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Tips to Win the Bedtime Battle With Your Kids

Welcome to the world of parenthood where bedtime becomes a power struggle between the child and the parent. What’s a sleep-deprived parent to do? Fret not. We’ve got some really simple and effective tips for getting your kid into bed on time, every time.

(For issues related to bed-wetting click here)

Bed is only for sleeping

Do not use bed for all the activities like playing, eating etc. It should be strictly used for sleeping

Avoid products with caffeine before sleep

Do not put hungry child to bed

No TV/Laptop/I pad in bedroom

These electronic gadgets distracts children a lot. It makes sleeping more difficult

Casting the monsters away

Switch on a dim night light to ward off those lurking shadows that fuel scary dreams. A stuffed toy will give a sense of security and a goodnight cuddle just might do the trick. It works all the time.

Ambient temperature

Wrestling with the blanket can make even that thin trace of sleep, vanish. Make sure you have the AC or the fan on at just the right temperature – not too cold nor too hot.

Make up a story

Give your children the solace they need by singing a lullaby or reading out a favorite story. Add a fun twist with a made-up fairy tale where your child is the prince/princess. Stories are a super way to doze into dreams high on imagination.

Exhaust the energy

Keep your kids on their toes by letting them dance to some fun music during the day. Playing a vigorous game or learning karate will tire them out and get them to sleep as soon as their head touches the pillow.

Ditch the sugar

Sugary treats too close to bedtime are a strict no-no. A sugar high will put your child into hyperactive mode. Curb those cravings by allowing them to munch on candy only during the day.

Seal the deal

Some smart kids need a deal to be struck before you can get them into their beds. Offer to buy something off their wishlist, or make a promise to take them out the very next day. Looking forward to something puts their mind at ease and seals the deal.

Always stay one step ahead with these tips to get them into bed. Remember to establish firm boundaries to discipline them into their own bedtime routine. So what are you waiting for? Set the ball rolling and be on the winning side of the bedtime battle!

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

Diabetes and its relevance in children

Today is “World Diabetes Day”

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14 th November (besides being children’s day in India) is also celebrated across the globe as World Diabetic Day to create awareness regarding this deadly disease.

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Diabetes do not discriminate. It can occur across all age group, geographical location, religion.

Common symptoms of this disease are frequent urination, excessive thrist, weight loss, lack of energy.

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Lifestyle modification is the key i.e good healthy food along with 30 minutes of physical activity daily.

For details regarding diabetes log on tohttp://who.int/mediacentre/factsheets/fs312/en/

Incidence in Children are also increasing. If corrective step and lifestyle modification is not done it can be life threatening. For more information in children with diabetes read on.

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For prevention; modification in lifestyle is needed. Physical activity and nutritious diet.

Regards

Dr Rahul Varma

 

Regards

Dr Rahul Varma

Nose Bleed: How to manage Epistaxis ?

Epistaxis (Nosebleed): What to do?

nose bleed (mayaclinic.in)

 

One of the most frightening sites for a parent is to see their child bleed from nose. But you can rest assure that in most cases it is not serious. Most of them can be treated at home.

 nosebleed

It occurs due to bleeding from small vessels of nose. It happens as a result of break in the tissue lining of nose (mostly in front part or “anterior” of nose).

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Cause:

  • Irritation and lack of moisture in the nasal membrane
  • Dry air or warm air can lead to crusting of membrane inside nose and it may cause itching which can lead to scratching or nose picking. It in turn leads to bleeding.
  • Allergic conditions and cold
  • Repeated nose blowing
  • Excessive use of antihistamines and Decongestant medicines can also lead to it.
  • Serious causes: Head Injury
  • Bleeding disorders

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In some cases bleeding can occur from posterior part of nose which can be dangerous. It leads to flow of blood down the back of throat.

Frequent or long time bleeding if occurs; you should consult doctor.

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What can be done at home?

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  • Do not Panic and remain Calm
  • Make your child sit in your lap and tilt his or her head slightly forward.
  • Gently pinch nose with clean cloth.
  • Keep applying pressure on nose for about 10 minutes. If we stop too soon bleeding may start again
  • If child is leaning back, it may cause blood to flow down the throat which may in turn cause gagging, coughing or vomiting.
  • Discourage child to blow nose, picking, rubbing.
  • Ice pack on forehead might help.

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When to call doctor?

  • Frequent nose bleed
  • Long time duration of bleeding or difficult to control bleeding
  • Foreign body in nose
  • Bleeding from any other site as well
  • Associated symptoms like fever, rashes etc
  • Easy bruising tendency
  • Medication: recently added or long term

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Urgent Attention needed if:

  • Bleeding is heavy
  • Associated with weakness or dizziness
  • Head injury or history of fall
  • Bleeding continues after two attempts of applying pressure for 10 minutes each

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Prevention:

  • Avoid nose picking (Keep finger nails trimmed most of the time)
  • Use saline nasal spray frequently during illness
  • Vaporizer or steam helps
  • Protective gears while playing or driving to prevent injury

 

Even after taking all the precautions, sometimes child starts bleeding without any obvious reason. So do not panic as most of them are harmless and can be stopped easily.

Discuss with your doctor (Child specialist/ ENT specialist) or contact us at Maya Clinic.

 

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”

What is the right breast pump for lactating mother?

 

(Source Indus parenting site)

Direct breast feeding is the best option, but sometimes due to medical conditions or working mothers need to express breast milk.

When nursing mothers need to express breast milk; it can be done manually (as it had been done traditionally for long time) or you can use breast pumps (mechanical stuff which has become fashionable in recent years to make the process more comfortable and easy).

From a baby’s point of view; baby needs clean hygienically expressed milk, whichever methods suits you, it is up to you. Whether you express it manually or use manual breast pumps or electric breast pump.

 

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As a new mother, you might have prepared a list of ‘things to do.’ You might have even stuck to this list that mostly reads, “Feed, clean, bathe, repeat.” But now it’s time to go back to the corporate jungle and claw your way back up the ladder. And if that’s the plan then you are probably in the market looking for a breast pump.

Since there are many kinds of breast pumps, you will have to select the one that you feel would work best for you. Which means that this type should keep the milk flowing and prevent clogged ducts or breast infection.

When exactly do I go for a breast pump

So on your next visit to the gynaecologist, you may be advised to buy it way before you actually plan to use it; which means almost a month or so before you head back to work or plan to introduce the bottle. Dr Ragini Agarwal, surgery and cosmetic gynaecologist, W Hospital by Pratiksha, Gurgaon, explains, “New mums who are about to resume work or need to stimulate lactation because of low milk supply, or to relieve engorgement (a painful condition whereby the breasts are overfull) urgently need a breast pump.”

You can also consider buying a breast pump for the following reasons:

  • The baby needs extra breastmilk as a ‘top-up feed’ following a breastfeed
  • The baby is in the nursery and, therefore, separated from the mother
  • The mother is forced to wean due to the infant’s death
  • You wish to maintain or increase milk production
  • To pump exclusively if the new mother is hospitalised after birth
  • If the mother cannot nurse for physical reasons such as a cleft palate
  • The baby may not be able to suckle well at the breast

In case you are planning to use a breast pump soon after delivery, experts advise that its best to start pumping within three to four weeks of delivery. Dr Geetika Gangwani, lactation consultant, Mamma Mia, Fortis, Delhi, says, “Each mother and baby is different, so the need to express milk will be very individualistic.

For instance, mothers whose babies are in the NICU soon after birth, need to start expressing using a breast pump within six hours of their delivery. Whereas some mothers only express once they go back to work and a few might not need to express at all.”

So how do you select a breast pump? Before heading out to the market, ask yourself two questions. First, what are the different types of breast pumps. Second, how safe is it for you as well as your baby?

Continue reading to know more about the types of breast pumps and their safety norms

Should you invest in a manual, an electric or a double breast pump? If you’re looking to buy one, then address these questions before your purchase

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Types of breast pump

Let’s begin with the first question. There are many models of breast pumps in the market, but they are primarily categorised into two types- electric and manual.

  • Manual breast pumps: They are operated by squeezing or pulling a handle in a repetitive fashion. This allows the user to directly control the pressure and the frequency of milk expression. Manual breast pumps are small and inexpensive and are, therefore, easy to use. They also come with many accessories such as breast shell, a pump membrane (this helps in maintaining the suction and is vital for pump functioning) and tubing (this connects the mechanical apparatus to the collecting bottle).
    Cost: They can cost anything between ? 200 and ? 3,000. “But they require significant effort and can be tiring because the user provides all the power. They also allow for only one breast to be pumped at a time,” says Dr Priyanka Mehta, senior gyneacologist, ePsyClinic.com, Delhi.
  • Electric breast pumps: They are ideal if a mother pumps daily. They are larger than manual pumps, but portable models are also available in the market. These are also divided between hospital grade and personal use pumps. While hospital grade pumps are larger and intended for multiple users, personal use pumps are smaller and generally intended for a single user.
    Cost: A high-quality, electric pump costs anything between ? 3,500 and ? 7,000. “These will help you express your milk most efficiently. You could also opt for a double breast pumps that pumps both breasts at same time and can cost up to ? 20,000,” says Dr Mehta.

A word of caution: Try to keep your hands off the piston type or the bicycle horn pump (they can damage breast tissue and harbour bacteria in the suction bulb) or the rubber bulb (they can also harbour harmful bacteria) from the range of manual breast pumps in the market.

Now how do you decide which type is best for you. Dr Gangwani explains why this is not a question to worry about. “Successfully expressing breastmilk is an art that mothers usually master over time. Research shows that electrical breast pumps along with massaging the breast gives maximum output.

When choosing a pump, please keep in mind the frequency of its use. If you plan to pump at least three to four times per week, an electrical pump is recommended. If the frequency is lesser, then you could use a manual pump or hand express as well,” she says.

Safety notes while buying a breast pump

The second question you must address is the safety of a breast pump. Because quality breast pumps don’t come cheap, you might consider borrowing it from a friend or buying a cheaper version. That’s a complete ‘no-no.’

Breastmilk can carry bacteria and viruses of hepatitis and HIV, and they can contaminate the pump. Also, in some cases an exclusive pump for your own personal use can be unsafe because the milk can get into its internal parts. However, pumps that are originally designed for more than one mother are still safer. You can try rental and hospital pumps, they are usually cleaned properly and are sterile.

“Dr Gagnwani says, “In addition, mothers can also try manual breast pumps. Apart from being less expensive they are also easy to clean and portable, making them a safe option.”

While you weigh in all of these options, also keep in mind a few other things:

  • If you have chosen a double breast pump, seal the unused side. If you avoid this practice, it can reduce the pump’s suction and reduce milk production.
  • Wisely choose the breast shields. Your nipple should not run along its chamber, you can hurt your breast this way.
  • If you are to feed within a few hours, take out all the parts and separately clean them with a mild soap and warm water.

Buying a breast pump can be tough, especially when you are a new mother. So to make things easy, first understand the types and functioning of the pumps you may have finalised for yourself and then read the safety precautions for their use. All this information will not only help you but also help another confused new mum who may turn to you for some advise.

Rashes over face in children: It could be Atopic Dermatitis

 ATOPIC DERMATITS

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ECZEMA: Very common skin problem in children.

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Atopic dermatits is a most common form of Eczema.

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It usually begins in Infants (less than 1 year old child). It improves as the child grows older and resolves by the time child starts going to school or reaches puberty. Some children may develop chronic disease.

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Causes:

Sensitive skin which is more easily irritated by sweating, heat , rough clothing and some detergents, soaps etc. Some may have allergies to food, pets, dust mites.

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Symptoms:

Red, dry, itchy patches on skin. Itching may be severe and constant; with frequent scratching, skin may develop blisters, oozing, crusting.

Affects mainly face, scalp arms, legs.

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Treatments:

No Cure , but can be controlled with good skin care

  • Bathing: gentle soap, limit time.
  • Topical (Skin) Medicines: topical steroids needed in severe cases or during flare up
  • Moisturizers: apply moisturizer 30 minutes after you apply any topical medicines. This allows it to seal the medicine. Eg vaseline or any petroleum jelly.
  • Anti histamines: anti allergic medicines to decrease itching. It can make child sleepy.
  • Environmental Triggers: Avoid food, pets, dust mites that can trigger this conditions.
  • Skin Infections: chances of secondary infections are there so your child might need topical antibiotics as well.

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When to call doctor:

Mild to moderate cases can be managed by your child specialist but in severe cases or if no improvement than need to consult dermatologist or skin Specialist.

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Regards

Dr. Rahul Varma

When is the right time to start (weaning) top feeds?

Complementary feeding: (weaning food)

It is defined as any non breast milk food or nutritious foods given to young children in addition to breast milk.( i.e. it is to complement breast milk, not to replace it.)

Age of Introduction: after 6 months

Attributes of Complementary feeds:

  • Soft and flowing
  • Thicker than Breast milk
  • Bland in taste
  • Homogeneous ( based on cereal or root staple foods)
  • 1 to 2 times a day to start with
  • Gradually increase frequency and quantity

Foods appropriate for complementary feeds:

  • Pulses (lentil, beans, peas), meat milk, vegetable oil and sugar
  • To increase dietary energy levels : oil, ghee, sugar
  • To increase quality of protein: milk product and animal food
  • Calcium: Milk
  • Iron: Meat, chicken, fish
  • Rich in Vitamin & Minerals: Vegetable and fruits

 

Conclusion:

Anything which is free flowing and well mashed and easy to swallow and calorie dense can be given. And you should always consult your Pediatrician at the start of weaning diet/ complementary feeding, so that he or she can guide you in best possible , culturally acceptable option.

Stay Healthy and eat healthy, For any queries do feel free to contact us.

regards

Dr. Rahul Varma

How to take care of your child’s EAR

Q.How to clean EAR?

Ans. No active cleaning is required as there are glands in the ear which cleans it naturally. No object should be inserted inside the ear canal, only the outer part of ear to be cleaned. No oil or any other liquid to be instilled; give medication ear drops only after consultation with doctor.

Q.What are common causes of pain in the ear in children?

Ans. Common causes are

  • Impacted wax (Cerumen)
  • Infection in ear canal
  • Infection in ear drum or middle ear
  • Trauma due to insertion of foreign objects like caps of pen, hair pin etc.

Ear pain should not be ignored and opinion of child specialist or ENT specialist should be taken.

Q.How to prevent ear infections?

Ans:Common measures to prevent ear infections are

  • Avoid Trauma: Educate children about not to insert anything in the ear
  • Do not let dirty water enter ear canal
  • Avoid feeding with bottle in lying down position
  • Do not Slap the child as it can damage the ear drum
  • Early diagnosis and treatment helps the spread of infection

Q.When to visit doctor?

Ans:ENT specialist opinion should be taken if

  • Persistent pain in ear
  • Ear discharge
  • Suspicion of hearing loss
  • Delayed speech
  • Difficulty in understanding of spoken language by child
  • Whenever in doubt, its better to consult rather than feel sorry later

Q.How long can a child listen to loud music safely?

Ans:Hearing hazard depends upon both level of noise and duration of exposure. It is best to avoid such situations and use well fitted ear plugs especially for babies.

Q.I enjoy listening to loud music through ear/headphones. Will it harm my hearing ability?

Ans:The risk of hearing loss increases as sound is played at high intensity (volume) and for long durations. It has been shown that listening through earphones at 95% of maximum sound volume for 5 minutes (with most devices) continuously will damage hearing. To protect hearing, volume should be minimized and breaks should be taken while listening through ear/headphones

Q.Is there any other function which ear has besides hearing?

Ans:Yes. Balancing and for maintaining posture. Inner ear is responsible for it.

Regards

Dr Rahul Varma

Avoid use of Phones and decrease screen time in young kids: it can hamper brain growth

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Smartphones and tablets are not meant for babies (< 2 years)

In today’s environment we all can see small babies and toddlers playing with phones. Whether you are at mall, driving in car, waiting somewhere , smartphones have become like babysitter for many parents. Parents feel excited to see their small babies handling touch screen phones so efficiently. Touch screen smartphones with their great picture quality, colorful images and good sounds appeals to babies. But are they really good for optimum brain development for young kids?

Answer:

Till now there is NO research done to know the connection between infant learning and smartphones. For older children with use of interactive elements it may help in learning concepts such as sequencing and cause and effect relations. But for small babies who are still in very young age of brain development, it’s long term effect is not known.

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Recommendations:

All the doctors are of the opinion to reduce screen time for small babies. Screen time includes time spent on TV, videos, laptops, phones etc. American Academy of Pediatrics (AAP) has made a clear stance that “NO screen time for kids less than 2 years”. Main reason being association of Language learning delays, poor reading skills and short term memory are seen more often in children with more screen time.

Facts:

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.

After a certain age technology and screen time can be used judicially for better interactive teaching. Older children can do lot more and screen time can help them in understanding concept better along with reading from textbook. But not for very small babies.

Another excuse which most parents give is that there baby will never eat food if we take phones out of there life. Just to remind them that before invention of smart phone kids used to eat well.  And Honestly speaking we have started spending more time on social networking like facebook and whats app which have lead to more exposure in children. Because it’s we who cannot live without phone rather then kids.

Regards

Dr Rahul varma

Signs of Nutritional deficiency in children

 

(source: Indus parenting website)

Identify these signs of nutritional deficiency in children and try to make up for it by adding essential nutrients in their daily diet. Here’s what to do

Nutritional deficiency in children can hamper their overall growth and development. It occurs when the body is unable to absorb basic essential nutrients. This primarily happens with children when their body is unable to absorb iron and vitamin D.

While this may lead to abnormalities or stunted growth in the physically, psychologically its effect is far more detrimental. But how do you identify nutritional deficiencies in children?

Dr Debjani Banerjee, consultant, Nutrition and Dietetics, PSRI Hospital, Delhi lists 10 signs of nutritional deficiency in children.

Depression and anxiety

Depression and anxiety begins in the brain but can be brought on by nutritional deficiencies. Take for instance, protein deficiency. Proteins are made up of amino acids that can be found in plant and animal foods. These amino acids are important because the brains uses them to create neurotransmitters such as serotonin, endorphins, catecholamine andgamma-aminobutyric acid (GABA). These neurotransmitters keep us feeling happy and calm instead of depressed and anxious.

What to do: A diet complete with high quality proteins can help to correct this nutritional balance. You can count protein intake or eat whole meals cuts that include fat and even make broth out of the bones. In severe cases supplementation with specific amino acids may be needed to help support the body.

Restlessness or hyperactivity 

Many of you might think that restlessness in kids is a good sign. However, hyperactive children have poor digestion and this makes it hard for the body to absorb many nutrients.

What to do: You should avoid or stop using artificial foods that aid in digestion. Instead, you can add foods like papaya, yogurt, and buttermilk in the diet of your child to aid digestion.

Delayed speech

Normally speech problems like delayed speech is related to heredity, but it indicates that your child might have vitamin B12 deficiency.

What to do: It is advisable to give natural foods rich in Vitamin B12 instead of supplementation. These foods are dairy products, eggs, pork, fish, chickens, beef and organ meats.

Dry Skin or Hair

Dry skin and hair can be related to deficiency in fat soluble vitamins such as vitamins A, D, E and K2.

What to do: You can accomplish this but supplementing the daily diet with fermented cod liver oil at half a tsp/day. However, you need to consult a pediatrician to find out if vitamin supplements can help.

Crowding teeth

Crowding teeth is another example which is usually related to heredity. However, scientific research has shown that crowding of teeth occurs mostly due to nutritional deficiency. It is not just the kids who eat more processed food and lack proper dental spacing, but also kids whose mothers are unable to pay enough attention to add nutrition food during their pregnancy and have poor spacing in their teeth.

Children who eat traditional food including rich fats, animal proteins and properly cooked carbohydrates, have enough spacing in teeth.

What to do: It is advisable to include properly cooked food and nutritious food items such as lentils, pulses, eggs and poultry.

Frequent colds and flu

A good healthy diet is a great way to prevent sickness. Focus on providing all nutrients through food apart from paying attention to any one nutritional deficiencies.

What to do: Always try to introduce traditional way of cooking and choices of foods. In that way child’s immune system will get better and his immune system will get better.

signs of nutritional deficiency in children

Dental cavities

Cavities are often thought to be a result of too much sugar or candy in the diet. Though this doesn’t help, cavities are found in children deficient in proper mineral and fat soluble vitamins.

What to do: It is advisable that you introduce food items that are rich in fat soluble vitamins such as green leafy vegetables, cabbage, milk and even liver.

Low energy level and foggy brains

Children who are deficient of iron (Fe), get tired easily and also get sick and have a foggy brain. They might not be able to keep up with the stamina of children their own age. This is a definite warning signal for all parents.

What to do: Introduce foods like meats, nuts, seeds, vegetables, legumes and dried fruits to cover up for iron deficiency in your child.

Cranky or sporadic emotions

It has been researched that fats (mainly Omega 3) are vital food for good mood stabilization. Good saturated fats like butter and coconut oil help keep these fats in our brains. Hormones are also a player. Unbalanced hormones can cause us to feed irritable and moody.

What to do: You can include saturated fats and also add carrots to your daily diet to help absorb extra estrogen in the body.

Obesity

When we eat foods that are not nutrient dense, our bodies are hungry. They become starved for good nutrition and that is why we do not feel satisfied. That is probably the reason that most of us are surprised to see obesity in the list of nutrition deficiency. However surprising it may seem, but it is the deficiency of proper nutrition that leads to obesity.

What to do: Remember that children feel satisfied when they eat properly balanced food, which includes animal products, milk, butter, cheese, fruits, vegetables and properly prepared grains.

So keep an eye on your child’s daily activities and behaviour and begin by first understanding the cause and follow it up by changing his diet.