Update #8

Meet the Pediatrician - in a conversational mood - PERIODIC UPDATES :
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All the registered parents have received these updates already.In case you
want a specific Update again -please e mail the request.In case you wish to
delist from these updates,you may e mail accordingly.

This Update shall touch upon some myths and misconceptions that lie in our
practice of bringing up our child.

You may not make out any specific pattern in the issues addressed.The reason
is that I have punched in the matter as it has come to my mind.In a day of
our Clinic practice there is a delectable variety of parental concerns,
parental misconceptions and confusions in the minds of the care givers of
the child.

I have drawn from this amazing variety and hence shall be brief to each
point.

DIARRHEA IN NEWBORNS : a messy affair - further messed up with lack
of knowledge !

It is common for newborns ( and also extended upto , say some 2-3 months of
age ) to have episodes of "diarrhea".They tend to get unduly disturbing for
mothers.

A few basic facts shall allay your anxiety :

All these put together tend to make the mother feel that the baby is "unable
to digest the milk, the milk is "too heavy" , maybe a change of milk is
needed ..and so on.

Please rise above these anxieties since now you are empowered with knowledge
of natural phenomena of the small baby.Let nature take its own course.

MILESTONE COMPARISON : MY NEIGHBOURS CHILD WALKED AT 1 YEAR - MINE
IS OLDER - DOES NOT WALK : the neighbours grass is always greener !

There are some basic facts underlying milestones :

Given all this , please put your comparisons aside.

Of course , seek your Pediatrician's advise if you sense there is something
that is disturbing enough.

As a rough rule of thumb, may I outline some milestones that SHOULD appear
at approximately the time indicated - in case your baby is lagging
appreciably ,please do see your Pediatrician.

1. fixing eyes 2 months
2. neck holding 3.5 - 4 months
3. sitting without support 7 months
4. babbling ( meaningless self made speech) 6-7 months
5. standing with support 1 year
6. walking a few steps 1.5 years

The list is virtually limitless - these shall suffice for early detection of
some deep seated problem.

RECURRENT PAIN IN THE ABDOMEN : a vexing issue for you and your
Pediatrician too !

It is fairly common for young children to complain of pain in the tummy.
This pain would commonly have the following features :

Any pain that fulfils these criteria will more often than not be purely
psychological. Your duty is to report to your Pediatrician , his duty shall
be to examine the child thoroughly and then he shall decide to go for some
tests ( only if he feels it suspicious enough to merit tests ) - the outcome
of the whole exercise shall be ZERO ! He shall then write down some
digestive syrup or whatever , reassure the child ( and the mother ) and
PRESTO......pain gone.

I have given a very simplistic and tongue in cheek account and you may
please excuse me for it.

A very basic dictum in medical science is ( especially applicable to
children ) : THE FARTHER THE PAIN IS FROM THE NAVEL , THE MORE THE CHANCES
OF ITS BEING SIGNIFICANT ( I.E. WORTH INVESTIGATING).

LEG ACHES - GROWING PAINS : usually an attention seeking device !

It is common for younger children ( say somewhere 5-6 years upwards) to
complain of ache/pain in the legs.The pain would usually be in the calves.There would
be no limitation of joint movement.

These are known as Growing Pains.The medical background is that the rapid
growth of limbs causes a stretch on the ligaments that attach the leg
muscles to the bones.This causes aches and pains.

With this background, you may well understand that there is nothing amiss
and this is a phase the child shall have to go through.

Some Pediatricians may advise some Calcium preparation - usually to satisfy
your urge for " some medicine".

You may be able to support by leg massage and how much attention you may
like to give will depend how you have chosen to bring up your child.

MEDICATED SOAPS : useless - may be harmful too.

It is rather common for parents to choose medicated soaps ( like dettol
soap ) in the enthusiasm to "prevent infection".

These are unnecessary and may actually cause skin problems.The disinfectant
may sensitize ( make the skin allergic ) and cause rashes.Avoid them
please.Any gentle soap is good enough.

SLEEPS IN THE DAY - AWAKE AT NIGHT : misery for the already burdened
parents !

In the first moth or so the young one usually has an inverted sleep
cycle.When you yourself badly need sleep, he is playful and / or
troublesome and needs attention.When you are available to give him time , he
can not use it since he is asleep.

This is a carry forward of the sleep pattern in the womb and there is little
anyone can do about it.

During pregnancy while the mother is up and about, he is rocked in the pool
of amniotic fluid - a lovely water bed for him.Who would not love to
snooze.At night, when the mother is resting, this rocking is switched off
and he switches on.Give him some weeks of adjustment time in the real world!

RETRACTED / FLAT NIPPLES - HOW DO I FEED : The syringe method as a
solution :

It gets extremely difficult to breast feed the baby if the nipples are
buried in or are "small".

You may try the following and we I trust you shall gain from it.

Take a 10 ml disposable syringe.Cut the syringe with a knife about a
centimeter above the nozzle part.Insert the plunger from the cut end.Keep
the smooth end on the nipple and pull the plunger so as to raise the nipple
into the syringe.Do this some 6-8 times and repeat this exercise as many
times in a day as you can find the time for.

In case you feel the need , you may extend the procedure such that you raise
the nipple by this method and then introduce it to your baby mouth.

Believe me , it works wonders.

PASSES URINE UNLIMITED - ALWAYS WET : no problem - no solution :

There is practically no upper limit to which the tiny one shall pass
urine.The capacity of the urinary bladder is limited and the holding power
is limited too.Hence the frequent urination.

CRIES BEFORE URINATION : no problem - no solution again !

Insight into the medical background shall help you.

In and adult, whenever the urinary bladder gets partly filled there is an
urge to pass urine and the brain reads it as an urge.If for some reason one
is not able to void , finally sets in the stage of pain.Contrasted with
this, even a partly filled Bladder is perceived by the immature brain the
young one as 'pain' and he cries.

No need for any urine test , no need to worry about obstruction to the
urinary passage - he shall grow out of it by some months.

STREAKS OF BLOOD IN EYES ON A NEWBORN : looks scary - no issue for
concern.

The sudden pressure change that comes by when the baby is delivered down the
birth passage may cause small streak/s of blood in the white part of the
eyeball.

This will dissolve on its own and does not merit any worry.

"FEVER" IN THE NEWBORN : common,worrisome - attack basics first.

The quote - unquote at Fever is with a reason.

There could be one or more of the following factors leading you to believe
he has fever: these are known as Spurious Pyrexia - check them out first :

1. overclothing : one of the commonest causes.Remedy is obvious.Reduce
the clothing and watch the result.

2. environmental heat : again a common cause.Keep your room temperature
comfortable.Measure after some time - maybe he won't have any fever then.

3. faulty thermometer / faulty reading method : this is commoner than
one tends to believe.Try out the thermometer on a few other members of the
family who appear " normal". If the thermometer is okay - please revert to
the site healthybaccha.com for correct method of recording temperature.

Given that none of these is doing the mischief - NOW IT IS TIME TO ACT :

You need to consult your Pediatrician if the baby has fever WITH :

dullness

poor feeding

excessive, unexplained cry

shivering like movements of limbs

rolling of eyeballs

pus at the navel

sticky discharge from eyes

or else , anything that looks "off the usual
" to you.

WHEN IN A FLIGHT - KEEP HIS MOUTH MOVING : for the baby with wings !

This is an important tip for your baby while he takes an aeroplane
flight.During ascent and descent, the cabin pressure changes tend to cause a
temporary vacuum in the middle ear cavity and that may suck in infection
from the throat.This can be terribly painful for the baby.

To avoid this, make sure his mouth is moving ( chewing or
sucking ) - this avoids the pressure effect. You may breast feed him ( if it
is possible ) , bottle feed him or allow a baby soother ( though we do not
recommend baby soothers otherwise ).For older children , chewing gum may be
allowed.

As an extension to this thought , it shall help you to understand
the cause of your baby if he happens to go into a fit of cry and
irritability. Use some standard pain relieving ear drops and then see your
Pediatrician soon enough.

STICKY EYES / PERSISTENT EYE DISCHARGE IN SMALL BABIES :

This is a fairly frequent occurrence.Either one or both eyes may continue to
have a discharge. The discharge may be watery or may be sticky.Eye drops may
have been put for a reasonable length of time and still the problem would
persist.

Medically it is known as Epiphora.It may clear your apprehension once you
know the scientific background to it.Both eyes have tiny holes which drain
away ( into the throat) the tears that are being formed continuously to keep
the eyes moist.In some babies one or both of these may be blocked.This would
naturally pool the eyes in tears and they would collect as a discharge.

Your Pediatrician would already have explained it to you as a blocked Naso
Lacrimal Duct and would have explained a massage for the eyes.Please follow
his advise and give the condition its own time to get okay.It is a simple
massage in which you roll your thumb and index finger at the point where the
eyes and nose meet and then slip down your thumb and index finger down the
crease of the nose.

Keep doing it - leave the rest to nature.

See an Eye Surgeon if it does not get okay by say 3-4 months - he may
consider Probing the holes and opening them up.Trust your Pediatrician in
that this is seldom required.

HEADACHES - WHICH ONES TO IGNORE - WHICH NOT TO : a vexing question
even for your Pediatrician !

Any child can have a headache once in a while just you or I can - let him
enjoy this privilege.

However, there is a rider attached to this laid back approach to it. Let
these be some rough guidelines to help you.It may be best to consult your
Pediatrician allthesame and the sooner the better.

The following headaches are NOT to be ignored :

· frequent and in the mornings

· with vomiting

· with associated abdominal pain

· with a family history of migraine

· with blackouts ( fainting )

· with vision related problems

Your Pediatrician would usually ask you to see an Ophthalmologist ( Eye
Doctor ) since weak vision is by far the commonest cause of headaches.He may
also ask you to see an ENT Doctor - sinusitis or ear problems are also usual
causes.

Allow me to give you a scary alert although we all know it is extremely
rare. Brain Tumors are the commonest of cancers in children after Blood
Cancers.Why I mention this is that your Pediatrician, confusing as the
headaches are, may ask you for a CT or MRI of the Brain.Please do not get
alarmed , please do not ignore / postpone his advice - just get it done as
any other routine laboratory test. The mental peace to him and to you ( yes
, in that order) shall be a reward unto itself.

There shall be more coming from us soon - till then good luck and happy
parenting.

Dr Jindal and team Healthybaccha.com