Category Archives: gastro problem

diseases related to gastroenterology

Why Doing Away With the Gadgets Is Important for Your Kid

mayaclinic-smarthphone-baby

Steve Jobs did not allow his kids to own and use an iPad at home. He feared that the iPad would turn his kids into addicts of the device. He should know. After all, he was the founder of Apple Inc. and the father of the digital revolution. Most, if not all, Silicon Valley techs and engineers limit and shield their kids from technology and prefer to send their kids to schools where the focus is on hands on learning and computers are not easily accessible.

Why do the people at the pinnacle of digital change shield their kids from this technological marvel? The reasons are too many and varied, but everyone agrees on some common pitfalls of early exposure to technology.

Children learn better from real life experiences rather than screen time. It is more so if activities involve moving and doing. Various surveys and studies show that on an average 12-month-old baby is exposed to up to 2 hours of screen time a day.

Young age (< 2 years) is very critical for learning of new concepts. Most of the learning involve 3 dimensional Sensory- motor experiences which cannot be replicated on a 2 dimensional screen. Active play involves better hand – eye coordination , fine motor skill development.

Example:  Compare a ball in real life and a ball on Screen.

Infants are still developing concept of 3 dimensional vision. For a small baby  watching on screen a BALL is just a flat, shaded circle. In real life if we roll a ball across floor it proceeds in a single motions and gradually slows and stops finally. But on Screen same action cannot be done; it will be broken up. Small babies may stare at bright colors and motions on screen but their brain is not capable of making sense or meaning out of these amazing pictures. By  the age 2 years brain has developed enough and baby can understand things better. Due to all this confusion it is better to avoid screen time in small babies.

Distorted sense of reality:

Early exposure to technological marvels such as tablets, smart phones and computers are detrimental to the physical and mental growth of children. They give children a distorted view of reality and interfere with the natural development of the child’s brain

Co-ordination and dexterity:

Children as young as 3 and 4 when exposed to the iPad may become experts at swiping the screen, but lag behind in developing dexterity in their fingers that comes by playing sports or musical instruments.

Concept of space:

Young children have still not developed a sense of space and each new walking, bending and climbing experience helps to develop a sense of space. Early exposure to the iPad interferes with this development and gives children a distorted sense of depth and space.

Social Skills:

Various studies have shown that children growing on iPads or other similar screen devices tend to lag behind in development of real time social skills. Regular activities such as developing social skills and making friends become a task for such children. Such children do not spend time with their own thoughts and imagination and require constant stimulation.

Emotional skills:

Development of internal mechanism of self-regulation is an important milestone in a child’s emotional development. Constant and continuous use of such devices to distract and control the behavior of children impedes their ability of self-regulation.

Maths and Science:

Playing with blocks in real time develops visual-motor skills and sensorimotor skills in children that are the base of all learning. Application of maths, science and logic in the classroom and outside comes naturally for kids whose basic skills are well – development. Playing with real blocks and puzzles is frustrating for young minds who are used to manipulating objects by swiping the screen.

The list of the evils of early exposure to screen only gets longer with time. There has been very little systematic research and the technology is still quite new to fully understand its complete effects. For now, the safest thing to do is keep that tablet away from your kids or at least stop using it as a baby sitter.

Worried About Your Child’s Obesity? Watch the Kilos Melt Away With This Action Plan!

childhood_obesity_mayaclinic.in

Childhood Obesity is on the rise! As a parent, it is not easy to accept the fact that your child might be obese or even overweight. The body mass index (BMI) uses height and weight to calculate whether a child falls into underweight, average, overweight or obese categories. Even if your child is a little overweight, it is easier to shed the extra pounds as compared to adults. (Moreover in young kids we just want baby to maintain that weight and do not allow the child to gain weight further and with time as the age grows child will fall in normal weight category)

Obesity, be it in children or adults, has multiple risk factors associated with it. It affects the entire body and causes our body functions to go haywire.

Most common associated risks with obesity are:

  1. Increased risk for type II diabetes due to insulin resistance;
  2. High risk for respiratory conditions such as asthma;
  3. Abnormal sleep patterns and snoring issues;
  4. Depression and low self- esteem due to the body shape and always stared upon;
  5. Risk of high blood pressure;
  6. Joint problems due to large weight

In current time, childhood obesity is spreading like an epidemic through all the cultures. The action plan to get rid of this menace includes:

1. Get rid of calorie-rich temptations

Avoid giving your child extra calories such as chocolates and fried chips for snacks. Instead try fresh fruits or vegetables with dips for snacking.

2. Decrease extra sugar

Try not to put extra sugar in milk or any other food that you might serve to your child.

3. Regular scheduled meals and adequate portion size

Having small meals and snacks in between the meals decreases production of fat and increases metabolism. Try child-size servings instead of adult-size. Add juices, smoothies, beans, pulses, five portions of fruit and vegetables.

4. Do not eat out too often

Outside food might contain too much oil, butter, salt and sugar. Basically, nothing beats homemade food! So avoid eating out.

5. Exercise

Exercising is the best way to lose weight. Make it interesting for your kids. Play sports with them, go bike riding or on any other activity they like.

6. Decrease sedentary lifestyle

Children’s life these days has become sedentary because of increased use of electronic devices such as TV, iPads, Tablets, etc. Lifestyle surrounding these gadgets must be avoided.

7. Lead by example/ Be a role model

Be the change you want to see in your child. Behave like you want them to in front of you. This is true especially for diet and exercise. If your kids see you eating healthy food and exercise regularly, they will try to follow your footsteps.

So, kick start these above mentioned activities and watch your kids transform from being overweight to being healthy and fit.

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

 

Children with Constipation : what can be done

CONSTIPATION

  • Pain or crying during the passage of a stool (bowel movement or BM) OR
  • Unable to pass a stool after straining or pushing longer than 10 minutes OR
  • 3 or more days without a stool (Exception: Breastfed and over 1 month old)

Imitators of Constipation: Normal Variations

  • If breastfed and over 1 month old: Infrequent stools every 4-7 days that are soft, large and pain-free can be normal.
  • Before 1 month old, infrequent stools usually means an inadequate intake of breastmilk.
  • Grunting or straining while pushing out a stool is normal in young infants. (Reason: difficult to pass stool lying on back with no help from gravity) Infants commonly become red in the face during straining.
  • Brief straining or pushing for less than 10 minutes can occur occasionally at any age.
  • Large stools – Size relates to amount of food consumed and stool frequency. Large eaters have larger stools.
  • Hard or dry stools are also normal if passed easily without excessive straining. Often relates to poor fiber intake. Some children even have small, dry rabbit-pellet-like stools.

Causes:

  • High milk or cheese diet
  • Low fiber diet
  • Postponing stools
  • Slow intestinal transit time (genetic differences)

Home Care Advice for Constipation

  1. Normal Stools:
  • Once children are on a regular diet (age 1 year), the normal range for stools is 3 per day to 1 every 2 days.
  • The every 4 and 5 day kids all have pain with passage and prolonged straining.
  • The every 3 day kids usually drift into longer intervals and then develop symptoms.
  • Passing a stool should be fun, or at least free of discomfort.
  • Any child with discomfort during stool passage or prolonged straining at least needs treatment with dietary changes.

2. Diet for Infants Under 1 Year:

  • For infants over 1 month old only on breast milk or formula, add fruit juices 1 ounce (30 ml) per month of age per day. Pear or apple juice are OK at any age. (Reason: treating a symptom)
  • For infants over 4 months old, also add baby foods with high fiber content twice a day (peas, beans, apricots, prunes, peaches, pears, plums).
  • If on finger foods, add cereal and small pieces of fresh fruit.

3. Diet for Children Over 1 Year Old:

  • Increase fruit juice (apple, pear, cherry, grape, prune) (note: citrus fruit juices are not helpful).
  • Add fruits and vegetables high in fiber content (peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, dates) 3 or more times per day.
  • Increase whole grain foods (bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn can be used if over 4 years old.)
  • Limit milk products (milk, ice cream, cheese, yogurt) to 3 servings per day.

4. Stop Toilet Training: Temporarily put your child back in diapers or pull-ups.

  • Reassure him that the poops won’t hurt when they come out.
  • Praise him for the release of stools.
  • Avoid any pressure, punishment or power struggles about holding back poops, sitting on the potty or resistance to training.

5. Sitting on the Toilet (if toilet trained): Establish a regular bowel pattern by sitting on the

toilet for 10 minutes after meals, especially breakfast.

6. Warm Water for Rectal Pain: Warmth helps many children relax the anal sphincter and release a stool. For prolonged straining, have your child sit in warm water or apply a warm wet cotton ball to the anus. Move it side to side to help relax the anus.

7. Flexed Position:

  • Help your baby by holding the knees against the chest to simulate squatting (the natural position for pushing out a stool). It’s difficult to have a stool while lying down.
  • Gently pumping the lower abdomen may also help.

8. Call Your Doctor If:

  • Constipation continues after making dietary changes
  • Your child becomes worse

Regards

Dr Rahul Varma

Typhoid Fever (mayaclinic.in)

Typhoid Fever: things we should know

 

 

Typhoid Fever (mayaclinic.in)

 

Typhoid Fever is so commonly heard off in our country. (I think most common as well as most over diagnosed disease in India).

typhoid

Cause: It is caused by bacteria called Salmonella Typhi (S.Typhi) typically living in humans and are shed through a person’s feces (poop) or urine (pee). Bacteria get into blood and spreads quickly inside leading to high grade fever within a week or two.

Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening. Even after treatment during recovery phase a person can transmit this disease to others.

  food infected

Cause of Spread: 

  • Due to unclean water intake, unhygienic food and poor sanitation facilities.
  • Drinking water (and other drinks) and eating food handled by someone who has typhoid or is still a carrier.
  • Infected people can pass it on to others by touching them with unwashed hands.
  • Contaminated water by sewage, more so in area with poor sanitation and inadequate water treatment

Typhoid fever is named after a lady called typhoid mary who was suffering from this disease and used to serve food in USA leading to epidemic of this disease in that area.

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Symptoms: Severity depends upon vaccination status, age, general health etc

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  • Mild to High grade Fever
  • Stomach pain
  • Body pain, weakness
  • Diarrhea or constipation
  • Poor appetite
  • Reddish spotted rash

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Complications

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Complications: Intestinal perforation (rare)

 

Diagnosis:

Salmonella_typhimurium- gram negative bacilli under high magnification of 15000 X

  • History and examination
  • Blood tests :
    • Typhi Dot IgM: during first few days of fever
    • Widal test: after 5 days of fever (It gives false report before that). Unfortunately this test is most misused test in India. And many false positives reports are given by various labs even on first day of illness.
    • Blood Culture is gold standard: But in most cases antibiotics have been started early so yield of this test is low. And beside it is costly, so many quacks start treatment rather than testing. This treatment is often incomplete and in inadequate doses leading to drug resistance and disease recurrence.

child_with_fever  

Treatment:

  • Antibiotics: important to give for proper duration and in adequate doses. Please do not stop medicine on your own once child starts feeling better after 2- 3 days.
  • Some Cases might not respond to oral medication and need for Intravenous medication along with fluids might arise.

Plant for treating Typhoid Fever

Stopping the Spread

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Prevent the spread to others: Wash hands regularly. People with typhoid fever should avoid preparing food. Children should stay away from school until doctor certifies them to join back school.

How to prevent Infection

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Vaccination: It is Available and routinely given around 2 years of age and every 3 years after that. Even if your child is vaccinated (Vaccine is not 100% effective and loses its effectiveness over time)

  • Sanitize water.
  • Cook all food.
  • Avoid raw food.
  • Wash hands frequently

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Feel free to contact your child doctor for any queries or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”

 

How long will this diarrhea (or loose motions) last in my child?

 

Diarrhea from a viral infection usually lasts several days to 2 weeks, regardless of the type of treatment.

gastroenteritis02

 

Acute watery Diarrhea (Acute Gastroenteritis)
Diarrhea is the sudden increase in the frequency and looseness of stools. Mild diarrhea is the passage of a few loose or mushy stools. Severe diarrhea is the passage of many watery stools. The best indicator of the severity of the diarrhea is its frequency.

The main complication of diarrhea is dehydration from the loss of too much body fluid. Symptoms of dehydration are a dry mouth, the absence of tears, infrequent urination (for example, none in 12 hours), and a darker, concentrated urine. The main goal of diarrhea treatment is to prevent dehydration.

AGE-DH

Diarrhea from a viral infection usually lasts several days to 2 weeks, regardless of the type of treatment. The main goal of treatment is to prevent dehydration. Your child needs to drink enough fluids to replace the fluids lost in the diarrhea. Don’t expect a quick return to solid stools.

What all can be given during Diarrhea?

Increased fluids and dietary changes are the main treatment for diarrhea.

Frequent, watery diarrhea

  • Fluids

Encourage your child to drink lots of fluids to prevent dehydration. Any fluid with both salt and sugar given in adequate amount is fine but we need to avoid only sugary drinks like juices etc. Salt helps in better absorption into the gut. Milk and water are both fine. However, if your child refuses solids, give your child just milk, rather than water. Offer short and frequent meals.

ORS (roughly 10 ml/kg per stool ) or simply as much as possible. Encourage child and offer ORS after every motion.

Avoid fruit juices, because they all make diarrhea worse.

  • Table foods

Keep giving your child table foods while he has diarrhea. The choice of food is important. Banana, curd, dalia, khichri, dal and rice , nimbu pani , sikangi etc. Starchy foods are digested best. Examples of such foods are dried cereals, grains, bread, crackers, rice, pasta, and mashed potatoes. Soft-boiled eggs and yogurt are easily digested and provide some protein.

Gastroenteritis-Treatment

How long will it last?

Mild diarrhea (loose stools)

Follow a regular diet with a few simple changes:

  • Eat more foods containing starch. Starchy foods are easily digested during diarrhea. Examples are cereal, breads, crackers, rice, mashed potatoes, and pasta.
  • Drink extra water. Avoid all fruit juices and carbonated drinks.
  • Milk and milk products are fine.
  • Avoid beans or any other foods that cause loose stools

What is the treatment and precautions?

There is no effective, safe drug for diarrhea. Extra fluids and diet therapy work best.

WHO recommends only 2 things: ORS and Zinc.

  • ORS
  • Zinc: 20mg/kg once a day for 14 days for children more than 6 months.
  • If you are breastfeeding, then keep breastfeeding on demand,
  • Probiotics

Probiotics contain healthy bacteria (lactobacilli) that can replace unhealthy ones.

Yogurt is the easiest source of probiotics. Give your child 2 to 6 ounces (60 to 180 ml) of yogurt twice daily.

Probiotic supplements in granules, tablets, or capsules are also available in health food stores.

  • Common mistakes

Fruit juices, cold aerated drinks, glucose water, Kool-Aid and soda pop, should be avoided because they contain no salt and too much sugar. Use only the fluids suggested here.

Fruit juices (especially apple and grape) should be avoided because they are too concentrated and make the diarrhea worse.

Clear fluids alone should be used for only 4 to 6 hours because the body needs more calories than clear fluids can provide. Milk is a good well balanced fluid for diarrhea.

The most dangerous myth is that the intestine should be “put to rest.” Restricting fluids can cause dehydration.

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  • Prevention

Diarrhea can be very contagious. Always wash your hands after changing diapers or using the toilet. This is crucial for keeping everyone in the family from getting diarrhea.

  • Diaper rash from diarrhea

The skin near your child’s anus can become irritated by the diarrhea. Wash the area near the anus after each motion. Cleaning should be done softly and by patting only (do not rub with pressure). Then protect it with a thick layer of petroleum jelly or other ointment (Zinc based). This protection is especially needed during the night and during naps. Changing the diaper quickly after stools also helps.

  • Overflow diarrhea in a child not toilet-trained

For children in diapers, diarrhea can be a mess. Place a cotton washcloth inside the diaper to trap some of the more watery stool. Use diapers with snug leg bands or cover the diapers with a pair of plastic pants. Wash your child under running water in the bathtub.

  • Vomiting with diarrhea

If your child has vomited more than twice, follow your doctor’s recommended treatment for vomiting instead of this treatment for diarrhea until your child has gone 8 hours without vomiting.

gastroenteritis-mid

When should I call my child’s doctor (Pediatrician)?

Call IMMEDIATELY if:

  • There are signs of dehydration (no urine in more than 10-12 hours, very dry mouth, no tears).
  • Any blood appears in the diarrhea.
  • The diarrhea is severe (more than 8 stools in the last 8 hours).
  • The diarrhea is watery AND your child also vomits repeatedly.
  • Your child starts acting very sick.
  • Oral intake almost zero i.e. child not even taking plain water

What should parents avoid giving their children if they have diarrhea or are vomiting?
Do not give your child sugary drinks, such as fruit juice or sweetened fruit drinks, carbonated drinks, sweetened tea, broth or rice water. These have the wrong amounts of water, salts and sugar. They can also make your child’s diarrhea worse.
Talk to your doctor before giving over-the-counter medications to stop diarrhea. If your child’s diarrhea is very serious, do not offer plain water. Drinking only water may lead to low blood sugar or low sodium levels in your child’s blood.

For any other query , feel free to contact us at MAYA CLINIC or talk to your child specialist.

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

Picky Eaters

Between 20% to 50% of kids are described by their parents as picky eaters.

Why do babies turn into picky eaters? What are the signs? And what can you do about it?

Understanding the Signs

The symptoms of a picky eater can seem pretty obvious: Your baby may push away the spoon or turn his head from it. She might close her mouth as you try feeding her, spit out food, or become cranky or tired at mealtime.

Yet these signals don’t necessarily mean your baby is picky. They can also be signs your little one is simply full, distracted, or not feeling well.

A baby can seem picky for dozens of reasons — or no reason at all. He may have an immature digestive system, which will cure itself with time. She might be teething, have an infection, food allergy, or just may not be ready for solid foods yet.

As long as growth and weight gain are normal, there’s usually no reason to worry about a fussy baby who prefers a limited diet. But if you find yourself worried about infant feeding problems, talk to me at maya clinic and try the following tips.

Tips to Help Tame a Picky Eater 

Never force feed. If your little one turns her head from the spoon, she’s telling you clearly she’s had enough — even if it seems she’s had very little. Trust that your child will eat what she needs. If you force baby to eat despite signs he says “no more,” your little one may start associating eating with tension and discomfort — and become even more fussy.

Try different textures. Even babies have food preferences. Some enjoy wet foods, others may prefer finger foods. Some may want to graze through a half dozen mini-meals, while others may favor liquids over solids for a time.

Transform the tempo. Some babies want to eat fast, others slow. Could you be frustrating your little one with the wrong feeding tempo? There’s only one way to find out: Try slowing down the next feeding, or picking up the pace.

Minimize distractions. Make food the focus of mealtime. Turn off the TV, remove toys and books, and help your little one focus on one thing: Eating.

Keep meal length reasonable. It’s tempting to let a picky eater take as long as she wants to eat. Although you shouldn’t rush mealtime, don’t let it go on much longer than 20-30 minutes.

Let baby touch his food. You probably wouldn’t eat a food you’ve never seen before without first looking it over. Your baby is the same, so let your little one touch a new food before you offer it.

Follow your baby’s timeline. Most babies begin eating solid foods between four and six months, but some may start a little earlier, others later. As with crawling, walking, potty-training, and just about every other infant milestone, there’s no perfect time, there’s your baby’s time.

Let your baby participate. By about nine months, many babies are interested in trying to feed themselves. Although your picky eater is likely to make a mess waving around the mealtime spoon, letting him take control is important to a child’s growth and development.

It’s natural for babies to slow down their feedings. As they reach the end of their first year, babies’ growth tends to slow and so too can their calorie needs. Be patient; growth spurts are on the way.

Keep trying, gently. Some babies may need to try a food eight, 10, even 15 times before they enjoy it, so be patient and continue to revisit a rejected food over time.

Don’t let on that you’re frustrated or angry. React emotionally to a picky eater and even a 1-year old will understand her power over you. Realize that you want your baby to eat for her own well-being, not to please you and that baby’s rejection of a food is not a rejection of you.

Understand who’s responsible for what. It’s your job to feed your baby, but it’s your baby’s responsibility to decide what and how much to eat. Children will always eat when they’re hungry. Remember that so long as a child is growing and gaining weight and you are feeding them healthy options, there’s little need to worry about a baby who’s a picky eater.

regards

Dr Rahul

stay healthy

“healthy kids, Happy family”

constipation

CONSTIPATION

  • Pain or crying during the passage of a stool (bowel movement or BM) OR
  • Unable to pass a stool after straining or pushing longer than 10 minutes OR
  • 3 or more days without a stool (Exception: Breastfed and over 1 month old)

Imitators of Constipation: Normal Variations

  • If breastfed and over 1 month old: Infrequent stools every 4-7 days that are soft, large and pain-free can be normal.
  • Before 1 month old, infrequent stools usually means an inadequate intake of breastmilk.
  • Grunting or straining while pushing out a stool is normal in young infants. (Reason: difficult to pass stool lying on back with no help from gravity) Infants commonly become red in the face during straining.
  • Brief straining or pushing for less than 10 minutes can occur occasionally at any age.
  • Large stools – Size relates to amount of food consumed and stool frequency. Large eaters have larger stools.
  • Hard or dry stools are also normal if passed easily without excessive straining. Often relates to poor fiber intake. Some children even have small, dry rabbit-pellet-like stools.

Causes:

  • High milk or cheese diet
  • Low fiber diet
  • Postponing stools
  • Slow intestinal transit time (genetic differences)

Home Care Advice for Constipation

  1. Normal Stools:
  • Once children are on a regular diet (age 1 year), the normal range for stools is 3 per day to 1 every 2 days.
  • The every 4 and 5 day kids all have pain with passage and prolonged straining.
  • The every 3 day kids usually drift into longer intervals and then develop symptoms.
  • Passing a stool should be fun, or at least free of discomfort.
  • Any child with discomfort during stool passage or prolonged straining at least needs treatment with dietary changes.

2. Diet for Infants Under 1 Year:

  • For infants over 1 month old only on breast milk or formula, add fruit juices 1 ounce (30 ml) per month of age per day. Pear or apple juice are OK at any age. (Reason: treating a symptom)
  • For infants over 4 months old, also add baby foods with high fiber content twice a day (peas, beans, apricots, prunes, peaches, pears, plums).
  • If on finger foods, add cereal and small pieces of fresh fruit.

3. Diet for Children Over 1 Year Old:

  • Increase fruit juice (apple, pear, cherry, grape, prune) (note: citrus fruit juices are not helpful).
  • Add fruits and vegetables high in fiber content (peas, beans, broccoli, bananas, apricots, peaches, pears, figs, prunes, dates) 3 or more times per day.
  • Increase whole grain foods (bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn can be used if over 4 years old.)
  • Limit milk products (milk, ice cream, cheese, yogurt) to 3 servings per day.

4. Stop Toilet Training: Temporarily put your child back in diapers or pull-ups.

  • Reassure him that the poops won’t hurt when they come out.
  • Praise him for the release of stools.
  • Avoid any pressure, punishment or power struggles about holding back poops, sitting on the potty or resistance to training.

5. Sitting on the Toilet (if toilet trained): Establish a regular bowel pattern by sitting on the

toilet for 10 minutes after meals, especially breakfast.

6. Warm Water for Rectal Pain: Warmth helps many children relax the anal sphincter and release a stool. For prolonged straining, have your child sit in warm water or apply a warm wet cotton ball to the anus. Move it side to side to help relax the anus.

7. Flexed Position:

  • Help your baby by holding the knees against the chest to simulate squatting (the natural position for pushing out a stool). It’s difficult to have a stool while lying down.
  • Gently pumping the lower abdomen may also help.

8. Call Your Doctor If:

  • Constipation continues after making dietary changes
  • Your child becomes worse

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