Tag Archives: Pediatrician vasundhara Ghaziabad

Erb’s palsy ( common injury to baby during birth)

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Erbs palsy  ( brachial plexus injury)

One of the common type of birth injury which happens in newborn baby while delivery. (happens mostly in assisted deliveries like vaccum or forceps). In this injury there is damage to nerves supplying shoulder and arm; which in turn leads to decrease in movement of that shoulder. Nerves are 5th and 6th cranial nerve (part of brachial plexus nerves) , which are damaged while passing through a point called Erb’s point.

One way that the brachial plexus nerves are affected is when the baby is passing through the birth canal at an awkward angle, with the head being turned to one direction while the arm is being pulled in the opposite direction.

1-2 babies per 1000 newborn delivery worldwide are affected.

Various risk factors involved in this condition are

  1. Large size baby/ good weight of baby.
  2. Assisted delivery .eg use of forceps or vacuum
  3. Excessive pulling/ traction on shoulders during delivery
  4. Gestational diabetes mellitus
  5. Prolong labour

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Symptoms:

  • Not able to move upper limb well. Especially shoulder joint. Affected arm is hanging by side of body and may be bent at elbow.
  • If not able to move even fingers; (not able to grip , your fingers properly) then it suggests severe injury and involvement of lower plexus of nerves too.
  • Can have collar bone fracture along with it, which might be worsening the movement of that side.
  • It often looks like that baby has paralysis of the affected side

 

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Types of Nerve Injuries

There are four types of nerve injuries.

  1. Neurapraxia: nerve is stretched, not complete tear. (so recovers early within 3 months).
  2. Neuroma: more serious damage to nerves
  3. Rupture: nerve is torn; will need intervention(as it will not heal on its own)
  4. Avulsion: is complete tear and most serious of all. ( luckily it is very rare)

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Treatment:

  • Multidisciplinary approach will decide the plan of care for baby: will include pediatrician, need help from neurologist, orthopedic and neuro physiotherapist.
  • Intermittent immobilization and positioning to prevent contractures
  • Gentle massage (as advised by physio)
  • Surgery if severe damage to nerve or complete tear of nerve.
  • Electric stimulation may help

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Prognosis:

  • It depends on degree of damage: likely most of the cases are mild.
  • If the hand grasp/ grip is good and finger movement is present: it suggests good prognosis.
  • It may take few months to few years to recover.

Be in regular follow and adhere to advice of your doctor.

Regards

Dr Rahul varma

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

Why Doing Away With the Gadgets Is Important for Your Kid

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

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

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

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

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

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

Distorted sense of reality:

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

Co-ordination and dexterity:

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

Concept of space:

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

Social Skills:

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

Emotional skills:

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

Maths and Science:

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

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

Snoring in Children

 

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As uncommon and abnormal as it may seem, snoring in babies is not always a red flag for your baby’s health. Many babies produce noises like whiffing, snuffing and snoring while sleeping. If your baby snores rarely or occasionally, then it’s not a cause of concern. But if it has become a chronic habit of your little angel to snore, then consulting your Pediatrician is always advisable.

But before you start panicking, let’s understand the causes of snoring in babies.

Causes of Snoring in Babies

  • Cold and flu infections: This is the most common cause of snoring in babies. As your baby’s airways are very small and narrow when they are few months old, mucous secretions during a cold or flu infection easily block her nose and throat. As a result, your baby may snore while she is suffering from cold or throat infections.
  • Allergies: Your baby may be allergic to down filling in the mattress or pillows or allergic to pet hairs if you have a dog or cat. This may obstruct the airways of your baby while she sleeps and become the cause of snoring.
  • Enlarged tonsils or adenoids: Adenoids are lymph nodes at the junction of nose and throat which may enlarge due to various infections. Similarly, tonsils are lumpy lymph tissues located at the back of throat, which can also enlarge due to repetitive infections. Although the rate in newborn babies, with time these can contribute to obstruction in breathing which can in turn cause snoring.
  • Deviated Nasal Septum: Nasal septum is the bone that separates both the nostrils and in case of a deviated septum, this bone may be structurally misaligned obstructing one of the nostrils. This could be a cause of chronic snoring in your baby.
  • Laryngomalacia: In very young babies, the cartilage that keeps the nasal airways open may remain underdeveloped for some time after birth. As a result, your newborn may snore frequently until this cartilage develops properly.
  • Throat abnormalities: Cystic formations in the throat or abnormal palate movement can also cause snoring in babies.
  • Sleep Apnea: This is a condition wherein your baby experiences obstruction in breathing for several seconds, causing lack of oxygen and acute breathlessness. This may happen multiple times during sleep and can cause loud snoring in your baby.

How to correct snoring in your baby?

Once you have identified the cause of snoring in your baby, in consultation with her pediatrician, you can start with the corrective measures to alleviate your baby’s snoring.

You can take the following steps to correct snoring:

If your baby is suffering from cold, flu or allergies; use a humidifier in your baby’s room and put saline nasal drops in your baby’s nose to help her breathe better while sleeping.

Also remove any allergens or allergy-causing agents from your baby’s room to avoid any breathing obstructions.

Change your baby’s position or put a pillow under her head when she’s asleep to help keep her airways open.

If your baby is suffering from sleep apnea, enlarged adenoids and tonsils may be responsible. You can either reduce this enlargement with medicines or can even get them surgically removed once your baby is a little older.

Throat abnormalities and deviated nasal septum can only be corrected surgically and you should consult your Pediatrician/ ENT specialist for complete corrective action.

Thus, if your little one snores, the next time she dozes off, rest assured that it’s nothing to worry about. With proper care and as she grows, this problem can be easily resolved.

 

Regards

Dr Rahul Varma

15 Things which you should not say to “Stay at HOME MOMS”

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Moms who decide to stay at home are in no way inferior to moms who work. If they are staying at home, it does not mean that they are not smart enough to work outside. It’s a Choice which they have made voluntarily, so that they can spend quality time with their kids and family. (15 things you should never say to “working moms”) 

Parenting is a full time job. And many mothers opt to stay at home to take good care of their baby. Many a times thoughtless words from observers can hurt feelings of “stay at home moms”. Honestly speaking both set of moms face challenges and no one has an easy life. In this blog will focus on Home moms and next blog will focus on challenges faced by working mothers.

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Here I am listing few statements which are commonly made by friends and relative which should best be avoided when talking to Home moms.

  1. So you are just a MOM: Any person making such foolish statement must never have raised a baby. We all know it is a full time job (24X7X365 days).

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  1. Why did you wasted money on studies and got a degree if you were planning to sit at home: Purpose of getting a degree is not only to earn good money rather it is to become a good human being who can inculcate good habits in next generation. And any day if need arise, they can get back to work.
  2. You husband must be earning a lot, so that you can relax at home: Any family where mom decides to stay at home make a lot of sacrifices in order to spend quality time with kids. It does not mean they earn a lot, it means they spend wisely. And besides mom is working full time at home, not relaxing.

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  1. You are lucky you do not have to work: No mom who decides to stay at home is sitting idle. They are on their toes all the time. They are working constantly. They have to look after meals for baby, do laundry, arrange stuff, do grocery, fix appointment with doctor and the list is endless.
  1. I can never stay at home, I need a life: All the ladies need life. Everyone loves to spend time with people, look for intellectual discussion, adult talk. That is why their sacrifice is more evident; isn’t it.

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  1. Your home should be spotless if spend whole day at home. Home mothers have whole lot of things to do. Priority is always kids, their health and their intellectual development, sensory as well as motor development. Kids will always be making a mess of home. Drawing on wall, cloths here and there, sussu & potty, spitting out meals, laundry etc.
  1. As you are home mom and you have lot of time, could you help me with…..? Friendly neighbors might always be looking to take advantage of you in order to get their stuff done.
  1. You must be enjoying and spending lot of time with friends and on social networking. Those who think, staying at home means plenty of time for themselves are mistaken big time. Reality is that many a time it gets worse, as moms too need a break.

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  1. If you are tired, why do you not sleep when your baby takes a nap. When baby sleep, moms usually have a long list of “to do things”. Prepare a meal, do the laundry, fold the cloth, look after mother in law and other elders at home and the list is endless.
  1. What do you do with all the free time you have; I will get bored staying at home. Believe me, you won’t know where time flies. If you are really looking after your babies 24 hours a day will be less.
  1. My husband is not that rich, I cannot afford to stay at home. Nobody minds extra money to spend and it’s never enough. Moms who decide to stay at home plans to spend wisely and are willing to make sacrifices in life.
  1. So this is the reason your baby is so clingy and cannot live without you. Babies always like to stay with person whom so ever spends the most quality time with them. It could be caregiver in case of working moms (eg grandmother, or even maid).

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  1. When are planning to get real job in life. Home moms will always tell you that “This is the real life”. Turning a little kid into a grown up responsible and sensible adult is the real job (or toughest job). Inculcating good habits in kids, encouraging your child to do good for humanity and good for society is tough in present circumstances.
  1. Had I been home, my house would be neat and clean. Then why do you try it. It’s all about priority. Babies will write all over the wall, spill milk, do hell lot of stuff to turn house upside down.
  1. That explains why you look so mumsy? Home moms never groom up properly. It does not mean they cannot or they do not want to. It’s just they want to dress the way it is most comfortable for them and their babies. So that they can feed them properly, do household stuff.

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It’s a big sacrifice a mother is making for her kids and family. We should always RESPECT “Home moms” and appreciate them rather than criticizing or making sarcastic remarks.

Working 24X 7 X 365 days a year without any financial gain is a big task; not many have the capability or patience to do that.

I ask many moms than what is the reward for which you work? What is the driving force which keeps you going?

Answer is simple, loud and clear. “Smile of my little angels face” which makes them forgets everything and wipes away all the tears and gives them energy to go on and on”

 

 

Regards

Dr Rahul Varma

“Healthy moms, Healthy Kids”

 

 

Common Feeding Problems

Feeding problems occur for a number of reasons, many of which vary according to age. Most of these challenges can be met through proper breastfeeding instruction from your doctor. It may come as a surprise, then, if your baby develops a resistance to feeding weeks or even months after you thought this was no longer a problem.

Tastes Change

One thing to consider when this happens is whether the taste of your breast milk has changed. Breast milk taste can change for a number of reasons, including the following:

  • New or different food in your diet
  • Medication you are taking
  • Pregnancy in the mother, which sometimes causes nursing babies to wean themselves a few weeks or months after the mother conceives
  • Strenuous exercise, which can lead to a temporary buildup of lactic acid
  • Breast infection, such as mastitis
  • Change in the taste of your skin caused by using lotion, cream, or oil on your breasts

Avoiding the new food, changing or stopping your medication if possible, exercising less strenuously, or refraining from applying oil or lotion to your breasts may be all that is necessary to encourage your baby to breastfeed at his normal rate again. If you have mastitis, seek treatment from your doctor right away and encourage your baby to breastfeed in order to drain your breasts. Once the infection has been treated and has passed, the taste of your breast milk will return to normal. You may be able to help your baby adjust to the new taste of your breast milk during pregnancy if you are persistent and patient and hold off on offering formula as an alternative.

If your baby starts to engage in frenzied short feedings that seem to signal frantic hunger, it may simply mean that your let-down reflex is occurring more slowly than she would like. If this is the case, try massaging your breast and expressing a little milk before you begin a feeding. This way, your milk will flow faster from the very beginning of the feeding and your baby will feel more satisfied.

Stress

If you do not believe that the taste of your breast milk has been altered or that your let-down reflex is causing the problem, consider whether you are experiencing a high level of tension or stress. Such emotional discomfort can be communicated to your baby, preventing her from settling down to feed well. Of course, we cannot always eradicate stress from our lives, but for the moments preceding breastfeeding, do your best to put upsetting thoughts out of your mind. Relaxed sessions not only will help your baby get more milk but may decrease your own stress level. Breastfeeding your baby and holding her skin to skin often promote a sense of well-being. Meanwhile, consider ways in which you might improve the general tenor of your day-to-day life.

Illness

It is also possible that your baby’s own condition may be making it harder for her to breastfeed. Decreased interest in feeding—possibly accompanied by lethargy, fever, vomiting or diarrhea, cough, or difficulty breathing—may indicate an illness. Consult your pediatrician or family physician if your baby resists feeding or you have any concerns that your infant may be sick.

Illness in your infant may affect your baby’s feeding pattern and desire to nurse, thus decreasing the amount of breast milk she receives. If she has a cold, clogged nostrils may make it difficult for her to breathe while feeding, or an ear infection may make nursing painful. Clearing the infant’s nasal passages with a bulb syringe prior to feeding may help with temporary nasal congestion. Teething can cause gum pain when nursing. Thrush can make nursing painful and requires a pediatrician’s attention.

Spitting Up

Some babies take in a great deal of milk but then spit up what appears to be a large part of it after each feeding. Spitting up is common during or after feeding, and some babies spit up more easily than others. There is generally no need to be concerned, however, that your baby’s spitting up is preventing her from getting enough milk.

Spitting up (as well as hiccups) can be minimized by keeping your breastfeeding sessions as calm, quiet, and leisurely as possible. Avoid interruptions, sudden noises, bright lights, and other distractions. Try to hold your baby more upright during and right after feedings, and attempt to burp her after she finishes each breast. Don’t jostle or play vigorously with her immediately after she has breastfed.

If she vomits forcefully a number of times or if you notice blood or a dark green color when she vomits, call your pediatrician right away.

Occasional small spit-ups or wet burps are generally more a laundry problem than a medical one. Fortunately, spit-up breast milk is less likely to smell sour or cause clothing to stain than infant formula. If you are worried that she is spitting up too much, consult your pediatrician, who will monitor her weight and check for any signs of more serious illness.

Dehydration

As always, the best way to be sure your baby is getting enough milk is to monitor her physical condition, her weight gain, and the content of her diapers. It is very important to call your pediatrician if you notice that your child is not showing usual interest in feeding, she has a dry mouth or eyes, or she is producing fewer wet diapers than usual. These may be signs of dehydration. Severe dehydration, while uncommon in adequately breastfed infants, can be extremely dangerous or even life-threatening and is most likely to occur when a young baby refuses to feed or is experiencing frequent vomiting or diarrhea.

 

regards

Dr Rahul

stay healthy

constipation in children

Constipation is an extremely common childhood condition. One I deal with almost on a daily
basis in clinic and one that can be surprisingly hard to get control of..

Parents are often at a loss on what to do about something that is causing their child significant
discomfort, but also something they feel should be relatively easy to treat.

The trick is to always be one step ahead of constipation when it comes to your child.

Here are some surprising truths about constipation:

  • It can really hurt and be a source of significant, recurrent abdominal pain. After a
    thorough history and physcial exam (sometimes even an x-ray, depending on the
    situation), parents are shocked to find out, that, yes excess and blocked stool is the culprit
    for the tears and complaints of pain.
  • A child can be constipated in spite of reported daily bowel movements. Often, parents
    will discount constipation as a cause of their child’s stomach pains because the child will
    report having a somewhat “normal” bowel movement. However, if the stools are small,
    hard, and difficult to pass; this could be a sign that your child is not completely emptying
    his bowels. Having abnormally large and infrequent stools is another sign of constipation.
    In both instances, stools are typically hard to pass and the child may start withholding
    which will only worsen the condition.
  • On the flipside, your child may only have bowel movements every 2-3 days and not be
    constipated. The defining features are not necessarily based on frequency but more on
    symptoms such as abdominal pain, hard and difficult to pass stools, blood streaked stools,
    or a fear of going to the bathroom due to the anticipated pain.

When children are most prone to it:

  • Transitioning to solid foods and whole milk.
  • Potty training
  • School entry

Stay one step ahead with these tips:

  • Make your child’s daily meals full of fiber rich foods. Think whole fruits, whole grains,
    fiber cereals, and green/leafy vegetables.
  • Water, water, and more water. Keep a refillable water bottle on hand and encourage your
    child to drink frequently.
  • Moderate milk intake. Too much of a good thing can be bad for your child’s digestion.
    Instead of filling up on fiber rich foods, she is filling up on this. After the age of 1 year, 500 ml per day is more than enough.
  • Make a smoothie: if you have a picky eater…have her drink her fiber. Add whole fruits,
    some skim milk, yogurt, and a splash of juice.
  • Try a daily “P” juice (prune or pear) for breakfast to get things back on track.
  • A daily fiber supplement can help fill in the fiber gap.
  • Exercise. Get your kids outside (or inside) and moving for a good hour per day.

Laxatives

Sometimes, your child just needs a laxative to get back on track. Discuss this possibility with
your child’s pediatrician. Once the cycle of constipation has set in, dietary changes alone may
not turn it around. Be sure to adhere to the plan outlined with your pediatrician and continue with
the constipation fighting foods above.

Discuss with your doctor and follow instruction carefully.. Incomplete treatment can lead to poor growth.

Regards

Dr Rahul Varma

 

What newer Vaccines are there for my child ?

Good day parents

As a parent u all must be aware of vaccines which u all must be giving to your child. There are various newer vaccines which keep coming in market after research and development. there are some painless vaccines too. It is your right to get information  regarding various new vaccines available for your child for better growth and prevention of infections.

traditionally following vaccines were given by govt of India in Delhi NCR:  BCG, polio drops , DwPT/DTwP (which causes pain and fever , usually lasting for 24 to 48 hours ),Hepatits B,  measles, MMR, typhoid.

Latest Immunization schedule as per Indian academy of pediatrics have added few more vaccines which are gentle DTaP along with Hib and IPV( Injectable polio vaccine) , Rotavirus, Pneumococcal, Hepatitis A, chicken pox . and in high risk children Flu, Meningococcal.

DTP:

One important thing which I wanted to emphasis that whether U give traditional DTP or gentle DTaP both has equal efficacy in Indian circumstance, only difference being in the side effects. So the huge amount of difference in cost is to prevent side effect only( these sypmtoms of fever and pain can be managed easily by giving crocin/ paracetamol). So its for u to decide which one to go for as medically both are equally potent. It all depends on your abilities to handle a baby who is cranky .

IPV:

injectable polio vaccine is the best option for complete protection of your baby in present circumstances. In countries where polio has been eradicated IPV is the only option available.

Rotavirus:

This vaccine helps in preventing against diarrhea / loose motion. But giving this vaccine does not mean that your baby will not have diarrhea ever in life. This vaccine only prevent against Rota Virus, which is a virus which causes serious diarrhea usually needing admission in hospital and IV fluids. .And this being a viral illness is difficult to prevent.

Hepatitis A:

Jaundice is very commonly seen in India through out calender year with peak in rainy season. This vaccine prevents against jaundice, as no matter how cautious you are, once in a while we all dine out and drink water from unreliable sources which can cause jaundice. So this vaccine is strongly recommended.

Chicken Pox:

regarding this disease you all know that it can cause rashes on face with permanent scaring. when this disease occurs in adult age group , it is much more severe, so this vaccine is also recommended by IAP.

Pneumococcal vaccine:

This organism causes , serious infections, which include ASOM (ear infection), Pneumonia, Meningitis (brain infection). And once child gets infection due to this pneumococcal , it invariably needs IV antibiotic ( ranging from 7 to 14 days). Some people promote this vaccine as vaccine against Pneumonia, but again it does not means that if U give this vaccine your child will never have Pneumonia (as there are many organism which can cause Pneumonia). The main problem with this vaccine is huge cost, if cost is not an issue then this vaccine must be given , atleast before your child starts going to play school.

 

Haemophilus influenzae type B:

This vaccine is being given along with DTP universally these days, now even govt of India has introduced this vaccine in pilot project in Delhi, so it is being given along with DTP and Hepatits B. A must vaccine for your child.

Flu:

Its a seasonal vaccine which needs to be given every year in high risk group. Flu keeps changing its structure every few year. eg you must have heard of Bird flu many years back, later swine flu few years back (latest vaccine covers against swine flu ) but few  year down the line some new virus will come.

Meningococcal :

Latest vaccine against this disease is Menactra, which is highly efficacious vaccine but the most expensive vaccine in children till date with MRP of 4500Rs. But this disease has very high mortality (can cause death within 24 hours), 2nd only to Rabies. Although incidence of this disease is low, but considering its high mortality , it can be given if cost is not an issue. Delhi had lots of cases in out break few years back.

you can send in your queries regarding any vaccine to me  and I will try to give you unbaised opinion about it.

Stay Healthy and prevent Diseases

Dr. Rahul

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

what to give in addition to breast milk after 6 months ?

 

Biggest queries of all mothers who has child aged more then 6 months is what food items to start with and in what quantity.

Important Principles for Weaning:

  • weaning should begin at 6 month of age
  • Introduce one food at a time
  • Energy density should exceed that of breast milk
  • Bland taste, nothing very spicy.
  • Food items should be mashed and free flowing, paste like, so that baby can swallow it easily.
  • Common food which can be started as per Indian settings are Banana, glucose biscuits dissolved in milk, soojie kheer, dalia , Khicihdi, upma etc
  • If cost is not an issue then formula milk is better than cows milk especially in less then 1 year of age as solute load is less and less chances of long term kidney problem in adulthood.
  • If opting for cows milk or mother diary milk, give undiluted full cream or toned milk only.
  • Many of us think that child might not be able to digest full cream or single toned milk ,so adds a bit of water, which is very wrong practice. eg if you have added water in 1:1 dilution of 500 ml milk  i.e. 250 ml water in 250 ml milk. You  will think that you have given 500 ml of milk to baby but actually you have given only 250 ml of milk. Rest 250 ml of water is only going to fill the stomach and will not give any calories, which will eventually  lead to poor weight gain.
  • Basically any food item that is free flowing , soft, cooked so as it is very soft (overcooked rather then under cooked), easy to swallow and calorie dense can be given under supervision with katori spoon.

Avoid bottle feeding, there is enough evidence to prove that babies who are bottle feed has increased incidence of loose motions, cough , cold, serious infection as compared to children who were katori spoon feed.

So if still choose to bottle feed your baby (which seems easier option then katori spoon), be mentally prepared that your hospital visits to your pediatrician will increase along with emergency visits to hospital.

 

Stay Healthy

Regards

Dr Rahul Varma