Tag Archives: child specialist in vaishali

Must read for first time parents

Must read for all first time parents

Trust yourself:

You know more than you think you do:

You want to be the best parent you can be but it`s not clear what`s best. Everywhere you turn there are experts telling you what to do. The problem is, they often don’t agree with each other. The world is different from how it was 20 years ago, and the old answers might not work anymore. We were brought up on traditional Indian diet whereas now you cannot get away from cosmopolitan culture and multiple cuisines available. Now more and more nuclear families are coming up, so grandparental guidance is not there.

Don`t take too seriously all that the neighbors or well wishers say. Don`t be overawed by what experts say. Don`t be afraid to trust your own common sense. Bringing up your child won`t be a complicated job if you take it easy and trust your instincts. (Remember baby is a part of you only). The natural loving care that parents give their children is a hundred times more important than their knowing how to make a diaper fit tightly or just when to introduce solid foods. Every time you pick your baby up- even if you do it little awkwardly at first- and change baby`s cloths, bathe ,feed ,smile , baby is getting the feeling that he/she belongs to you and that you belong to them.

The more people have studied different methods of bringing up children, the more they have come to the conclusion that what good mothers and fathers instinctively fee like doing for their babies is usually the best.

So better to relax and make a few mistakes than to try too hard to be perfect.

Enjoy your parenthood. This time is not going to come back. Upbringing of a child is most pleasurable job and spending quality time with your child is important.

For specific query you can write to us and also keep track of future update on blog and patient update.

Stay healthy

Regards

Dr RahulVarma

Can my child have hypertension ?

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

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

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2 types: Primary (Essential) and secondary

Cause:

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

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

Risk Factors:

Genetic as well as environment

Primary Hypertension:

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

Secondary Hypertension:

Due to underlying medical conditions like

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

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

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

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

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

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Diagnosis:

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

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

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

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

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

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Management:

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

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Medications include Diuretics, beta blockers, ACE inhibitors etc.

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

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Life style modification:

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

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

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

Regards

Dr Rahul varma

“Healthy kids, happy family”

Potty-Training-Toilets

When is the right time to start Toilet training in children?

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Training the children for toilet is a big issue for parents. It is perceived as a big developmental milestone. But the real problem starts when we start comparing our kids with others. Every child has different pace of developing milestones. And few accidents regarding Susu (Urine) and potty (Stool) once in a while should be dealt with patiently. Compassionate and encouraging attitude towards toddlers will help us better, than showing frustration and anger.

What is the age when our baby will be ready?

  • First action which suggests that your baby is ready to train is when baby start to tell you while doing susu or soon after that before you take notice. And when baby is praised for telling the same, they will soon be telling you before doing.
  • Most babies should be ready by 2 years but some may take time until they turn 3.
  • Girls are ready earlier than boys of similar age
  • Control over susu comes before potty
  • Other features which indicates that your baby is ready for toilet training are
    • Telling you that his nappy is wet
    • Pulling at wet or dirty nappies
    • Baby does not want to wear nappies any longer
    • Shows interest in others using toilet

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Patience is the Key to success in this case too. Most problems arise when we start too early or we want our baby to be trained before certain major event in our life. eg arrival of 3nd baby, family marriage, long planned vacation, before going to play school. If we try to put pressure on child it will only worsen the case and increase your frustration levels.

How to train your baby

  • Teach your child meaning of words needed to define urine, stool, dry, wet , it’s coming. Choose words you are comfortable with eg susu, potty, wet (geela), dry (suukha), etc. Clear words and constantly same words to be used by everyone at home will make it easier for baby.
  • Need to have thing with you which are needed like toilet seat (different types are there, choose which ever you are comfortable with), footstool near the seat so that baby can climb up, proper lighting in the area, something to hold on while sitting on toilet seat so that baby will feel safe and relaxed.
  • Keep the area safe. Keep toilet cleaner, household cleaner and other toiletries out of range of children.
  • Talk to your child, if you are comfortable you can let your baby go along with you and tell them all the steps you are doing like cleaning flushing etc.
  • Learn the signal which baby gives before, keep your toilet ready (because your baby won’t be able to hold on for long), loose cloths which can be easily removed.

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Few important things you need to know:

  • Never start toilet training when something new is happening and child is trying to adapt. eg change of home, grandparents leaving home, arrival of 2nd baby, you are very stressed out etc
  • Give your child time to get familiar with stuff in toilet (so that they are not scared). Eg let him touch the toilet seat, feel it.
  • Encourage an appreciate child’s behavior and things when they tell in time. Hug them or cuddle them and say something like “You are good baby”. And always support them if they do in their pants.
  • Never embarrass or punish your Child. It will only worsen the situation.
  • Remember it is very difficult skill to learn for child and it will take time. The more you support your child easier it will be for them.
  • Hygiene: Girls should be taught to wipe front towards back to avoid chances of getting the potty into vagina and Boys should be taught to shake penis after susu to get rid of any drops.
  • Teach your child to wash hand every time and also assist them in early stages of cleaning.

 

“Toilet training works best when there is no pressure for either the parent or the child”.

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  • If you are stressed out or getting angry seeing that your baby is not learning, it is best to leave it for few days and do not pressurize your child. Punishment will never help.
  • Some baby will hide at some weird place and do susu or potty. Like behind the sofa, or curtain or cupboard. You need to be patient and support them and no Punishment.
  • Most babies will make a mess after doing potty; they may soil their hands and spread it. Do not punish them but also do not pretend to be happy about it. Child should know that it is not good in non threatening way.
  • Constipation can make things worse as doing potty becomes painful and child try to avoid passing stool and is afraid to sit on potty seat. Give warm bath, it may relax the muscles.
  • If a child who has been dry, start to wet again then look for causes of stress or visit a doctor to rule out urinary infection. Features suggestive of urinary infection include:
    • Increased frequency, pain during susu
    • Blood in susu

Consult a doctor if even after age of 4 years child is wetting pants to rule out Urinary infection, bladder abnormalities like Vesico ureteral reflux and behavioral issues like BED-WETTING.

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To Summaries

  • Toilet training is not easy and child needs your support during this difficult phase to learn this new skill.
  • Go slowly at your child’s pace,not as per your need or wish.
  • Praise child at every step and encourage him/her.
  • Do not get dishearten by few accidents (susu & potty) after child had been dry.
  • Punishment has no place in toilet training.

 

Regards

Dr Rahul Varma

nose bleed (mayaclinic.in)

How to manage child with nose bleed (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.

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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).

 Epistaxis Management        images

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”

 

How to manage Motion Sickness ?

Motion sickness

 

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Motion sickness as we all know happens while traveling. It is more common in young children.

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Motion sickness is very common while traveling especially to hilly areas. It can happen in any mode of transportation.

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Symptoms can start suddenly or gradually. Most common symptoms are Nausea, Vomiting, dizziness, sweating etc.  It usually stops as soon as we journey is completed. More frequent travelers have less of these symptoms.

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How to prevent it

  • Try to occupy the seat where minimum motion will be felt
  • Road Trip: better to sit in front seat or drive yourself
  • Train travel: Window seat and face forward
  • Plane travel: Seat over front edge of wing is better. Direct the air vent flow towards your face
  • By water (Ship): try to get front or middle cabin which is near the water level.

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Treatment options:

  • Focus on distant stationary object. Do not stress yourself and avoid reading.
  • Try to keep your head still
  • Avoid smoking
  • Avoid spicy food or heavy meals
  • Avoid Alcohol
  • Drink carbonated beverage to help settle stomach or Eat dry crackers

 

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  • Drugs:
    • Antihistaminics: 30 to 60 minutes prior to journey
    • Transdermal Patch
    • Hyosine (Buscopan)
    • Phenergan (Promthazine)

These drugs should be given only under medical supervision after advice from your doctor.

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For detail reading log on to below mentioned link

http://motionsickness.org/

 

Dr Rahul varma

 

dengue-fever heading

Want to stay safe from Dengue Fever? Read on

 Dengue Fever

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Dengue Fever as we all know spread from bite of an infected Mosquito. It has 4 serotypes. It can cause very severe life threatening illness; however most cases are milder in nature.

Huge number of cases has been reported worldwide (50-100 million cases every year worldwide).

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Dengue virus is transmitted by Aedea Mosquito. It bites during day time only. Outbreaks can occur at anytime, however rainy season with high humidity increases changes of transmission.

Symptoms:

Occurs after 4-10 days of mosquito bite and symptoms can last from 2 to 7 days usually.

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High grade Fever associated with atleast 2 of the below mentioned features should raise suspicion of Dengue Fever:

  • Headaches
  • Body ache.  esp pain behind eyes
  • Joint Pain, bone pain, Muscular pains
  • Nausea, vomiting
  • Rashes (usually extensive red colored all over body)
  • Itching

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Most crucial Phase of Dengue illness occurs once fever subsides; i.e. at deffervescence of Fever as most of the complications arises at this time. At this time platelet counts start decreasing along with rise in Hematocrit values. 3rd space losing occurs, so it is very important to prevent dehydration and let your child have PLENTY OF FLUIDS.

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Severe Cases (also called dengue hemorrhagic fever):

Special attention needs to be given to these warning signs as it could lead to severe dengue:

  • Severe abdominal pain
  • Persistent vomiting
  • Bleeding from any site eg gums, blood in vomiting etc
  • Rapid breathing
  • Fatigue/ restlessness
  • Altered sensorium

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Treatment:

  • At present no vaccine is available.
  • No specific medication for dengue fever.
  • Mainstay of treatment is supportive
  • Patients should seek medical advice, rest and drink plenty of fluids.
  •  Paracetamol (Crocin) is the drug of choice for Fever. Other medications like aspirin or ibuprofen should be avoided as it increases the risk of bleeding.
  • Vital Monitoring along with blood test to have a look at Hematocrit along with platelet count.
  • Platelet transfusion in some cases

Infection with one strain will provide life-time protection only against that particular strain. However, it is still possible to become infected by other strains and develop into severe dengue. Usually re-infection cases are severe.

With proper medical care and early recognition, case-fatality rates are below 1%.

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What should be done by Patients and Relatives?

  • If you suspect you have dengue you first need to avoid panic and consult a doctor soon.
  • Drink plenty of fluids, watch for urine output & watch for bleeding from any site.
  • For diagnosis, your doctor will
    • Evaluate your signs and symptoms
    • Test your blood for evidence of a dengue virus using NS1 Antigen or serology test (IgG& IgM).

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How Dengue is spread:

  • Bite from infected mosquito (Aedes aegypti)
  • Day time biting by this mosquito (esp early morning & evening)
  • Does not spread by contact

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Mosquitoes  breading Ground:

  • Clear water in nearby areas esp water filled containers etc.
  • Rest Indoors in dark areas like closet, under beds, behind curtain etc.

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Preventive measures:

  • Source reduction: eliminate mosquitoe’s egg laying sites.  Examples of the following habitats are listed:
  • Indoor, Ant traps, Flower vases and saucers
  • Water storage tank (domestic drinking water, bathroom, etc…)
  • Plastic containers, Bottles, Outdoor, Discarded bottles and tins
  • Discarded tyres, Artificial containers, Tree holes, potholes, construction sites, Drums for collecting rainwater
  • Shells, husks, pods from trees, Leaf axils of various plants
  • Community participation is the key to dengue prevention. As every household aims to reduce vector density, the transmission rate will decrease or maybe even stop.
  • Protecting yourself from mosquito bites: It can be done by using
    • Long-sleeved clothing and mosquito repellents are the most viable options.
    • Window and door screens, air conditioning reduces the risk of mosquitoes coming into contact with the household members.
    • Mosquito nets (and/or insecticide-treated nets) will also provide additional protection to people sleeping during the day, or protect against other mosquitoes which can bite at night (such as malaria).
    • Household insecticides aerosols, mosquito coils or other insecticide vaporizers maybe also reduce biting activity.

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Feel free to contact your doctor for detail or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

 

 

Cough in Children: What to do ?

 

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Cough is the most common symptom and in all probabilities every child has had it once.  Important fact which I would like to share is that COUGH is a Protective reflex. It protects the spread of infection to airways in lung. But on certain occasions it needs a doctor’s visit; especially if the child is having breathing difficulty and not able to sleep at all at night.

Different types of Cough:

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Cough with barking sound:

Swelling in upper airway leads to barking cough i.e. swelling of Voice box (Larynx) or Windpipe (trachea) or whole of upper part in LTB (Croup). Croup is due to viral infection in most cases. It is sudden in onset and severe in younger kids with narrow airway. It has harsh, noisy character which occurs when child inhales.

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Cough with whistling (or musical sound):

When lower airway is involved it leads to musical or whistling sound. It can be sometimes audible from a distance too. Common causes are viral infections like Bronchiolitis in young children, WALRI & Asthma. Foreign body is also important cause in kids.

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Cough with Fever:

Cough associated with mild fever & running nose is mostly due to common cold. But if cough is associated with high grade fever and no running nose and breathing difficulty than Pneumonia needs to be ruled out. You should visit your child specialist soon.

 

Cough with vomiting:

Post tussive vomiting is very common in young children and should not be a cause a worry. As babies are not able to throw up mucus and secretions from lungs naturally by taking deep breath voluntarily, so vomiting with cough might relieve the child for some times . It occurs as cough can sometimes trigger gag reflex.

Persistent Cough:

Viral infections can last for 2 weeks. Children with asthma, allergies or chronic infections or repeated viral infections can cause persistent cough but if cough persists for more than 3 weeks than doctor visit is needed.

Prevent triggers: Cold Air, perfumes, Smoke, ice creams etc can start or prolong the cough in children.

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When is the right time to visit Child Specialist?

If your child is having any of the below features, you should contact your pediatrician

  • Fast breathing
  • Deep and effortful breathing
  • Bluish color on lips, face
  • High grade fever and no running nose
  • Young child less than 3 months old especially with fever
  • Special sound with cough. Eg Whopping cough, Stridor (noisy), musical sounds/ wheezing etc
  • Blood with cough
  • Child is very weak, irritable and cranky
  • Poor oral intake, decrease urine output and looks dehydrated.

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Expected treatment from Doctor?

Listening to the sound of cough can help doctor, besides History and clinical examinations.

Doctor should try to find the cause of cough and treat that. If it is viral infection, it will have its own course and will settle down with time only (usually around 2 weeks in children). No need of any cough syrup (medicine), unless the cough is disturbing sleep or child is coughing continuously for few minutes at a stretch and his life is disturbed significantly.

If cough medications are to be used than it is better to avoid combination drugs.

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Home remedies:

  • Honey at bed time can have soothing effect and prevent cough.
  • Warm milk with Haldi
  • Warm saline gargles
  • Steam inhalation can be given in certain cases. But in small kids , need to be very careful that they do not get burn injury with hot water. Best way is to generate steam via hot water in closed room or bathroom. And sit with your child in that room and let the child breath normally.
  • Cool-mist humidifier in your child’s bedroom might help with sleep.
  • Keep child well hydrate
  • Avoid over the counter medications and give them only on prescription of a child specialist.

 

Feel free to contact MAYA CLINiC for any queries.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

 

Breath-holding spells

Breath-holding spells

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Your child cries, and stops breathing, and almost turns blue. It is one of the scariest situations for parents. The episode seems life threatening but in reality, it is relatively benign (not serious). And it does not pose any risk to the health of the child.

It’s a very challenging situation for the caregiver, and needs to be handled with patience rather than panic. One thing which parents need to understand is that breath-holding spells are an involuntary reflex. The episodes usually last less than a minute (though it may seem like ages to the anxious parent), and after that the child regains consciousness and starts breathing normally.

Usual age of occurrence is from 6 months to 6 years but they can occur at earlier age too. Few cases have been reported in newborns also, but in such small babies, other factors need to be ruled out. Family history may be positive in some cases.

Episodes typically start after excessive crying.  Children usually outgrow this disease by the time they start going to school.

Breath holding spells are of two types

  • Cyanotic:  Child turns blue in face
  • Pallid:       Child turns pale, almost white

In both the cases the child stops breathing and loses consciousness for few seconds. In very rare cases seizures might occur, but these are benign and do not cause any long term harm.

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What to do if your child stopped breathing during a spell

  • Stay calm
  • While your child is in the brief unconscious phase, just check she is safe and has fallen flat on the ground
  • Remove any sharp object in vicinity which can cause damage to child.
  • Once she is awake, try to appear normal and unaffected by the whole thing.

When to See your Child Doctor

  • After first episode
  • These episodes are not harmful but proper check up and investigations might be needed to rule out underlying medical condition.
  • Consult your child specialist to determine triggers of spell and to know how to prevent future spells and how to deal with it if it happens again.

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How to prevent Future Spells

  • Try to prevent the trigger
  • You should try not to give in to tantrums of children
  • No special attention after spells, otherwise in a way we might reinforce the behavior.
  • Iron supplementation might help in decreasing the incidence, more so if child is anemic.
  • Reassure yourself and find a way to discipline your child in a way that does not provoke another spell
  • As the child grows old he develops better coping skills
  • With experience, courage and guidance from your child specialist you should be able to provide a safe and structured environment to your child.
  • In some cases when episodes are very frequent, some medications (like Piracetam) might be needed. But in most cases it can be avoided.

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Condition that should be ruled out

  • Heart conditions with rhythm disturbances like Arrhythmia etc via ECG or ECHO.
  • Anemia (Get Hemoglobin done)
  • Seizure like episodes and Seizure Disorder.

 

Feel free to contact Maya Clinic for any queries or discuss with your pediatrician.

Regards

Dr Rahul Varma

 

Preterm babies; what to expect?

Preterm Baby

 

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Q: What does “preterm” mean?

A baby is born “preterm” if he or she is born before 37 weeks of pregnancy have been completed. Normally, a pregnancy lasts about 40 weeks.

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Q: Why do preterm babies need special care?

Preterm babies are not fully prepared to live in the world outside their mother’s womb. They get cold more easily and need more help to feed than full-term babies. Because their bodies are not yet fully developed, they may have problems breathing and can also suffer from other complications including infections.

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Q: How many babies are born preterm every year and where?

About 15 million babies are born preterm each year; that is more than one in ten babies worldwide. 60% are of them are born in sub-Saharan Africa and South Asia.

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Q: How many preterm babies could be saved?

Around 1 million preterm babies die each year, and countless others suffer some type of lifelong physical, neurological, or educational disability, often at great cost to families and society. An estimated three-quarters of these preterm babies could survive if they had access to proven and often inexpensive care.

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Q: What health challenges do preterm babies face?

The earlier in a pregnancy that babies are born, the less prepared their bodies are for the outside world. They need special care to overcome the following challenges:

Staying warm: Preterm babies lose body heat more easily, putting them at risk of life-threatening hypothermia. They need extra energy and care to stay warm and grow.

Feeding: Preterm babies can have trouble feeding because the coordinated suck and swallow reflex is not yet fully developed. They may need additional support for feeding.

Breathing: Many preterm babies start breathing on their own when they are born, but others need to be resuscitated. If the lungs are not fully developed and lack surfactant (a substance that helps keep the lungs expanded), preterm babies may have difficulty breathing. Sometimes, premature babies that start off breathing are not strong enough to continue on their own. They exhaust themselves and may stop breathing (apnoea).

Infections: Severe infections are more common among preterm babies. Their immune systems are not yet fully developed, and they have a higher risk of dying if they get an infection.

Brain: Preterm babies are at risk of bleeding in the brain, during birth and in the first few days after birth; about 1 in 5 babies weighing less than 2kg have this problem. Preterm babies can also have brain injuries from a lack of oxygen. Bleeding or lack of oxygen to the brain can result in result in cerebral palsy, developmental delays and learning difficulties.

Eyes: Preterm babies’ eyes are not ready for the outside world. They can be damaged by abnormal growth of blood vessels in the retina. The condition is usually more severe in very premature babies and if they are given too-high a level of oxygen. This can result in visual impairment or blindness.

Q: What are the consequences of preterm birth later in life?

Preterm babies are at risk of developing disabilities that will affect them for their entire lives. The extent to which this will affect their life strongly depends on how early they were born, the quality of care they received during and around birth and the days and weeks that follow.

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Q: What are the precautions to be taken at home after discharge of preterm baby from nursery?

  • You should keep in regular touch with your Pediatrician/Child Specialist.
  • Develpomental checkups regularly as advised
  • Schedule eye examinations for ROP
  • Baby will take extra time to develop skills

 

For any queries feel free to contact us at Maya Clinic.

 

Regards

Dr Rahul Varma

“ Healthy Kids, Happy Family “

 

Could my child have Diabetes ?

Diabetes in Children

     signs

Diabetes Mellitus (DM); name itself is  fearful and more so if in context to children. It is a metabolic disorder with high blood sugar level. Major Symptoms are increased urination, increased thirst and hunger. Insulin is the only way by which body can use sugar. If insulin decreases sugar rises.

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4 types: three most common types are type 1, type 2, and gestational diabetes. 4th is due rare genetic disorders

Most common in children is DM type 1 (Insulin dependent, IDDM or Juvenile diabetes).

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Type 1DM:

 

It is an autoimmune disorder in which body starts to destroy its own cell (beta cells of pancreas that makes insulin). Pancreas loses its ability to produce Insulin.

Type 1 is less common than type 2 DM.

2 main factors: genetics and the environment (certain viruses, toxins which can trigger autoimmune response).

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Type 2 DM:

 

More common in adults but nowadays seen in children too.

Pancreas still makes insulin but is not effective (Insulin resistance)

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It is hard to diagnose in adolescent; as some cases are asymptomatic.

Lifestyle changes (which are leading to unhealthy gain in weight) like

  • Decrease physical activities
  • More screen time
  • Fast food

It can be managed with Exercise and change in diet but in some cases medicine or Insulin injections are needed.

Gestational DM is diabetes that develops during pregnancy.

 

SYMTPOMS:

symptoms-of-diabetes

 

Chart is depicting few signs and symptoms of adults too.

Early

  • frequent peeing (urination) in large amounts (polyuria)
  • increase in thirst (polydipsia)
  • dry mouth or throat
  • weight loss
  • increase in appetite (polyphagia)
  • feeling tired or weak
  • diaper rash that doesn’t improve with medicated cream

s,s

Late

  • weight loss
  • stomach aches
  • nausea and vomiting
  • heavy, rapid breathing (Kussmaul breathing)
  • drowsiness

 

Diagnosis:

Random Blood sugar level > 200mg/dl

Urine test for ketones

It will need further evaluation under guidance of child specialist or Pediatric endocrinologist.

Complications:

comp

 

Life changes full circle at the time when diagnosis is confirmed. 

Coping with the diagnosis is also difficult to start with as parents are in denial /shock. It usually is followed by sadness/fear/anxiety. Some will have feeling of guilt and some will have anger.

diabetespic

Parents (and children as well):

  • Need to learn the skills needed to take care of child (injection insulin, measure blood sugar at home etc)
  • Face Emotional Disturbance
  • Life style changes (dietary changes, need to count calories.)

 

Project_outline_circle

Treatment

Aim:

  • Maintain the blood sugar level as close to normal as possible at all times to avoid complications.
  • Coping well with disease and trying to have a healthy and productive life.

 

Basic treatment of type 1 diabetes:

  • Insulin ( via injections or pump)
  • Balanced meal with help of dietician
  • Monitoring of blood sugar levels
  • Regular check up

Nursing Intervention Nursing Care Plan for Children with Diabetes Mellitus

 

Basic Treatment Type 2 diabetes:

What-causes-diabetes

  • Healthy Lifestyle
  • Increased physical activity
  • Balanced food
  • Weight loss
  • In some cases medications

 

Dietician: Proper Meal plan is needed to have a calorie count.

Guidelines_for_Treating_Type_2_Diabetes_in_Kids_

Growth and Development should not be affected and child should be able to live a healthy life.

prevention at school

School life should also be not affected.

For any queries refer to your child specialist or Pediatrics endocrinologist. Feel free to contact Maya Clinic .

Regards

Dr Rahul varma

“Healthy Kids, Happy Family”