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Anemia: more common in children than we think.

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

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

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

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

How deficiency develops?

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

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What are Effects of iron Deficiency?

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

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

Common source of Iron in Diet

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

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

How to avoid Iron Deficiency in your child

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

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

Regards

Dr Rahul Varma

Ways to Get Your Toddler’s Attention and Keep It

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You might have experienced this- you are reading aloud a book to your 15-month- old kid and halfway through she wanders away across the room towards the bookshelf. Well! This is a perfectly normal behaviour for her. Psychologists explain that toddlers are innately distractible. They cannot stick on with one thing as long as an older child or adults can. After a couple of minutes, they venture in search of other things. Besides, another reason for your toddler to not comply with your instructions is that she is taking the first step towards becoming her own person. She is walking her way to independence and may tend to do exactly the opposite of what you might have suggested to her.

Read on to find simple ways to get attention of your toddler and have them be seated for a couple minutes to play with a toy or draw etc.

  • First and foremost, is your time. If you want results, it require good quality time. Take time out from your social networking and other stuff and focus on your child’s future. Father’s too have equal responsibility to take out time.
  • Get down to their level to talk to them. Squat down or pick them up, make an eye contact to get their attention to what you have to say.
  • Put in confident good humor in your language. Use silly voices, make up tunes to sentences or sing your instructions to them. For example, if you want to tell them, ‘It’s time to take a bath’, just sing it to them. This will intrigue them to listen to you. Always remember, yelling instructions may get the work done, but no one enjoys the process of doing it.
  • Never impose your choice of play or activity on them. Let them choose what they want for themselves. This makes them pay more attention to things they do while enjoying the task.
  • Television or videos are a complete ‘No No’ in the first two years of a child’s life. In fact, TV, rattles and other noise-making toys overwhelm a child’s attention rather than encouraging the child to actively flex his/her muscles to focus. On the contrary, give them toys that are more open-ended so that they can curiously engage in them with more than one special sense.

Children enjoy games. Engage with them in fun-filled games so that they learn to pay attention. Here are few games you can play with your children:

  • Make hand puppets or finger puppets and use them to give simple instructions (like clap your hands, spin around, etc) to your child. It paves the path for the budding independence of the child as it is a friendly puppet that is instructing them.
  • Go on a treasure hunt with them. This way they learn to follow two- to three-step instructions as well.
  • Mimic voices. Draw the child’s attention to the distantly heard voices and then both of you can mimic it one by one.
  • Use flashlight to focus on different objects in a dark room and let them name them.
  • Last but not the least, model good behavior. Listen to them respectfully and they will learn to be good listeners.

A long attention span is vital for creative, athletic and academic achievement. Attentive listeners make the best friends, spouses and parents. The basic skills of focusing and concentrating learnt in the first few years of life go a long way to help them deal with difficult problems of life and pursue their dreams.

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

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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.

Breast feeding is the best gift from a mother to his/her child

” Breast feeding is the best gift from a mother to his/her child “

breast feeding is the best option which mother has in regards with fulfilling nutritional needs of their newborn babies and to ensure that baby reaches its growth potential. but sometimes its very challenging and difficult especially in first time mothers .

  • Preparation for the same should start during antenatal classes i.e. before delivery. (providing all pregnant women with information and counseling)
  • Breast feeding should be initiated as soon as possible after delivery. (within 1 hour, if medical condition of both baby and mother is stable)
  • During time spent in hospital it is advisable to keep mother and baby in same room i.e “rooming in”. Skin to skin contact can provide warmth to baby along with ample time for feeding.
  • Assessment and teaching by doctors and nursing staff, regarding correct technique and need for proper attachment for establishing breast feeding.
  • First 48 hours, babies nutritional requirements are less, so milk output is less and babies urine output is also less. Gradually over 1st week of life , babies nutritional needs increases, so correspondingly mothers milk output increases and urine output also is 8 to 10 times per day.
  • Most important thing is to have confidence in yourself that you can breast feed (as every mother breast feeds and you are no different). It takes time to develop arelationship with your baby.
  • Breast milk output increases by help of 2 hormones secreted by brain (oxytocin and prolactin). one of these hormone is secreted when child sucks on breast and other when you have positive thoughts in mind. So if are having relaxed mind free of negative thoughts and your baby is sucking well on your breast, you can rest assure that you will have adequate milk for your baby.
  • Exclusive breast feeding i.e. no other pre lacteal feeds like honey, gripe water should be practiced for 1st 6 months. Remember god has sent the baby, and digestive system is best suited to absorb breast milk and anything extra done on your part can cause more harm then benefit.
  •  If your baby is sucking well on breast, passing urine >8 to 10 times in 24 hours and gaining weight well, you can be assured that your breast milk output is adequate for needs of your baby.
  • Confidence on your part and proper guidance from your pediatrician can ensure that breast feeding is a feeling you will cherish for rest of your life. \

Stay healthy, take nutritious diet and breast feed your baby as ” breast feeding is the best gift from a mother to his/her child “

 

Healthy kids, Happy family

regards

Dr Rahul

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

Vaccination reminder service for your baby via sms

http://www.immunizeindia.org/

Click on the above link for vaccine remider service

 

The world’s largest vaccination reminder service

IAP-Immunizeindia is the world’s largest vaccination reminder service, and is available free of cost to parents anywhere in India. It is a national non-profit initiative, promoted by Indian academy of Pediatrics.

IAP-Immunizeindia aims to prevent half a million child deaths and disabilities by 2018.

IAP-Immunizeindia is supported by Vodafone, which is the national telecom partner. IAP-Immunizeindia’s national press campaign, promotional posters in hospitals and clinics and promotional pamphlets are funded by an education grant from another leading Fortune 50 multinational corporation.

How to register for the service

Parents opt-in to the service by sending a text message by SMS to the national shortcode 566778 from any mobile phone in India, in the following format*** :

Immunize <Space> <Baby’s pet name> < Space> <Baby’s date of birth>

Example : Immunize Rekha 04-11-2013

The phone will immediately receive a confirmation message.

Text message reminders** will  be sent to the phone for 12 years, following the IAPCOI Immunization schedule.

3 reminders are sent, at 2 day intervals, for each vaccination that is due. An example of a reminder is – “Rekha is due for a vaccination this week, please do not forget to visit your doctor”**

Reason for the service

Over 2 Million children under the age of 5 die every year in India* and another 1 Million or more are disabled for life. ??

A major cause is that parents often forget to vaccinate the child on time, as most parents in India do not maintain a vaccination calendar for their child in a disciplined manner. Other reasons are-

            – parents’ misplaced priorities
– low awareness
– busy lifestyles
– forgetfulness
– social and cultural causes

Vaccination reminder services in several countries have been effective in increasing compliance by 20%. There are over 40 published scientific studies that prove the effectiveness of vaccination reminders.

India has 700 million mobile phones which support Text Message Service or SMS (every family has a phone). A well promoted, national, Text Message reminder service will be the the most cost effective method of  reminding parents that a vaccination is due.

Contact – For clarifications and support please send an email to info@immunizeindia.org

*     Source- Global Immunization Vision and Strategy (GIVS). 2006-2015, World Health Organization
**    Reminders do not advertise, recommend or promote any vaccine brands or products.
***   Service not available for phones outside India

 

Feel free to contact your pediatrician or contact us at our website www.mayaclinic.in

 

Regards

Dr Rahul varma