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Meet the
Pediatrician - in a conversational mood - PERIODIC UPDATES :
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SOME CHILD REARING MYTHS - continued
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 breast fed babies WILL have frequent
stools
- Usually the stool will be ill formed and
quite liquid
- Usually it will follow a feed - you may note
a distinct pattern :
here goes in the feed and there comes out a stool. This is known
medically as Gastro ( stomach ) - Colic ( intestinal) Reflex. This
reflex exists in all individuals but is more pronounced in newborns.
The moment some substance ( liquid, gas or solid ) enters the
stomach , it causes the Intestines to work and produce a stool.
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 :
- Girls are destined by nature ( since they
have to acquire maturity/puberty earlier) to " do everything" some
2-3 months earlier than boys
- Milestones always have a few months' leeway
either side of time
and when we talk of the time a milestone should be achieved, we
always keep this margin.
- There are many factors that affect milestones
:
1. environmental stimulation and opportunity
2. genetic influences
3. the second born usually stands at an advantage since he is
continuously seeing, feeling,hearing and getting a chance to ape the
elder one.
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 :
- Around the navel ( umbilicus)
- Never severe enough to cause crying or
anguish
- Usually disappears with some form of
distraction
- Then the television is on and the favourite
cartoon is running -
dare there be any pain !
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. over clothing : 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 all the same 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
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