While most parents use a stroller or carry their little ones when they are out and about, Nur used to make her toddler Adam (not his real name) walk.
Carrying him was out of the question, even when he was exhausted and his short legs could no longer catch up with his parents.
"Even if he cried, we would not carry him," the 40-year-old sales administrator shares.
Before you call Nur hard-hearted, consider this.
At the age of three, Adam tipped the scales at a whopping 75kg, which is equivalent to the weight of a grown man or a standard-sized refrigerator.
Carrying him would require the strength of a weightlifter. And no toddler carrier or regular-sized stroller was able to support his massive weight.
"It was difficult for us to bring him out because of his weight. We could not take longer trips or go on overseas family vacations as he was too heavy to be carried," Nur says.
By sharing Adam's story, Nur hopes to raise awareness on childhood obesity that has plagued her firstborn since the age of two.
Now 10, Adam now stands at a height of 140cm and weighs 65kg.
He manages his weight with the help of a multidisciplinary paediatric weight management team in the National University Hospital (NUH), which is supported by a paediatrician, dietitian, occupational therapist and physiotherapist.
The NUH team runs a monthly clinic that acts as a one-stop weight management clinic to help children and their families fight obesity.
As a baby, Adam was not fat, Nur shares. His extreme weight gain started after he turned two years old.
Encouraged to eat nonstop by a doting close relative, who was his main caregiver while both his parents worked full-time, Adam's eating habits soon spiralled out of control.
TEN BOTTLES OF MILK
"The caregiver kept feeding him milk throughout the day. It was difficult for us to put a stop to the situation as we weren't at home.
"We tried telling her that it wasn't easy caring for an obese child but she continued to feed him excessively," shares Nur, who wants to remain anonymous due to the sensitive nature of Adam's condition and to prevent further straining family relationships.
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His six- and eight-year-old siblings, who were not cared for by the same caregiver during their toddler years, are of normal weight.
Adam's daily staples consisted of bars of chocolate, fast food and other processed junk food. To keep him satiated between meals, he drank 10 bottles of milk every day.
"The caregiver did not follow the label instructions and would often add extra scoops of powder to thicken it. He never touched vegetables or real fruit until he was around six or seven years old," Nur shares.
Not unless you count preserved fruit bits in his favourite fruit and nut chocolate bar, or fruit-flavoured candy, she adds wryly.
By the age of six, Adam's obesity had taken a toll on his everyday life, including sleep. "His snoring was so loud that anyone sleeping nearby would wake up. He also kept waking up at night," she says.
He was later diagnosed with obstructive sleep apnoea (OSA), a sleep disorder that causes him to stop breathing frequently in his sleep. During a sleep test, he stopped breathing 21 times in his sleep.
THE TURNING POINT
However, the incident that strengthened Nur's resolve to get her son's weight and health back on track was when she noticed that he was ostracised in class.
He was told to sit in corner as the preschool teacher had deemed him "too slow" to interact with the rest of the children, she shares.
"I felt really guilty when I saw my son being left in a corner. From that day on, I kept telling my husband that we must do something for our son," Nur says.
"I don't want him to feel neglected because he can't move around like other children because of his weight. I was an obese child myself and I know how hard it is."
When reasoning with Adam's caregiver to change his diet did not help, Nur knew that desperate times called for desperate measures. She made the drastic decision to move out.
By then, her relationship with Adam's caregiver was so strained they could not talk to each other.
"Even if my helper or I wanted to cook healthy dishes for Adam, there were constraints when we were living with my relatives. Eventually, we had to make a firm decision, and that meant moving out of our home," she says.
They sought professional help to manage his weight when Adam entered Primary 1. After a routine health check-up in school, he was referred to the Health Promotion Board and subsequently, to NUH.
EATING GREENS FOR THE FIRST TIME
At the age of seven, Adam underwent a major diet overhaul that involved replacing refined carbohydrates, fried foods and processed snacks with wholegrains and healthier meals prepared using clean cooking techniques.
Sweet drinks were also cut out of his diet.
To get him to eat his greens, Nur shares that she blended vegetables like carrots and spinach with rice. She also swapped his usual chicken rice, fried rice and ayam goreng (fried chicken) with steamed chicken rice or chicken soup with vegetables.
The initial months were "hell", Nur says - everyone scolded her for changing Adam's diet, which left him in tears.
"Initially, it was tough for him to go through the diet. He cried, threw tantrums and wouldn't eat his food. In the first week, he would throw the plate with the food on it. At first, even my husband felt pity for him," Nur shares.
To motivate him, she also changed the entire family's diet and ate whatever she prepared for Adam. For her son's sake, Nur also took up baking courses to learn to make low-fat, low-sugar cakes and pastries.
"The diet change was good for all of us, including my husband who has diabetes," she adds
It took Adam about half a year to get used to his new diet. Now that he has gotten the hang of eating more healthily, he particularly loves spinach and oranges. He also took up football in school and now plays Futsal on weekends.
A HEALTHIER, HAPPIER CHILDHOOD
Together with treatment for his OSA, which involved surgery to remove his tonsils and the use of a Continuous Positive Airway Pressure mask at night, Adam's diet and lifestyle changes made a huge difference to his health and even personality, Nur shares.
"His studies have improved. He used to be a very quiet boy (in preschool) but he now takes the initiative to ask questions in school. He's also doing well in sports and is the striker on the team," says the proud mum.
Two years ago, after Adam lost some weight and no longer tires so easily, the family was able to take their first overseas holiday in Batam together.
Although Adam now eats more healthily at home, Nur shares that she still occasionally struggles to control his food intake, particularly during the festive season and whenever well-meaning relatives visit.
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"They still bring unhealthy snacks over whenever they visit but I don't leave the snacks at home. I bring it to the office to share with my colleagues. That said, I can't really control what he eats when he is in school," Nur says.
One of the plus sides of enrolling in the weight management programme is that Adam is now more health-conscious and has become more motivated to keep his weight in check.
"He gained quite a lot of weight after the recent Hari Raya festivities as all our relatives were pampering him. When I pointed out that his pants were getting tight, he remarked that he has to lose some weight before he sees his doctor at the weight management clinic," Nur says with a laugh.
She advises parents to steel themselves mentally when making lifestyle and dietary changes for their kids and family. There are no quick fixes. Support from an experienced medical team is also important.
For now, Adam's battle against obesity is not over. There is more work to be done, such as refining his portion control. But Nur knows that her son is making progress and will eventually win the fight as long as she is there to support him.
When she looks through photos of Adam over the years, she is glad that she stood her ground in changing his diet even when it felt like the whole world was against her.
"When I see how my son is now able to do the things he wants and pursue his interest in sports, I feel so happy for him," she says.
This article was first published in Young Parents.