Category Archives: child growth and development

growth and development, nutrition

Anemia: more common in children than we think.

anemia-child_mayaclinic.in

Anemia is very commonly seen in young children who are mainly on milk based diet (As milk is poor source of iron). Breast milk has small quantity of iron but it is readily absorbed in body; so for first 6 months of life iron deficiency is not prominent. But after 6 months, when top milk is started, it can lead to anemia if proper iron supplementation or appropriate weaning food is not given.

That is the very reason you will see all the infant formula feeds and cereals fortified with iron these days. As iron is needed to make Hemoglobin; which is oxygen carrying component of red blood cells (RBCs).

 What is the right Quantity of Iron needed by my Kid?

  • From birth till 6 months: Adequate iron is there in mother’s breast milk. No need for supplementation unless baby is preterm or suffering from any illness.
  • 7 -12 months: 11mg per day. It can be given by using infant formula feeds or cereals fortified with Iron or using iron supplement drops.
  • Toddlers: 7 mg/day; Kids aged 4-8 years need around 10 mg per day. Older kids between 9- 13 years need around 8 mg/day.
  • Adolescent boys need 11 mg /day and girls 15 mg/day of iron. Girls need more during their adolescence as more blood is lost during menstruation.
  • Special need in athletes and children involving extreme physical activities need even more iron.

How deficiency develops?

  • Infants and young children mainly on cow’s milk develop iron deficiency as cow’s milk is low in iron and it also makes child less hungry and there is a less likelihood of child eating iron rich foods.
  • Cow’s milk also decreases absorption of iron and can irritate lining of intestine causing minor intestinal bleeding and gradual loss of Iron in stool.
  • Worm infestation
  • Iron requirement is more than normal in certain conditions like preterm babies, menstruating adolescent girls, children involved in extreme physical activities.

Anemia-in-children-mayaclinic.in

What are Effects of iron Deficiency?

  • Irritability
  • Poor appetite
  • Poor growth and development
  • Behavioral problems
  • Fatigue and weakness
  • Pale skin and mucous membranes
  • Rapid heartbeat or a new heart murmur (detected in an exam by a doctor)

If any of the above symptoms is there in your child, consult your child specialist / Pediatrician and discuss regarding iron deficiency and need for supplementation. Excess of iron is also bad, so it should be taken in appropriate doses only after consulting your child doctor.

Common source of Iron in Diet

Both animal and plant source foods are available which are rich in Iron

  • Red meat
  • Dark poultry
  • Tuna
  • Salmon
  • Eggs
  • Tofu
  • Enriched grains
  • Dried beans and peas
  • Dried fruits
  • Leafy green vegetables
  • Blackstrap molasses
  • Iron-fortified breakfast cereals

How to avoid Iron Deficiency in your child

  • Limit the intake of milk: 500 to 700 ml a day after 1 year of life and focus on staple diet.
  • Continue serving iron-fortified cereal until kids are 18-24 months old.
  • Avoid giving iron supplements with milk as leads to poor absorption.
  • Serve iron-rich foods alongside foods containing vitamin C — such as tomatoes, broccoli, oranges, and strawberries — which improves the body’s absorption of iron.
  • Avoid serving coffee or tea at mealtime — both contain tannins that reduce iron absorption.

Once Iron is started in Iron deficient child; within 2 -3 days you will see significant improvement in diet.

Regards

Dr Rahul Varma

Snoring in Children

 

snoring_mayaclinic.in

As uncommon and abnormal as it may seem, snoring in babies is not always a red flag for your baby’s health. Many babies produce noises like whiffing, snuffing and snoring while sleeping. If your baby snores rarely or occasionally, then it’s not a cause of concern. But if it has become a chronic habit of your little angel to snore, then consulting your Pediatrician is always advisable.

But before you start panicking, let’s understand the causes of snoring in babies.

Causes of Snoring in Babies

  • Cold and flu infections: This is the most common cause of snoring in babies. As your baby’s airways are very small and narrow when they are few months old, mucous secretions during a cold or flu infection easily block her nose and throat. As a result, your baby may snore while she is suffering from cold or throat infections.
  • Allergies: Your baby may be allergic to down filling in the mattress or pillows or allergic to pet hairs if you have a dog or cat. This may obstruct the airways of your baby while she sleeps and become the cause of snoring.
  • Enlarged tonsils or adenoids: Adenoids are lymph nodes at the junction of nose and throat which may enlarge due to various infections. Similarly, tonsils are lumpy lymph tissues located at the back of throat, which can also enlarge due to repetitive infections. Although the rate in newborn babies, with time these can contribute to obstruction in breathing which can in turn cause snoring.
  • Deviated Nasal Septum: Nasal septum is the bone that separates both the nostrils and in case of a deviated septum, this bone may be structurally misaligned obstructing one of the nostrils. This could be a cause of chronic snoring in your baby.
  • Laryngomalacia: In very young babies, the cartilage that keeps the nasal airways open may remain underdeveloped for some time after birth. As a result, your newborn may snore frequently until this cartilage develops properly.
  • Throat abnormalities: Cystic formations in the throat or abnormal palate movement can also cause snoring in babies.
  • Sleep Apnea: This is a condition wherein your baby experiences obstruction in breathing for several seconds, causing lack of oxygen and acute breathlessness. This may happen multiple times during sleep and can cause loud snoring in your baby.

How to correct snoring in your baby?

Once you have identified the cause of snoring in your baby, in consultation with her pediatrician, you can start with the corrective measures to alleviate your baby’s snoring.

You can take the following steps to correct snoring:

If your baby is suffering from cold, flu or allergies; use a humidifier in your baby’s room and put saline nasal drops in your baby’s nose to help her breathe better while sleeping.

Also remove any allergens or allergy-causing agents from your baby’s room to avoid any breathing obstructions.

Change your baby’s position or put a pillow under her head when she’s asleep to help keep her airways open.

If your baby is suffering from sleep apnea, enlarged adenoids and tonsils may be responsible. You can either reduce this enlargement with medicines or can even get them surgically removed once your baby is a little older.

Throat abnormalities and deviated nasal septum can only be corrected surgically and you should consult your Pediatrician/ ENT specialist for complete corrective action.

Thus, if your little one snores, the next time she dozes off, rest assured that it’s nothing to worry about. With proper care and as she grows, this problem can be easily resolved.

 

Regards

Dr Rahul Varma

Common Feeding Problems

Feeding problems occur for a number of reasons, many of which vary according to age. Most of these challenges can be met through proper breastfeeding instruction from your doctor. It may come as a surprise, then, if your baby develops a resistance to feeding weeks or even months after you thought this was no longer a problem.

Tastes Change

One thing to consider when this happens is whether the taste of your breast milk has changed. Breast milk taste can change for a number of reasons, including the following:

  • New or different food in your diet
  • Medication you are taking
  • Pregnancy in the mother, which sometimes causes nursing babies to wean themselves a few weeks or months after the mother conceives
  • Strenuous exercise, which can lead to a temporary buildup of lactic acid
  • Breast infection, such as mastitis
  • Change in the taste of your skin caused by using lotion, cream, or oil on your breasts

Avoiding the new food, changing or stopping your medication if possible, exercising less strenuously, or refraining from applying oil or lotion to your breasts may be all that is necessary to encourage your baby to breastfeed at his normal rate again. If you have mastitis, seek treatment from your doctor right away and encourage your baby to breastfeed in order to drain your breasts. Once the infection has been treated and has passed, the taste of your breast milk will return to normal. You may be able to help your baby adjust to the new taste of your breast milk during pregnancy if you are persistent and patient and hold off on offering formula as an alternative.

If your baby starts to engage in frenzied short feedings that seem to signal frantic hunger, it may simply mean that your let-down reflex is occurring more slowly than she would like. If this is the case, try massaging your breast and expressing a little milk before you begin a feeding. This way, your milk will flow faster from the very beginning of the feeding and your baby will feel more satisfied.

Stress

If you do not believe that the taste of your breast milk has been altered or that your let-down reflex is causing the problem, consider whether you are experiencing a high level of tension or stress. Such emotional discomfort can be communicated to your baby, preventing her from settling down to feed well. Of course, we cannot always eradicate stress from our lives, but for the moments preceding breastfeeding, do your best to put upsetting thoughts out of your mind. Relaxed sessions not only will help your baby get more milk but may decrease your own stress level. Breastfeeding your baby and holding her skin to skin often promote a sense of well-being. Meanwhile, consider ways in which you might improve the general tenor of your day-to-day life.

Illness

It is also possible that your baby’s own condition may be making it harder for her to breastfeed. Decreased interest in feeding—possibly accompanied by lethargy, fever, vomiting or diarrhea, cough, or difficulty breathing—may indicate an illness. Consult your pediatrician or family physician if your baby resists feeding or you have any concerns that your infant may be sick.

Illness in your infant may affect your baby’s feeding pattern and desire to nurse, thus decreasing the amount of breast milk she receives. If she has a cold, clogged nostrils may make it difficult for her to breathe while feeding, or an ear infection may make nursing painful. Clearing the infant’s nasal passages with a bulb syringe prior to feeding may help with temporary nasal congestion. Teething can cause gum pain when nursing. Thrush can make nursing painful and requires a pediatrician’s attention.

Spitting Up

Some babies take in a great deal of milk but then spit up what appears to be a large part of it after each feeding. Spitting up is common during or after feeding, and some babies spit up more easily than others. There is generally no need to be concerned, however, that your baby’s spitting up is preventing her from getting enough milk.

Spitting up (as well as hiccups) can be minimized by keeping your breastfeeding sessions as calm, quiet, and leisurely as possible. Avoid interruptions, sudden noises, bright lights, and other distractions. Try to hold your baby more upright during and right after feedings, and attempt to burp her after she finishes each breast. Don’t jostle or play vigorously with her immediately after she has breastfed.

If she vomits forcefully a number of times or if you notice blood or a dark green color when she vomits, call your pediatrician right away.

Occasional small spit-ups or wet burps are generally more a laundry problem than a medical one. Fortunately, spit-up breast milk is less likely to smell sour or cause clothing to stain than infant formula. If you are worried that she is spitting up too much, consult your pediatrician, who will monitor her weight and check for any signs of more serious illness.

Dehydration

As always, the best way to be sure your baby is getting enough milk is to monitor her physical condition, her weight gain, and the content of her diapers. It is very important to call your pediatrician if you notice that your child is not showing usual interest in feeding, she has a dry mouth or eyes, or she is producing fewer wet diapers than usual. These may be signs of dehydration. Severe dehydration, while uncommon in adequately breastfed infants, can be extremely dangerous or even life-threatening and is most likely to occur when a young baby refuses to feed or is experiencing frequent vomiting or diarrhea.

 

regards

Dr Rahul

stay healthy

constipation in children

Constipation is an extremely common childhood condition. One I deal with almost on a daily
basis in clinic and one that can be surprisingly hard to get control of..

Parents are often at a loss on what to do about something that is causing their child significant
discomfort, but also something they feel should be relatively easy to treat.

The trick is to always be one step ahead of constipation when it comes to your child.

Here are some surprising truths about constipation:

  • It can really hurt and be a source of significant, recurrent abdominal pain. After a
    thorough history and physcial exam (sometimes even an x-ray, depending on the
    situation), parents are shocked to find out, that, yes excess and blocked stool is the culprit
    for the tears and complaints of pain.
  • A child can be constipated in spite of reported daily bowel movements. Often, parents
    will discount constipation as a cause of their child’s stomach pains because the child will
    report having a somewhat “normal” bowel movement. However, if the stools are small,
    hard, and difficult to pass; this could be a sign that your child is not completely emptying
    his bowels. Having abnormally large and infrequent stools is another sign of constipation.
    In both instances, stools are typically hard to pass and the child may start withholding
    which will only worsen the condition.
  • On the flipside, your child may only have bowel movements every 2-3 days and not be
    constipated. The defining features are not necessarily based on frequency but more on
    symptoms such as abdominal pain, hard and difficult to pass stools, blood streaked stools,
    or a fear of going to the bathroom due to the anticipated pain.

When children are most prone to it:

  • Transitioning to solid foods and whole milk.
  • Potty training
  • School entry

Stay one step ahead with these tips:

  • Make your child’s daily meals full of fiber rich foods. Think whole fruits, whole grains,
    fiber cereals, and green/leafy vegetables.
  • Water, water, and more water. Keep a refillable water bottle on hand and encourage your
    child to drink frequently.
  • Moderate milk intake. Too much of a good thing can be bad for your child’s digestion.
    Instead of filling up on fiber rich foods, she is filling up on this. After the age of 1 year, 500 ml per day is more than enough.
  • Make a smoothie: if you have a picky eater…have her drink her fiber. Add whole fruits,
    some skim milk, yogurt, and a splash of juice.
  • Try a daily “P” juice (prune or pear) for breakfast to get things back on track.
  • A daily fiber supplement can help fill in the fiber gap.
  • Exercise. Get your kids outside (or inside) and moving for a good hour per day.

Laxatives

Sometimes, your child just needs a laxative to get back on track. Discuss this possibility with
your child’s pediatrician. Once the cycle of constipation has set in, dietary changes alone may
not turn it around. Be sure to adhere to the plan outlined with your pediatrician and continue with
the constipation fighting foods above.

Discuss with your doctor and follow instruction carefully.. Incomplete treatment can lead to poor growth.

Regards

Dr Rahul Varma

 

Can my child have hypertension ?

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Hypertension is traditionally considered as disease of old age. But now almost every 5th person is suffering from hypertension. Young adults and even children also are not untouched.

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In simple words, Hypertension = high blood pressure; i.e. more than 95th centile of same age, sex and height. There is no cut off figure for all children (like in adults where 120/80 mmhg is considered normal) rather charts for blood pressure for children.

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2 types: Primary (Essential) and secondary

Cause:

In less than 10 years of age, hypertension is usually secondary to some medical condition.

In children incidence is on a rise due to changing lifestyle.  It can develop for the same reason as adults too (i.e. junk food, no exercise and overweight).

Risk Factors:

Genetic as well as environment

Primary Hypertension:

  • Obesity or overweight child
  • High blood sugar level (Diabetes)
  • High cholesterol or triglycerides
  • Positive family history

Secondary Hypertension:

Due to underlying medical conditions like

  • Heart disease (eg. Coaractation of aorta)
  • Kidney disease (eg. Polycystic kidney diease, chronic kidney disease, RTA)
  • Adrenal gland disorder (including pheocromocytoma)
  • Metabolic disoreders (eg. Hyperthyroidism)

Premature babies and low birth weight babies are also at risk for hypertension.

High blood pressure usually does not cause any symptoms in children.

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Parents: To do list (that will help you to get maximum out of your visit to child doctor)

  • Note down any symptoms child have (if any)
  • Reports of any blood test done in past
  • Family history (both from mother and father side)
  • List of medications, if any, your child is taking.
  • Child’s daily routine in context of diet and physical activities.
  • Note down all the queries which you have (no matter how silly the question may sound to you). It is your right to know in detail regarding health status of your child.

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Diagnosis:

Painless procedure of Blood pressure (BP) measurement using inflatable arm cuff will help reach diagnosis. Cuff sizes will vary as per arm size of child so that it covers 2/3rd of circumference of child’s arm.

BP reading has 2 numbers: First (or higher) is systolic pressure and second (or lower) is diastolic pressure.

Diagnosis can only be made after taking minimum 3 readings over a course of 3 visits.

Some tests will be done to know the cause of high BP which will include

  • Blood tests like blood sugar, kidney function test, blood count, cholesterol etc.
  • Urine test
  • Echocardiogram to rule out  heart disease
  • Ultrasound abdomen (specially kidneys)
  • Repeated BP monitoring

PhysicalActivityPyramidKids

Management:

Simple lifestyle modification can help like better eating habits and more physical activity. But some children might need medication as well.

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Medications include Diuretics, beta blockers, ACE inhibitors etc.

If hypertension is due to obesity, than with lifestyle modification will help and gradually medications can be stopped. But if it is due to some underlying medical condition, treatment of that condition will lead to stoppage of anti hypertensive medications.

new-food-pyramid-plate 

Life style modification:

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High blood pressure is treated similarly in children and adults, typically starting with lifestyle changes.

  • Weight management
  • Salt restriction
  • Healthy diet
  • Physical activity
  • Psychological support from family

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Feel free to contact your child specialist or Maya clinic for any queries.

Regards

Dr Rahul varma

“Healthy kids, happy family”

Kangaroo Mother Care: A precious gift for babies who are born too soon

  KMC (mayaclinic.in)

 What is Kangaroo Mother Care (KMC)?

Kangaroo Mother Care is a way to give warmth to babies who are born too soon by skin to skin contact mother. It has other advantages like better feeding, emotional bonding and better long term neurological outcome. It can be given by father or any other member of family as well.

KMC tips

Preterm babies have very little fat and hence are more prone to cold stress and hypothermia. Skin to skin contact keeps baby warm and help all the other body functions to go on smoothly.

Technically it is defined as procedure in which baby is held on to chest of an adult (mostly mother) with skin to skin contact for long duration of time.

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KMC is given to whom?

  • Best suited to babies who are preterm
  • Full term babies with birth weight less than 2 kg.
  • Babies should not be suffering from other serious health issues (heart rate and breathing is normal).

KMC

How to give KMC? Proper technique

  • Baby is placed on mother’s chest between breast with babies chest facing mother’s.
  • Given day and night.
  • Held in place by cloth that is wrapped and yied at back as depicted in photographs.
  • Kangaroo Mother Care could save an estimated 450 000 preterm newborns a year.

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Benefits of KMC?

  • Warmth
  • Frequent breastfeeding
  • Emotional support
  • Protection from Infection
  • Stimulation
  • Love and bonding

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Kangaroo Mother Care can be given by any family member. It is very precious gift for parents who are not financially well to do. And in very poor parents it could be the only hope of survival.

Kangaroo Father Care

Regards

Dr Rahul Varma

My Child had a fall; what should I do?

Protect Your loved ones: Child injuries can be prevented

  sub-injured

 

Young children are always on the go, running around, jumping, climbing, and exploring things. That is why they are bound to fall a few times. But situation can be a bit panicking sometime for parents. Most of these falls will cause minor injuries only like bruising cut etc, but some can be serious and we should know what to do for first aid and when to contact child doctor and emergency services.

What need to be done?

If any of the below things happen, need to call ambulance and plan to shift child to nearby hospital

  • Child unconscious
  • Having difficulty in breathing
  • Having Seizure
  • Suspected serious injury to head, neck, back
  • If not breathing at all start CPR

injury in child

If by your assessment you feel child is fine i.e. actively moving, breathing, conscious and no major bleed; then

  • Make your child comfortable (either taking child in lap or putting child to bed with you close by)
  • Cold sponging can be done on any obvious bump or minor bruises
  • Can give Ibuprofen or paracetamol (in age appropriate dose as told by your pediatrician in past)
  • Do not leave child unattended for next few hours
  • Let the baby rest, as after initial period child might sleep for next few hours.
  • Watch closely for any danger sign (explained in next section)

Danger signs to look for

  • Repeated vomiting
  • Bleeding from Ear, Nose or Throat
  • Child is sleepy most of the time or loses consciousness at any time
  • Very irritable all the time and difficult to comfort the baby even after giving painkiller
  • Child is complaining of severe pain in any part of body especially head, neck
  • Not able to see properly or difficulty in focusing on objects
  • Not able to walk properly
  • Any other thing or symptom which you feel is not right (it is always better to consult child doctor in case of doubt)

 How-to-Help-Your-Child-Learn-to-Fall

Prevention is better

  • Never leave children unattended while they are playing (whether indoor or outdoor)
  • Childproof all the gates, doors, side railing on stairs, so as to avoid child accidentally opening them and putting themselves in danger
  • Child-Proofing
  • Always put straps/ seat belts for kids while they are using high chair, car seats, strollers etc
  • Wear all the protective gears in outdoor activities like skating, biking etc
  • Do not keep sharp objects in open and try to avoid furniture and decorative stuffs with sharp edges.
  • Supervision is must whenever your child is in balcony, roof or any place that is high up
  • Fall from bed is very common at night. So try to have cot with railing which is properly fixed
  • If you are sharing your bed with kids (common practice in India), make sure baby in sleeping in between both the parents. Best is try to have some sort of protection on all the four sides of child, as your baby can turn 360degree during sleep and fall from any side. (You can have low floor beds).

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Discuss with your child specialist during routine visit what all you can do to prevent injuries in children.

 

Regards

Dr Rahul Varma

“Safe kids, Healthy kids”

Childhood Obesity: a serious and growing concern in our society

food     

Childhood Obesity is a major health problem these days. Initially it was supposed to be disease of western countries and affluent class, but data clearly shows that it is very rampant in middle class families. Main reason as we all know are changing lifestyle with lots of junk food and minimal physical activity. It is important to be in touch with your pediatrician.

Definition: Simplistically, Obesity results from an imbalance of caloric intake and energy expenditure.

BMI (Body Mass index): BMI charts are available which can be used in children > 2years old,

BMI= Weight (in kg)/ Height (in meter)2

Obesity:  BMI more than or equal to 95th percentile

Overweight:  BMI between 85th and 95th percentile

Factors leading to obesity:

child-obesity

  • Enviornmental factors:
    • calorie dense food
    • consumption of processed foods
    • limited physical activity
    • sedentary interests: computers, TV, video games

 

  • Genetics factors also play important role in some cases

Co-Morbidities associated with childhood obesity:

  • Cardiovascular: Dyslipidemia, Hypertension
  • Endocrine: Type 2 Diabetes Mellitus, Metabolic syndrome, polycystic ovary Syndrome
  • Gastrointestinal: Gall bladder disease, Non Alcoholic fatty liver disease
  • Psychosocial effects and stigma
  • Orthopedic complications:  joint pain etc.
  • Respiratory: Sleep Apnea
  • Neurologic:  Pseudotumor cerebri

     Obesity-Cycle 

Interventions:

Successful intervention for obesity is challenging and is best accomplished using multimodal approaches to accomplish lifestyle change. In children we do not want rapid weight loss as child is in growing phase and adequate nutritious diet is needed. So it is best to try to retain the same weight or very slow weight loss.

  • Catch them young – school age children must be targeted
  • Do not skip meals especially Breakfast
  • Increase awareness: media; school teachers; governmental and NGO effort
  • Minimise advertising pressure for  “junk foods”
  • School play grounds; “Games periods”
  • Health food in school canteens

Traffic light Diet Plan:

Features Green light food Yellow light food Red light food
Quality Low -calorie, high –fiber, low-fat, nutrient-dense Nutrient-dense, but higher in calories and fat High in calories, sugar and fat
Types of food Fruits, vegetables Lean meats, dairy, starches, grains Latty meats, sugar, fried foods
Quantity Unlimited Limited Infrequent or avoided

  

Conclusion:

  • India is in the midst of an escalating epidemic of life style disorders associated with childhood obesity.

• The important causes of the epidemic in India appear to be:  unhealthy eating pattern, reduced physical activity, increased sedentary pursuits .

• Prevention must begin early in the form of a public health campaign directed towards lifestyle

changes of the family / society as a whole. The campaign requires strong social and political will.

• Health professionals must think `prevention of obesity’ at all visits, monitor BMI and ensure that ‘nutrition messages’ are not conflicting and confusing.

• Special strategies for different ages and channels of interventions for prevention of obesity have been outlined.

• Clinic based individual assessment of the obese child and principles of therapy are provided.

For any queries consult your child doctor or feel free to contact Maya Clinic. we will be more than happy to answer all of them.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

Coping with Stress in Kids

 

How to cope with stress in Kids?

Question: To many of us, childhood might seem a very carefree time without any stress. Kids do not have to pay bills, think about job, relationship etc. SO what could kids be worried about?

Answer: Plenty!!!

Every kid worries a lot and has plenty to stress about.

Source of Stress for kids:

  • Sepration Anxiety: When starts going to day care to preschool
  • Too busy a schedule for kids: Many parents overschedule their kids with lots of extracurricular activities (many a times to fulfill their dreams rather than kids)
  • Parental discord or distress: Parents should watchful when they discuss their professional issues or personal issues at home when kids are nearby (as kids are always watching or listening).
  • Media/ TV Screen: media can provide disturbing videos or images which can cause distress to the child.

 

Let your kids know that you understand they’re stressed and don’t dismiss their feelings as inappropriate.

As a parent, you can’t protect your kids from stress — but you can help them develop healthy ways to cope with stress and solve everyday problems.

Signs/ Symptoms:

  • Change in moods, change in sleep pattern, bed wetting, thumb sucking , change in academic performance etc
  • Some kids might even complaint of stomachache or bodyache too

 

Kids deal with stress in both healthy and unhealthy ways. And while they may not initiate a conversation about what’s bothering them, they do want their parents to reach out and help them cope with their troubles.

How to manage stress in kids?

It’s not always easy for parents to know what to do for a child who’s feeling stressed.

Most important is to spend Quality time with your kids. By quality time I mean doing what kids want, rather than making them do what is easier for you.

Proper rest and good nutrition will help in coping with stress better.

Some of the things which you can try are:

  • Notice out loud.Tell your child when you notice that something’s bothering him or her. If you can, name the feeling you think your child is experiencing. (“It seems like you’re still mad about what happened at the playground.”) This shouldn’t sound like an accusation (as in, “OK, what happened now? Are you still mad about that?”) or put a child on the spot. It’s just a casual observation that you’re interested in hearing more about your child’s concern. Be sympathetic and show you care and want to understand.
  • Listen to your child.Ask your child to tell you what’s wrong. Listen attentively and calmly — with interest, patience, openness, and caring. Avoid any urge to judge, blame, lecture, or say what you think your child should have done instead. The idea is to let your child’s concerns (and feelings) be heard. Try to get the whole story by asking questions like “And then what happened?” Take your time. And let your child take his or her time, too.
  • Comment briefly on the feelings you think your child was experiencing.For example, you might say “That must have been upsetting,” “No wonder you felt mad when they wouldn’t let you in the game,” or “That must have seemed unfair to you.” Doing this shows that you understand what your child felt, why, and that you care. Feeling understood and listened to helps your child feel supported by you, and that is especially important in times of stress.
  • Put a label on it.Many younger kids do not yet have words for their feelings. If your child seems angry or frustrated, use those words to help him or her learn to identify the emotions by name. Putting feelings into words helps kids communicate and develop emotional awareness — the ability to recognize their own emotional states. Kids who can do so are less likely to reach the behavioral boiling point where strong emotions come out through behaviors rather than communicated with words.
  • Help your child think of things to do.If there’s a specific problem that’s causing stress, talk together about what to do. Encourage your child to think of a couple of ideas. You can start the brainstorming if necessary, but don’t do all the work. Your child’s active participation will build confidence. Support the good ideas and add to them as needed. Ask, “How do you think this will work?”
  • Listen and move on.Sometimes talking and listening and feeling understood is all that’s needed to help a child’s frustrations begin to melt away. Afterward, try changing the subject and moving on to something more positive and relaxing. Help your child think of something to do to feel better. Don’t give the problem more attention than it deserves.
  • Limit stress where possible.If certain situations are causing stress, see if there are ways to change things. For instance, if too many after-school activities consistently cause homework stress, it might be necessary to limit activities to leave time and energy for homework.
  • Just be there.Kids don’t always feel like talking about what’s bothering them. Sometimes that’s OK. Let your kids know you’ll be there when they do feel like talking. Even when kids don’t want to talk, they usually don’t want parents to leave them alone. You can help your child feel better just by being there — keeping him or her company, spending time together. So if you notice that your child seems to be down in the dumps, stressed, or having a bad day — but doesn’t feel like talking — initiate something you can do together. Take a walk, watch a movie, shoot some hoops, or bake some cookies. Isn’t it nice to know that your presence really counts?
  • Be patient.As a parent, it hurts to see your child unhappy or stressed. But try to resist the urge to fix every problem. Instead, focus on helping your child, slowly but surely, grow into a good problem-solver — a kid who knows how to roll with life’s ups and downs, put feelings into words, calm down when needed, and bounce back to try again.

 

Parents can’t solve every problem as kids go through life. But by teaching healthy coping strategies, you’ll prepare your kids to manage the stresses that come in the future.

Most parents have the skills to deal with their child’s stress. The time to seek professional attention is when any change in behavior persists, when stress is causing serious anxiety, or when the behavior causes significant problems at school or at home.

 

(Many of the above lines are copied from various other website. The purpose of this article is to create awareness among parents).

 

Regards

Dr Rahul Varma

How should I manage Diaper Rash in my baby?

 Diaper rash

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rash

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).

DR

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

home-remedies-for-diaper-rash

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