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text is designed for an International readership at Dr Ashutosh Jindal’s
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UPDATE # 6
:
SOME CHILD REARING MYTHS -
continued :
This Update shall touch upon some myths and misconceptions that lie in our
practice of bringing up our child.
I have drawn from this amazing variety and hence shall be brief to each
point.
#1
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.
#2 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.
#3
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
-
when 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).
#
4 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.
#
5 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.
#
6 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 !
#7
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.
#
8 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.
#9
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.
#10
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.
#
11 “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.
#
12 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.
#
13 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.
#14
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
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