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Are you worried about use of Nebulizer for your child? Read on

Nebulizers: Myths and Facts

In my Clinical practice I have seen so many parents and relatives of young children saying “NO to Nebulization”. Many parents do not want to nebulizer their kids as they think it causes addiction and is meant only for severe asthmatic patient.

Any person who is new to nebulization may have some misconceptions (especially lots of myth in public). The aim of this blog is to clear them.

 nebulizer_mask

What is Nebulizer?

It is a device which delivers liquid medicine in form of a mist inhaled in to the lungs. It is battery/electricity operated. Patients breathe through mouthpiece or face mask. They come in different shapes and sizes and create sound (as driven by a motor).

 nebulizer (mayaclinic.in)

 

Myth #1: It will cause addiction and will have to be used every time.

Fact: Nebulization is a mode of delivering a medicine. It does not cause addiction. Addiction is a attribute of drug (or medicine); it does not depend on mode of delivery. If any medicine has addiction potential, it will be for every mode of delivery i.e. oral, intravenous, intramuscular etc.

 

Myth#2: It is very strong i.e very high dose of medicines given through it.

Facts: Doses of medicine is very less as compared to oral medicine.  As drug goes directly where it is intended lower dose is needed. (Up to 100 to 1000 times less dose is needed in nebulizer as compared to oral or intravenous medicine).

 

Myth#3: It has more side effects

Facts:  Side effects are far less with nebulizers. As the drug is delivered directly into the lungs where it has to act; hence side effects are less. Whereas oral medications in form of syrups and dispersal tablets first goes into stomach where they are absorbed and then distributed in body so side effects are more.

 Nebulizer-Time

Myth#4: It takes longer time for drug to start acting.

Facts: Wrong.  As the medicine is going in form of mist directly into the lungs, so it will act faster and give relief much more quickly than oral medication.

 

Myth#5: It is very expensive.

Facts: No, the cost of each vial of medicine is very low as compared to oral medicines. And in case condition of child worsens than cost of one day of hospitalization will be much more than entire course of nebulization.

Myth#6: It is used ONLY for ASTHMA patients.

Facts: Nebulization is used in many conditions in children eg. Bronchiolitis, Wheeze associated lower respiratory tract infection (WLARI), RSV infection, emphysema. Most commonly it helps via dilating respiratory passage (bronchodilation) or decreasing edema (in case epinephrine is used). For children it is difficult to spit out sputum, so use of nebulization might help.

 

Myth#7: It is very complicated.

Facts: It is very simple and easiest way. You just have to connect the tubing with mask and fill the medicine and turn on the device. Child can breathe normally; no need to take deep breathing. Even your child can do it on its own and may feel like it’s a playful activity rather than and forceful thing (giving oral medicines). Inhalers are more complicated for children.

 

Myth#8: Proper dose is not delivered via nebulizer as most of it will go in air.

Fact: Nebulizers are considered as the best way to deliver the medicines in children (in case of hyper reacting airway illness). With inhalers you need to coordinate breathing with medicine dispersal. Oral medications can have erratic absorption as it depends on condition of gut (stomach upset can lead to poor absorption of medicines).

 nebulizer kids(mayaclinic.in)

Myth#9: You have to carry your nebulizer with you.

Fact: Now, so many portable ones are there, so it is very easy to carry them.

 nebulizers 3 clinic

Myth#10:  My baby is very small, it may harm the baby.

Facts: No. Smaller the baby more difficult it s for them to take out their flem. Nebulization will help them to take out all the secretions as it  will dilate the  respiratory passage. Nebulization will not harm your baby.

And lastly have faith in your doctor; they will not advise anything that is not good for baby. Remember both parents and doctors want your baby to get well soon.

 

 nebulizaion (mayaclinic.in)

 

Feel free to contact your child specialist or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”

First Aid for Urinary Pain in kids

home page UTI 

Pain, irritation or excessive crying while passing urine should not be ignored as it could be sign of urinary tract infection. If urinary infection spreads it can cause damage to kidney in children. Other causes of Pain during urination could be local injury, stones (which are small masses of minerals).

UTI (urinary tract infection) is the most common cause of pain during passage of urine.

What are the common sign and symptoms of UTI? :

  • Increased frequency of urine i.e Urgency
  • Burning sensation while passing urine
  • Blood in urine
  • Lower back pain
  • Fever
  • Vomiting
  • Poor appetite

 UTI 2

What can be done at home? :

  • Do not panic
  • Give one dose of Ibuprofen to make child comfortable
  • Encourage child to drink lots of water and other fluids, like juices (some say cranberry juice is best).
  • Call your child doctor (if child is not able to pass urine or having severe pain not responding to medication).
  • Follow your doctor’s advice
  • Do not give Antibiotics without consulting your doctor and without sending sample for Urine routine and microscopy.

 watch for temp in UTI

How to prevent Urinary Infection? :

  • Change diapers frequently. Soiled diaper to be removed right away.
  • Encourage child to go to bathroom at regular interval. Prevent child from holding urine for long.
  • Avoid perfumed soaps. Wash genital area with mild soap and water.
  • Wipe potty from front to back (especially in girls). This will avoid contact of soiled potty particle to come in contact with urinary and genital area.
  • Adolescent kids to be screened for sexually transmitted diseases.

  Urinary-Tract-Infection

Feel free to discuss with your child specialist regarding any queries regarding your child’s Health or contact Us at MAYA CLINIC.

Regards

Dr Rahul varma

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”

Your child keep waking up at night; looks frightened and crying: It could be night terror

 night-terrors

Occasional Nightmare; most of us had nightmares when we were young or even today sometimes. Most of us have comforted our children for that too. But Night Terror (or Sleep terror) is something more than that.

Night Terror as the name suggests is more fearful and challenging than nightmare. Any parent whose child has experienced it, knows that it is inconsolable fear, no matter what you try.

Night terror has more alarming or dramatic presentation. It is also a type of sleep disruption similar to nightmare. It usually is not a sign of serious medical issues or neurological dysfunction.

Normal sleep cycle has several stages; most important are 2 phase:

  • Rapid eye movement (REM) stage where most of the dreams occur.
  • Non- REM stage: night terror occur during deep non-REM sleep

Technically speaking Night terrors are not dreams. They are rather a sudden reaction of fear that happens during transition from one phase of sleep to another.

 campare NT VS NM

It occur about 2- 3 hours after child goes to sleep. It is the time when child is moving smoothly from non-REM sleep to REM sleep. But sometimes during this transition, child becomes very frightened and agitated and that fear reaction is labeled as night terror.

How the scenario looks like during Night Terror?

Child might suddenly sit up in bed or starts to scream / shout. Child’s Heartbeat and breathing is much faster than normal, he/she might start to sweat a lot, looks scared and horrified. At that time no matter what you try child will not settle down. But after few minutes child will return back to sleep and calm down.

Kids will not remember anything when they wake up in the morning (unlike nightmare where kids remember most of the dream or something).

 night terror

What Causes Night Terrors?

Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep. It can happen as the brain is still maturing in young kids. Some genetic factor could be there as in more than 80% of cases one of the family member might have experience some form of sleep disturbance (i.e sleep walking or night terror etc).

Night terrors are more commonly seen in children:

  • Who are in some form of stress or ill
  • Who are fatigued or overtired
  • Who are sleeping away from home or in new environment
  • Who have just started taking some new medication

Incidence:  3- 6% of young children may have night terror (whereas almost every kid has a nightmare once in a while). More common in boys

Age: 4- 12 years (but has been reported in kids as young as 18 months).

Prognosis:  They disappear on their own once the nervous system of brain matures. Some children might have only one episode whereas some have multiple episodes before they stop.

 

Toddler Girl closing her eyes in the bed, perhaps she is seeing bad dreams.

How to Cope With Night Terrors as parents?

  • Keep calm: It can be very upsetting for parents, as they start feeling guilty sometimes as they are not able to comfort or calm their kid during episode of night terror.
  • Be patient and wait it out. Child will settle down in few minutes and will go back to sleep on their own.
  • Provide safe environment for child during might terror (so that child doesn’t hurt himself or others during the episode).
  • Do not try to wake up child: It does not help, it can make things worse; once they has woken up , he/she will be disoriented and confused and may take longer to settle down and go back to sleep.

Treatment:

No treatment for night terrors is available, but we can help prevent them by following these steps.

  • Have a good bedtime routine (try to stick to it during non school days too)
  • Try to reduce your child’s stress
  • Bedtime routine should be simple and relaxing like reading story books, dim light etc
  • Make sure your child gets enough rest
  • Prevent your child from becoming overtired by staying up too late

Understanding night terrors can reduce your worry — and help you get a good night’s sleep yourself.

But if night terrors happen repeatedly, talk to your child doctor, if needed a referral to a sleep specialist can be taken (Besides we need to rule out other brain abnormality).

Regards

Dr Rahul Varma

Dehydration in kids: How to Manage / Prevent it?

Dehydration in kids (mayaclinic.in)

Dehydration is very common in present circumstances of heat wave and very high temperature in Delhi-NCR (almost touching 45 degree). Kids are more prone to dehydration, as they are always engrossed in playing and do not drink sufficient water unless we are reminding them frequently.

Children may develop vomiting or diarrhea along with dehydration; which can make things worse.

SignsOfDehydration

Sign and symptoms:

 Early feature (milder):

  • Thirsty
  • Dry tongue
  • Irritable child
  • Decreased urine output/ dark yellow colored urine
  • Fast heart rate

Dehydration

Severe features:

  • Sunken eyes
  • Excessive sleepiness/ poor activity
  • No urine for last 8-10 hours
  • Skin pinch very slow (wrinkled or doughy skin)
  • Rapid and shallow respiration
  • Weak pulse or very fast heart rate

  Manage Dehydration

How to manage?

  • Plenty of fluids
  • ORS if possible; otherwise any home made fluid which has sugar and salt both eg. nimbu pani , shikanji, juices satu etc
  • Use fan to lower the temperature
  • Elevate feet and let the child lie comfortably.
  • Give short and frequent drinks and meals
  • Urgent Medical opinion needed if Signs of severe dehydration

Dehydration in kids

Think Prevention!

  • Make sure your little angels drink plenty of fluids, especially when environmental temperature is high, child is sick or child is participating in sports activity.
  • Washing handswell and often can help prevent many of the illnesses that can lead to dehydration.
  • Encourage frequent, small amounts of fluids to avoid dehydration during illnesses.
  • A child who’s mildly dehydrated due to overexertion will probably be thirsty and should be allowed to drink as much as he or she wants. Plain water is the best option. Also, the child should rest in a cool, shaded environment until the lost fluid has been replaced. If your child is engaged in prolonged vigorous activity, sports drinks containing sugar and electrolytes (salts) are a good option.

summary dehydration kids

Regards

Dr Rahul varma

Seat belt safety for kids and adults

A few important lessons to be learnt from the the car accident involving  car of actress Hema Malini  and another car in which a child died:

1) Hema Malini was in a Mercedes-Benz, without doubt one of the 3 safest brands in the world. So was Lady Diana. Both suffered massive injury, with Diana succumbing to injuries.

2) If they’re such safe cars with Lakhs of rupees worth latest safety equipment why the injury? That is because both were not wearing seat belts.

3) Airbags are meant to save you beyond the safety offered by seat belts. If you are not wearing a belt, the airbag can kill you rather than the accident. So as a safety feature airbag WILL NOT deploy if belt is not worn.

4) Seat belts are to save you and not to save the traffic police. They’re to be worn at all times, on all seats and all speeds. A head injury at 20 kmph will kill you as efficiently as an injury at 150 kmph.

5) The toddler killed in the accident would surely have survived provided a) she was in the rear seat b) strapped in with a child seat. Remember : Children below 16 always in the rear seat and always strapped into a child seat (under specific body weight) or booster seat (over specific weight).

Above lines are copied from facebook post of Mr Pratik Thakkar; but they are worth sharing to create awareness.

 

 

Seat Belts are for our own safety and safety of loved ones. If you as a parent can buy cars worth in lakhs, then surely you guys can buy car seat worth few thousand. Every year so many lives are lost due to not wearing seat belts effectively.

 

It is a criminal offence in developed countries not to have the children in child seats. The kid will resist for first week, but once used to it won’t be comfortable without a child seat.

As a parent, we should be responsible for safety of our kids, once anything bad happens, you will feel guilty for rest of your life. No matter how much you fight with others after the accident (no matter how much you hold responsible the other guy for accident), damage will be done once and for all.

So it is better to be safe than sorry.

 

Regards

Dr Rahul Varma

” Safe kids, Happy Family”

Disciplining kids; Are you too tough ?

How to Discipline kids

 

Common questions by parents:

Parents have noticed that the more sternly they speak to their kids — for example, after they’ve run into the busy street with vehicles around; without looking here and there  the more distraught they get. How can we make sure they understand the seriousness of certain situations without making them feel worse?

 

Solution:

As the saying goes, “Desperate times call for desperate measures.” When your child’s safety is at risk — whether he’s run into the street, reached for an open flame, or gotten dangerously close to a pool — yelling, screaming, or crying out is a perfectly normal (and necessary!) response. After all, at that moment, you would do anything possible to get your child’s attention and get him out of harm’s way.

After an episode like this, it’s natural for kids to cry — and for you to want to apologize. But the truth is, your kids are likely crying in response to the fear and urgency in your voice, not because you’ve been “too stern.” At times like these, it’s OK to comfort them without apologizing. Give your child a hug and say something like, “I know you’re upset. But what you did was dangerous and I was scared that you were going to get hurt. You must never do that again.” Punishing kids after an event like this is usually not necessary, since they’ve probably learned their lesson.

On the other hand, there are times when being too stern — like yelling regularly for minor offenses — can backfire. Kids can become immune to parents’ overblown reactions and fail to take them seriously. If you feel yourself getting into this habit, take a deep breath before responding to your child’s behavior and ask yourself, “Am I about to overreact?” If so, walk away for a few minutes and come back when you’ve calmed down.

In general, when it comes to disciplining kids, it’s best to speak with a low, firm voice and to keep your focus on the behavior, not the child. It’s also helpful to use natural consequences whenever possible. That means if your child has thrown a toy, ask her to pick it up. If she’s taken something from her sibling, ask her to return it. If she chooses not to comply, an age-appropriate timeout or other consequence should follow, despite tearful pleas. Consistency is the key to effective discipline, and giving in to a child’s tears may inadvertently reinforce negative behavior.

 

Regards

Dr Rahul Varma

Febrile Seizure in Children; What to do?

fever

What is Febrile Seizure?

Febrile means feverish; any seizure or convulsion which is accompanied by fever is known as febrile seizure.  The look of child during seizure seems life threatening (Child’s whole body is shivering, shaking, twitching, eyes may roll up, there could be frothing from mouth and child may become unconscious) and it can be very frightening for parents.

They are scary to witness but remember that they are fairly common.  But they are usually not serious and there have NO long term bad effects on brain.

Simple Febrile Seizure typically occurs in

  • Age: 6 months to 5 years
  • Usually happens on the first day of febrile illness
  • Lasts for few minutes only
  • It is generalized (i.e. not localized to one body part)
  • Usually occurs once in 24 hours
  • No previous neurological illnesses in child

  Febrile seizure 2

Salient Features:

  • Currently there is no evidence that simple febrile seizures cause structural damage to the brain
  • With the exception of a high rate of recurrence, no long-term adverse effects of simple febrile seizures have been identified.
  • Administering prophylactic acetaminophen/Paracetamol (any other fever drug) during febrile episodes was ineffective in preventing or reducing fever and in preventing febrile-seizure recurrence
  • Long-term therapy with antiepileptic drugs is not recommended
  • Febrile seizures are not considered epilepsy, and kids who’ve had a febrile seizure; only have a slightly increased risk for developing epilepsy compared to the general population.

Management:

Just the site of your baby during seizure can be terrifying and very distressing for parents but Do not Panic (The episode might look life threatening but febrile seizures are very benign and child’s brain development is normal)

Febrile_Seizures-11

Follow  these steps:

  • Make sure your child is in a safe place.
  • Put your child sideways by turning the body to one side; to prevent choking
  • Watch for danger signs like breathing difficulty, child turns blue.
  • Wait for Seizure to get over and then shift the child to nearest hospital/medical care facilities for proper evaluation of your child’s condition and to rule out serious illnesses like Meningitis.

Things one should NOT DO:

  • Do not shake the child, or try to hold or restrain your child.
  • Do not put anything in your child’s mouth.
  • Do not try to give any medicine while child is in active seizure not even fever-reducing medicine.
  • Do not try to put your child into cool or lukewarm water to cool off.

When the seizure is over, meet your child doctor to look for causes of Fever. The doctor will examine your child and ask you to describe the seizure. In most cases, no additional treatment is necessary. The doctor may recommend the standard treatment for fevers, which is paracetamol or ibuprofen.

Conditions which need urgent Hospitalization are

  • If the child is under 1 year old, looks very ill, or has other symptoms such as diarrhea or vomiting; child will go through few tests to rule out other illnesses like Meningitis and determine the cause of fever.
  • The seizure lasts more than several minutes
  • If the child is having breathing difficulty or child turns blue
  • If the child looks ill, lethargic and is not responding normally
  • Persistent vomiting is there

febrile seizure

Medications:

Midazolam nasal spray, Tablet Frisium, and various other medications might be prescribed by your child’s doctor as per need of your child and hospital protocol.

Investigations:

Neuroimaging and EEG need to be done during first episode just to rule out other illnesses with seizure. Investigations to find the cause of fever may also be done which may include few blood test and urine test.

EEG seizure

Recurrence of Febrile Seizures is high in following cases:

  • Younger children (less than 18 months)
  • Shorter duration of fever before onset of seizure increases the risk of recurrence
  • Family history of febrile seizure (in sibling or any other family member)
  • Lower the peak of Fever at onset of seizure ,higher the chances of recurrence

Few children might develop seizure without fever later. These children have

  • Complex febrile Seizure
  • Family history of epilepsy
  • Neurological illness or developmental delay (eg. Cerebral palsy, Hydrocephalus etc)
Simple Febrile Seizure Complex Febrile Seizure
Age: 6months to 5 years They can occur before and after that
Lasts only few minute Last longer even up to 15 minutes
Generalised (Whole body involved) Localised / Focal (May involve only one body part)
No previous neurological issues May have previous neurological illnesses like Cerebral Palsy
Once in 24 hour period Can occur more than once in 24 hours

 

To Summaries:

Simple febrile seizure is a benign and common event in children between the ages of 6 and 60 months. Nearly all children have an excellent prognosis. There is evidence that both continuous antiepileptic therapy with phenobarbital, primidone, or valproic acid and intermittent therapy with oral diazepam are effective in reducing the risk of recurrence, the potential toxicities associated with antiepileptic drugs outweigh the relatively minor risks associated with simple febrile seizures. As such, long-term therapy is not recommended. In situations in which parental anxiety associated with febrile seizures is severe, intermittent oral diazepam at the onset of febrile illness may be effective in preventing recurrence. Although antipyretics may improve the comfort of the child, they will not prevent febrile seizures

For any queries feel free to contact Maya Clinic.

Regards

Dr Rahul Varma

Jaundice in Newborn

Jaundice: why is the incidence of jaundice in newborn baby rising ?

Over the years , we all have seen lots of newborn baby diagnosed with jaundice on 3rd or 4thday of life, which turn out to be of great concern for most parents. First thing that comes to mind (esp. of grand parents ) that in old days jaundice was not so high, why is it now ? are doctors over diagnosing it ? is our baby kept unnecessarily in nursery?

Jaundice-In-Newborns 

I will try to answer these question in this article and will not go into too much technical details.

Facts: Jaundice is universal phenomenon i.e. it occurs in every baby who is born.

  • Normal trend is that Jaundice starts from day 2 or 3 and rises till 7th day and decreasesgradually by 14th day of life. If its goes beyond a certain level then we need to treat , otherwise it will decrease on its own with time.
  • Sunlight can not decrease jaundice. Enough scientific data is there, as it requires particular wavelength of light to be given from close range in order to decrease it. Still some of the doctors (  who have not updated their knowledge ) might suggest sunlight exposure, which is incorrect. However giving sunlight exposure to your baby has various other advantage most important being Vitamin D3, hence it is advisable to give sunlight but not for jaundice.

Baby-with-Jaundice-getting-Phototherapy

Important points for parents:

  • Do not panic , it is very normal for babies to have jaundice  and it is easily treatable by giving Photo therapy in most cases.
  • But if there is significant delay in starting photo therapy and bilirubin level rises very high it can cause brain damage which cannot be reversed.
  • It cannot be predicted at birth how high jaundice will go i.e.most likely  you will be told about jaundice by your child doctor on day 3 or 4 of life (that unfortunately ,usually coincide with the timing of your discharge from hospital) .
  • There is no way that it can be prevented as it is a normal (or physiological) phenomenon.
  • As the treatment is so simple and risk if not treated is so high, its always better to be cautious and over treat rather then under treat.
  • Sunlight do not have any effect on jaundice as the distance is too far away and particular wavelength of light is required to decrease it.
  • Have faith in your doctor , not everyone is there to make money, most of the child specialist are honest and have soft corner for children.

Phototherapy charts

Given above  is the chart most commonly used by newborn specialist  and Pediatrician.

 

Further details  regarding Jaundice (if you wish to know in details,  otherwise you can skip it):

  • We as a doctor  has various cut off values for bilirubin level . ( Bilirubin levels is tested in blood which helps in assessing the severity of jaundice). These cut off guide us to decide whether your child need treatment or the level of bilirubin is with in normal limits and baby can be sent home. These cut off values varies as per , how old is your baby, what was birth weight, how mature your baby was i.e. born as per date or before that, blood group of baby and mother etc.
  • In most of the babies who are born on time and are good size babies and whose blood group matches their mother, jaundice is less likely to go above danger level (however photo therapy may be needed).
  • As the baby grows older, his liver starts functioning better and he can tolerate higher  level of jaundice. For eg a bilirubin level of 12 at 36 hours of life is more alarming than level of 15 at 60 hours of life.
  • Best thing which you as mother can do for your baby is breast feed, as feeding gets better child is able to metabolize and tolerated  bilirubin levels better.
  • This jaundice is newborn babies (indirect bilirubin is high)technically different from what usually occurs in adults (direct bilirubin is high). And it is not very dangerous unless until levels become too high.  A very high level of indirect bilirubin can cause brain damage, and once that damage occurs , its difficult to treat and child`s brain functions are hampered for life.
  • As medical science has evolved , we are able to diagnose more cases and start photo therapy early and actually prevent lots of cases of brain damage, which were there is past. (enough scientific data is there to suggest decrease in incidence of bilirubin induced brain damage).
  • Besides today most of us wants to have one baby or at the max 2, and do not want to take risk and want our children in best health.
  • Treatment of Jaundice is Photo therapy and in rare cases of very bilirubin Exchange transfusion.
  • Photo therapy:Special wavelength lights are given to babies from a particular distance. If level is high , we might give light from both side i.e.  one above the child hanging and one below the child. We give it continuously, interrupted only for feeding. We keep monitoring bilirubin levels and do repeat blood tests 12 to 24 hours usually but in some cases more frequently. It usually take around 48 hours to get jaundice in lower range but time taken to control jaundice is very variable.
  • MK-BY847_LEDBAB_G_20121119162220 
  • Exchange transfusion: In this we change the whole blood of baby gradually over few hours and replace it with blood from blood bank after cross matching. Its relatively serious process and is our last option when bilirubin levels are very high and neurological damage is suspected.

If you really want to go in for further detail then this is the link to know in detail regarding Jaundice.

Its virtually impossible to write everything here, so for any queries , feel free to contact us or your pediatrician. Its your right to discussion , the plan of care of your baby with treating pediatrician or Newborn specialist.

Stay healthy

Regards

Dr Rahul Varma

“ Healthy kids, happy family”

 

Single best way to stop infection: Hand Wash

Hand washing can save many lives. It prevents spread of infections and decrease incidence of illnesses which in turn leads to increase productivity.

Five simple and effective steps are

  • Wet
  • Lather
  • Scrub for 20 seconds
  • Rinse
  • Dry

It helps prevent spread of germs and prevent sickness.

When to wash hands:

  • Before and after eating food
  • After using washroom/changing diapers
  • Coughing, sneezing, blowing of nose
  • Handling garbage
  • Playing with pets
  • Taking care of sick person at home
  • Coming back after long day at office (especially before greeting small children)

What If there is no water and soap??

Use hand sanitizer. These are alcohol based sanitizers; they quickly reduce microbes significantly. But washing hand with soap and water is the best option.

Hand washing is like vaccination, it prevents spread of infection. More important it is, if you have a small baby at home.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”