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Infinity The Family Medicine Clinic Dubai Doctors

Teen Nutrition

Teen Nutrition

March 29, 2017

Second to the first 2 years of life, adolescent years involve the most rapid growth, which means that this time it is most important for nutritionally adequate eating. What we eat during this time will have a big impact on what our health will be like into adulthood.

These days we are finding ourselves struggling with the burden of teenagers who are overfed but undernourished. What does this mean? Basically it means that teens are eating too much, but they aren’t eating the right foods. So teenagers are gaining weight, however when we measure their micronutrient levels we are finding that they are deficient in many necessary nutrients.

What do we do? Teens need more food, but they need more of the right food!

Here are 7 tips to help improve your teenager’s diet:

  • Model good nutrition. As we do with infants and toddlers, model healthy habits rather than preach them. Encourage your teens to help with shopping and cooking of nutritional foods so that they learn the connection between good food and good health.
  • Say no. Simple as this. Teenagers will often respond “but all my friends are eating it”. Just because this is the case doesn’t mean that they should. These foods tend to be loaded with sugar and hydrogenated fats which are nutrient poor. So increasing nutrition quantity not quality.
  • Relevance. For a teen to be interested they want to know that something is relevant to them. Explain why eating particular foods are beneficial for them in terms of what they would respond to. For example tell them that by eating a diet varied in vegetables and fruits, it will help keep their skin healthy. Teens pay a lot of attention to their appearance so they may start to focus on this more.
  • Eat more iron. This is especially important for girls; however boys will also require more iron. Boys require this additional iron during rapid muscle growth and girls because they lose iron once they start menstruation.
  • Eat more protein. This one pertains more to boys to girls. Again boys require the additional protein because of rapid muscle growth. They can require up to 25% more (approximately ½ gram more per kilogram weight, roughly 15g more in total).
  • Eat more zinc and calcium. Daily micronutrient requirements increase for both zinc and calcium compared to their pre-teen years.
  • Eat smart fats. Even though the brain has completed most of its growth by teen years, vital connections continue to be made. Focus of foods that contain high levels of fatty acids, such as fatty fish, avocadoes, olives, olive oil and nuts.
Jordana Smith (Dietitian)
Jordana Smith

Breastfeeding 101

December 3, 2015

Designed by nature, breastfeeding is the most natural way to provide safe nutrition to a newborn baby. Breastfeeding provides numerous benefits for the infant, mother, family unit as well as the community in the short and long term. There are benefits to the mother and child with respect to nutrition, gastrointestinal function, immune system and psychological well-being. Breastfeeding is safe, free and convenient, and full of natural goodness to enhance the health and well-being of the child.

It is believed that fatty acids and vitamins found in breast milk promote neural growth and brain development. There are probably other complex gene-environment interactions that also contribute to improved neuro-developmental outcomes in breastfed babies compared to formula-fed infants. Studies link breastfeeding to improved functions of vision, hearing and mean IQ based on cognitive testing.

The list of nutrients in breast milk is very long. While commercial formulas attempt to closely match human breast milk, and offer an excellent alternative for babies who can’t breastfeed, they are still lacking in some nutrients found in breast milk. The main one that comes to mind is maternal antibodies, which are proteins formed in the mother’s body to help her fight a whole host of organisms and prevent infectious diseases. This protection gets passed on to the baby via the mother’s breast milk. There are other nutrients and natural antimicrobial agents that we are just discovering which also provide protection to the baby.

Breast feeding reduces the risk of the baby getting ear infections, vomiting and diarrhoea, pneumonia, UTIs, forms of spinal meningitis, bronchitis and croup — this is true for a whole host of common acute infectious illnesses in babies, due to the transmission of the mother’s antibodies to the baby. In both developing and developed nations, breastfeeding reduces the risk of acute illnesses during the period the infant is breastfed. There is also a reduction in allergic diseases. In addition, in developing countries, there is an overall reduction in infant morbidity and mortality.

Breast fed babies are less likely to be obese on adulthood. Why? Because there are a number of publications providing good evidence of the protective effect of breastfeeding against obesity later in life. There are lots of hypotheses with regards to the causal relationship between breastfeeding and obesity. I believe the protective effect is multi-factorial. To start with, exclusively breastfeeding young babies allows the baby to titrate their feed volumes based on their individual hunger and growth needs. The total energy intake is less than that for formula fed babies. Other hormonal differences between breast milk and formula have also been suggested. It is also believed that breastfeeding helps with the regulation of food intake and overall energy balance.

Dr. Rania Ayat Hawayek (Specialist Paediatrician)
Dr. Rania Ayat Hawayek
Specialist Paediatrician
Child Health – Bringing Up Baby

Child Health – Bringing Up Baby

June 25, 2014

The first 1,000 days are a crucial period that shapes the future of a child. The period from the start of the mother’s pregnancy till the child’s second birthday especially, is a critical window where there is rapid growth and development, both mentally and physically. Health, lifestyle habits and proper nutrition – of both the parents and child – play the key role during this period, to lay the foundation for a healthy body and rewarding future.

Good nutrition and care in the early years, for both the mother during her pregnancy and the child who is still an infant-toddler, are essential to develop a healthy immune system. A weak immune system is responsible for acute illnesses like pneumonia or diarrhea, and other illnesses such as food allergy, eczema and asthma. If this period is neglected, the damage is irreversible.

On a worldwide scale, the consequence of poverty and under nutrition in developing countries is severe and often irreversible. Worldwide campaigns to improve maternal and infant nutrition in this 1,000-day window claim to be able to save over 1 million lives per year. On an individual level, attention to nutrition in this period reduces the risk of chronic mental and physical disease in the person’s lifetime.

The benefits of breastfeeding in early life cannot be emphasized enough. For the first few months of a baby’s life, all it needs is breast milk. If breastfeeding is not possible, infant formulas are the best alternative. We recommend introducing solids between the ages of 4 to 6 months. First solids are usually baby rice cereal, cooked and pureed fruits and vegetables (eg: pumpkin, sweet potato, carrot, apple, pear) or mashed fresh foods (eg: banana, avocado).

After a few weeks, once the baby is enjoying a range of fruits and vegetables, you can introduce protein like beef, lamb, chicken, fish and lentils. Other dairy products can also be introduced now – like yogurt and mild cheese.

Water should not be introduced before 4-6 months; it should coincide with the introduction of solid food. Even in hot weather conditions, babies get all the hydration they need from milk. After 12 months, formula milk can be replaced with fresh cow’s milk. Breastfeeding can continue until 1 or 2 years of age or as long as the mother and baby desire. Breast milk is the most natural, safe and optimal nutrition you can offer your baby in this crucial early period, to give them a healthy start to life. It also protects fro a host of childhood illnesses, for instance, ear infections or gastroenteritis, as well as obesity, cancer, and allergy. Breastfeeding is also linked to higher IQ and cognitive development.

Nothing helps a baby’s long-term health and disease-fighting ability like breastfeeding

Right from conception to delivery, maternal nutrition and health has a direct impact on the health of the baby. An undernourished mother has a higher risk of infant death and long-term health problems. Similarly, obesity during pregnancy is becoming a growing problem in the UAE, and leads to an increased risk of complications for the mother, such as diabetes and high blood pressure and complications during the delivery. Babies born to mothers with a high Body Mass Index (BMI) are also at risk of being born overweight, which carries its own labour and post-partum risks.

It is very important for mothers to recognize that healthy eating habits and an active lifestyle – starting from pre-conception to after delivery – will have a direct impact on the health of their baby. Even after delivery, mothers are role models for their children, and promoting good nutrition and regular exercise will enable their children to maintain a healthy lifestyle.

During the first three years, parents also need to watch out for warning signs. Major ones include the baby being unresponsive to sounds, vision concerns or the yes deviating in different directions, not sitting independently by 10 months, not walking by 18 months, not uttering a single word by 15 months and preference for right or left-handedness before the age of 1. Also look out for developmental regression at any age, when a child is no longer able to perform a skill previously acquired.

  • Talk to your child, tell them stories
  • Sing to your baby
  • Read to your child-a baby is never too young to read to
  • Display unconditional love and affection in your house
  • Make time to play together
  • Play outdoors
  • Encourage floor play time
  • Choose creative, imaginative toys
  • Have family meals at the table
  • Feed your kids nutritious meals
Dr. Rania Ayat Hawayek (Specialist Paediatrician)
Dr. Rania Ayat Hawayek
Specialist Paediatrician
May is Asthma Awareness Month

May is Asthma Awareness Month

May 5, 2014

On World Asthma Day (Tuesday, May 6) and throughout May, people with asthma and organizations dedicated to asthma control and education join together to increase awareness about asthma and improve the lives of all people with asthma.

Corona Virus / MERS

Corona Virus / MERS

April 19, 2014

What are the symptoms of MERS-CoV?

It is not always possible to identify patients with MERS-CoV early as they may have mild or unusual symptoms. Common symptoms are acute, serious respiratory illness with fever, cough, shortness of breath and breathing difficulties, often with abnormal chest X-ray findings. In some cases this will progress to pneumonia and renal/kidney failure. In people with immune deficiencies, the disease may have an atypical presentation. It is important to note that the current understanding of illness caused by this infection is based on a limited number of cases and may change as we learn more about the virus.

How do people become infected with this virus?

We do not yet know how people become infected with this virus. Investigations are underway to determine the source of the virus, the types of exposure that lead to infection, the mode of transmission, and the clinical pattern and course of disease. What we do know is that both Camels and Bats are particularly important in the life cycle of this disease and that it is not as easily transmitted as Influenza for example.

Can the virus be transmitted from person to person?

Yes. We have now seen multiple clusters of cases in which human-to-human transmission has occurred. These clusters have been observed in health-care facilities, among family members and between co-workers. However, the mechanism by which transmission occurred in all of these cases, whether respiratory (e.g. coughing, sneezing) or direct physical contact with the patient or contamination of the environment by the patient, is unknown. Thus far, no sustained community transmission has been observed.

How do we avoid catching this?

People at high risk of contracting the disease should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing and following food hygiene practices, should be adhered to. Avoiding contact with members of the general public who display symptoms is also advised. The World Health Organization is NOT recommending special screening points or advising restrictions on travel at this time.


There is not specific treatment for this illness management is supportive and will address any ongoing health issues that the patient may have. If you have concern about you or your family’s health then you need to consult a doctor. If you feel that yourself or a member of your family is showing symptoms suggestive of the illness then please inform your health care provider by telephone, to allow them to make appropriate arrangements for isolation.

Further information regarding this virus can be obtained from the WHO Global Alert and Response (GAR) and by following the links below.


Infinity Clinic Supports Dubai Center for Special Needs

July 2, 2013
Infinity Clinic Supports Dubai Center for Special Needs

Support A Child's Future

June 24, 2013
Support A Child's Future
Your baby's weight: Does it matter?

Your baby's weight: Does it matter?

June 9, 2013

In the first year of life, babies grow at an astonishing rate; they almost triple their birth weight and grow around 25 cm (10 inches) in length. During their check-ups, babies will have their weight, height and head circumference measured and plotted on a growth chart, to assess their rate of growth and compare it to that of other babies their age and gender.

A baby is considered underweight if he or she is seen to cross the centiles on the growth chart downwards; in other words, if their rate of growth is slower than that of other babies their age. With regards to being overweight, a baby is categorised as such if he or she is seen to cross the centiles upwards. Another example of an overweight baby is one where the weight is consistently on a higher centile than the height.

There is no one ideal centile for each child. Healthy children come in all shapes and sizes, and a baby who is in the 5th percentile can be just as healthy as a baby who is in the 95th percentile. Ideally, each child will follow along the same growth pattern over time, growing in height and gaining weight at the same rate, with the height and weight in proportion to one another. This means that usually a child stays on a certain centile on the growth curve.

Following a high or a low centile does not necessarily mean that a baby is healthier or has a growth or weight problem. For example, if a 1 year old boy is on the 10th centiles for both weight and height, 10% of boys his age are shorter and weigh less than he does, and most babies (90%) are taller and weigh more. That just means that he is smaller than average, which usually does not mean there is a problem. If his parents and siblings are also smaller than average, and there are other signs that he is healthy and developing well, we would conclude that there is no cause for concern.

Babies, who do not have the expected growth rates and begin to cross centiles downwards, may be diagnosed with ‘failure to thrive’. This refers to a baby who is unable to take in, retain and utilise the calories needed to gain weight and grow appropriately. Danger signs that a baby is not growing well are feeding difficulties, poor appetite, recurrent vomiting, diarrhoea, reduced number of wet nappies, signs and symptoms of malabsorption, recurrent infections and delayed or regressing developmental milestones. There are several causes for ‘failure to thrive’ and these can be assessed during a paediatric consultation and managed accordingly.

At the opposite end of the spectrum, babies who have a tendency to becoming overweight, are seen to cross the growth centiles upwards. This may be due to several causes, some of which are genetic, endocrinological or environmental. Danger signs that a baby is becoming overweight or obese are a rapid increase in weight over time that is disproportionate to linear growth, dry skin and constipation suggestive of hypothyroidism, a history of damage to the central nervous system and developmental delay.

A baby’s weight concerns should be dealt with as they arise. A delay in doing so may well cause increased clinical risk. In the underweight baby, for example, a delay in diagnosing and treating failure to thrive can lead to nutritional deficiency, recurrent infections, stunting or delayed growth and a delay in development. Some of these may be irreversible and thus have a lifelong effect on the child.

The overweight or obese baby, as is very often highlighted in present times, is at high risk of developing type 2 diabetes, cardiovascular disease, osteoporosis and other musculoskeletal disease in later life. It is thus of extreme importance to pay attention to a baby’s weight if it starts to increase at a higher than expected rate.

Regular paediatric check-ups, during which a baby’s growth weight, height and head circumference are measured and the baby is examined, are the best way to monitor a baby’s growth and ensure that any change in growth rate is noted and addressed. We recommend that these check-ups are done at the time of the baby’s vaccinations as these happen at birth, 2, 4, 6 months, 1 year of age and so on. We also encourage the parents to keep a record of their baby’s growth, so that they can add and refer to it whenever needed in the future. At Infinity Clinic, we also provide a Baby Clinic, which is run by one of our senior nurse specialists, during which she discusses with parents all sorts of issues related to feeding, growth, sleeping and general wellbeing of the baby.

If the baby’s weight issue is found to be due to a clinical problem or disorder, then the parents are strongly urged to follow and adhere to whatever management plan is put in place.

Some of the babies that begin their life as underweight or overweight infants may well grow up to be underweight or obese children. To address these issues, a multidisciplinary approach is needed, involving the parents, carers, medical team and their schools.

Dr. Rania Ayat Hawayek (Specialist Paediatrician)
Dr. Rania Ayat Hawayek
Specialist Paediatrician