prevent overeating. 

10. Eating right – with the right nutritional balance and portion size – is also critical when a child transition from being fed to independent eating. The guidelines also offer recommendations to help infants and young children develop sustainable and progressive feeding and eating habits. This set of guidelines will be made available to our healthcare professionals, parents and caregivers of children aged up to 2 years.

11. The team has put in a lot of effort to make the guidelines reader-friendly. That is an important outcome, not just for lay persons, parents and caregivers but actually you have to make it reader-friendly for the professionals as well. I commend the team for their efforts in making sure that professionals and lay persons find this useful and engaging. I encourage parents of newborns, expecting mothers, their spouses very importantly, families and friends, to read the guidelines and learn how they can better support and chart their children’s milestones and goals in healthy eating and feeding. 

Closing 

12. In closing, I would like to thank and congratulate KKH and all our participating institutions for forging ahead to improve the health outcomes of women and children. Every little effort and step that we take today will go a long way to improving the health of our population in the years to come. Together, we can work for a healthier generation and I wish you all a successful conference. Thank you very much.