Monthly Archives: December 2014

Diaper rash (mayaclinic.in)

How should I manage Diaper Rash in my baby?

 Diaper rash

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I think virtually every parent must have faced this problem once in their babies at some point of time. Diaper rash basically develops due to direct contact of skin with moist surface or soiled diaper. It develops mostly in genital area, perianal area, thigh folds and buttocks.

Diaper rash (mayaclinic.in)

Causes of Diaper Rash:

  1. If potty soiled diaper is left for too long.
  2. If wet diaper is kept for too long a period.
  3. Allergic reaction to diaper material, soaps or baby wipes
  4. Too much moisture
  5. Too much rubbing of skin while cleaning or too much friction from diaper if put very tightly on baby.
  6. Bacterial infection, yeast infections

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Once the rash has started developing and skin is damaged, there are more chances of developing infections like bacterial, fungal or yeast.

Babies who are breast fed have less chance of diaper rashes.

More common when baby is having diarrhea, baby on antibiotics, recent change in dietary habits like starting with solid foods. If babies are not kept clean or dry for long periods.

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Steps to manage/ prevent Diaper rash:

  • Keep area as clean and as dry as possible.
  • Pat dry; the area rather than rubbing. Allow it dry fully before putting on diaper.
  • Use oil based barrier like Vaseline petroleum jelly, coconut oil etc.
  • Keep diaper area dry for as long as possible. Best is to avoid use of diaper during day keep it open to dry air.
  • If temperature of room is ambient, try to keep baby in open without nappies, so that rashes can air dry.
  • Change diaper more frequently
  • Avoid wiping with alcohol based wipes, use soft cotton washcloth.
  • Apply thick layer of any Zinc based ointment like Siloderm etc. Or any napirash cream available. Important is to put a thick layer and it is not necessary to completely remove the whole cream on next diaper change.
  • Most important thing to remember is that heavy rubbing or scrubbing is only going to damage it more.
  • Wrap the diaper as loose as possible (too tight diaper can prevent proper air circulation is there and wet or soiled parts do not rub against the skin too much).
  • Avoid use of Steroid based creams as far as possible (unless until recommended by your child doctor, as they can harm your baby).

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When Consult your child doctor (Pediatrician) if

  • Pus filled blister or sores appear near rashes
  • Rashes are not improving
  • They are getting worse even after taking all the precautions.
  • Baby has fever along with rashes
  • Rashes all over the body

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Various home remedies available for Diaper rash treatment are listed in the below mentioned link.

http://www.top10homeremedies.com/home-remedies/home-remedies-diaper-rash.html

 

Regards

Dr Rahul Varma

 

My child is hyperactive; what should i do ? Could it be ADHD

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A typical child with ADHD

Child with ADHD will not be able to focus or sustain interest for more than few minutes in toys or any activity. Kids with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what’s expected of them but have trouble following through because they can’t sit still, pay attention, or focus on details. Teachers comment about his inattention and disruptive behavior in class. These symptoms are present over a longer period of time and happen in different settings. They hamper a child’s ability to function socially, academically, and at home.

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What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common types of behavioral disorders in children. Children with ADHD may have trouble paying attention, controlling impulsive behaviors and are hyperactive. It is important that these features are present in more than 2 settings (i.e. at home, school, play area etc). It feels as if they are “driven by a motor” or “are always on the go”.

Age of onset: less than 7 years with more common in boys

Symptoms:

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Inattention
  • Often has a hard time paying attention, daydreams
  • Often does not seem to listen
  • Is easily distracted from work or play
  • Often does not seem to care about details, makes careless mistakes
  • Frequently does not follow through on instructions or finish tasks
  • Is disorganized
  • Frequently loses a lot of important things
  • Often forgets things
  • Frequently avoids doing things that require ongoing mental effort
Hyperactivity
  • Is in constant motion, as if “driven by a motor”
  • Cannot stay seated
  • Frequently squirms and fidgets
  • Talks too much
  • Often runs, jumps, and climbs when this is not permitted
  • Cannot play quietly
Impulsivity
  • Frequently acts and speaks without thinking
  • May run into the street without looking for traffic first
  • Frequently has trouble taking turns
  • Cannot wait for things
  • Often calls out answers before the question is complete
  • Frequently interrupts others

 

Cause: ADHD is not caused by poor parenting, too much sugar, or vaccines. Exact cause is still not known but there is possible genetic and environmental links.

Diagnosis:

For diagnosis detailed evaluation by developmental pediatrician/child psychologist is done. Various Checklist and Performa are developed in this regards. It involves besides clinical observation of child; detail history from parents, teachers or other caregiver.

Medical examination (including hearing and vision) to rule out other problems may be needed sometimes.

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What can you do as a parent?

Talk with your child’s doctor. If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist or developmental pediatrician.

Treatment of ADHD

ADHD can’t be cured, but it can be successfully managed. Aim is to help child to learn to control his or her own behavior and to help families create an atmosphere in which this is most likely to happen.

Combination of Medication and behavior therapy is needed in most cases. Plan of management will include multidisciplinary approach (pediatrician, child developmental specialist, child psychologist, behavior therapist etc) with close follow up and monitoring.

Medications help to curb impulsive behavior and attention difficulties and are more effective when combined with behavioral therapy.

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This therapy attempts to change behavior patterns by:

  • reorganizing a child’s home and school environment
  • giving clear directions and commands
  • setting up a system of consistent rewards for appropriate behaviors and negative consequences for inappropriate ones

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Here are few examples of behavioral strategies that may help a child:

  • Create a routine. Following a proper schedule day in and day out help child and they know what is going to follow so their anxiety level is less. You can make a schedule or time table and put in important places in house, so that your child can see what is expected of him.
  • Organize yourself and your home well, so that everything is kept at its regular place, so that less chances of losing things like schoolbag, cloths.
  • Try to avoid distractions as far as possible; especially while doing homework etc
  • Do not give too many choices to baby. We should limit choices, so that it is easier for children to make decision.
  • Give brief and clear instructions to children. Do not speak ambiguous words or open ended statements, which can lead to confusion in child’s mind.
  • Rewards can be helpful in these children.
  • Like all illnesses, patience is the key
  • Parents should lead by example and behave properly in front of children.

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For further reading click on the link:  http://www.cdc.gov/ncbddd/adhd/

Regards

Dr Rahul Varma