Paediatric Disorders

The tale of the eight limbed girl

2007-12-20T22:46:00.000-08:00

Do you have this???

2007-11-08T07:56:00.000-08:00

Q Our 3-year-old son keeps coming into our bed at night. What can we do to stop this without making a big deal of it?

Health Visitor Dawn replies: As soon as your son arrives in your bed, gently take him straight back to his room and his own bed with as little talking as possible. If he needs a cuddle, calming down or reassuring then it's important that you give him this, but wait until you are back in his room before doing so. Let him know that it's time for him to go to sleep now and that his room is a nice place to be.

Do you have this problem???

2007-11-08T07:52:00.000-08:00

My 1-year-old daughter’s favourite new word is ‘no’. Every time I offer her something—even something I’m sure she really wants—she shakes her head and responds negatively. She also refuses to hold my hand. I’m finding this quite annoying and I fear we’re going to be constantly at loggerheads.

Therapist Lesley replies: Your daughter's becoming a toddler and saying no often is actually a normal and essential part of her development-even if it doesn't make life easy for you. For the first time, she's able to test limits, exert some power and have her own opinions, which is vital in helping her become her own person. It may seem strange when she rejects treats you know she'd really love, or a helping hand from you, but to her, saying ‘yes' can feel as if she's handing her power over to you. Try to respect her resistance rather than get into battles. A bit of tact will help you steer through most tricky situations, so try giving her choices rather than yes or no options. For example, ask ‘Do you want an apple or a banana?' rather than ‘Here's a banana', or say, ‘Walk or piggy back to bed?' rather than ‘Go to bed'.

Breast Feeding

2007-11-03T13:53:00.000-07:00

Breast-feeding

Nourishing your baby can be a daunting task for the first few weeks. Here's a guide to print out and keep at hand during feedings.

How to Breast-feed Your Baby

Breast-feeding may be natural, but that doesn't mean it always comes naturally. It often takes practice, so be patient and persistent -- it's worth the effort. In the first few days, your baby may not be too hungry, but she'll become more interested as her need for nourishment increases.

If you or your baby finds nursing difficult, seek advice from your healthcare provider or a lactation consultant.

Things to Know:

Nurse your newborn as soon as possible after birth, preferably within the first hour, and every time she shows signs of hunger thereafter. Watch for increased alertness, mouthing, nuzzling against the breast, or rooting (a reflex in which your baby opens her mouth and turns her head toward something that touches her cheek).

If you follow her cues, you'll probably be breast-feeding every two to three hours around the clock for the first four to six weeks. But do allow your baby to breast-feed more frequently if she wishes.

In the early weeks, if four hours have elapsed since the last feeding, you should rouse your infant by gently moving her arms and legs. If she doesn't awaken enough to nurse after a few minutes, stop and try again in half an hour.

Getting Started:

Settle into a comfortable position: sitting up or lying down, with baby angled across your breasts or alongside you. The baby's entire body should be facing you, not just her head. Use pillows as needed to support your arms, your back, and/or the baby. (Make sure no part of the pillow might impede baby's breathing.)

Ignore distractions and concentrate on the softness of your baby's face against your breasts. If your baby doesn't immediately suckle, you can usually trigger the rooting reflex by gently stroking her cheek with your finger or your nipple.

Help your baby to latch on to your breast correctly. Her mouth should encircle the entire nipple area (called the aureole), not just the nipple itself. Some babies take a while to learn how to do this, but it's essential, because incorrect latching-on quickly leads to sore nipples. Help her by placing your nipple in the center of her mouth, with as much of the as possible aureole within her lips. Press your breast down away from her nose, if necessary, to allow her plenty of breathing space.

Adjust your position and hers as necessary while she's feeding. The more relaxed you feel, the better the feeding will go.

Allow your baby about five minutes on each breast when you first begin. Over the course of the next few days build to ten to fifteen minutes per breast. This depends on your baby's appetite -- and each baby's needs are different. Don't force the issue -- you'll know if you're baby is getting enough nourishment by your pediatrician's weigh-ins and the number of wet diapers (about 5 to 8 per day during the first few days, 6 to 8 per day thereafter).

To break suction so you can switch breasts, simply slide your finger between her mouth and the nipple.

Unless your nipples are sore, it's okay to let her enjoy slowly sucking for as long as she likes.

After she's finished with each breast, burp her by patting gently on her back as you hold her against your shoulder or in some other comfortable position (some babies prefer a sitting up position on your lap). Put baby atop a clean cloth as you do this -- occasionally milk comes up with the burp. Be aware that she won't always burp audibly, but it's important to try to help her get rid of any gas.

NURSING BASICS
BREAST MILK AND SUPPLY
BREAST FEEDING AND PAIN

Breast Feeding and Pain

2007-11-03T13:51:00.000-07:00

Pain

Check your latch. I knew I had the latch down when there was no white tip or line across the nipple and it didn't hurt after a few seconds to nurse. The initial pain went away after a few weeks.

Frozen peas aren't just food. A bag of frozen peas [is] awesome as a cold compress for engorgement.

Cabbage combats soreness. Use cabbage leaves for soreness -- they are cooling and feel great! Just place individual cabbage leaves inside your bra (break them apart, wash, separate with paper towels, place in a big plastic bag, and keep them cold in the fridge.)

No biting allowed. The advice I got was to watch while the baby is latched on. If you watch, you can see when the latch is dropped and a bite is coming, so you can pull out before it happens. If you do get bitten, I've been saying "No bite!" and then not letting him back on for a minute so he associates that with not nursing.

Breast Milk and Supply

2007-11-03T13:47:00.000-07:00

Breast Milk and Supply

Breast Milk

Give it a swirl. Milk that has been stored in the refrigerator tends to separate and that is normal. So before you give it to your baby, give it a swirl. You'll see that it will come back together.

Don't worry about the consistency. If your milk is watery, you're extracting the foremilk. If it is thicker and whiter, it is the hind milk. You may also find that after your baby drinks your breast milk, the bottle has a residue. Don't worry -- it's the fat of the hind milk left in there.

Milk Supply

Moist heat encourages let down. I was stressed and worried I wouldn't let down. The worst thing for me was hearing everyone tell me to just relax. What helped was moist heat. I put a wet towel in the microwave for a short time. A shower worked as well.

Reading may help you relax. I found that reading or doing a crossword puzzle while pumping would really help. I guess it took my mind off getting enough milk, or pumping for a certain time. It sort of distracted me. Find something you like to do and if possible do it while pumping.
Pump while you nurse to boost output. One way to quickly pump is to pump the boob baby's not nursing on while she nurses on the other. That way, your let-down happens faster. I always had trouble alone, but got a great stash by nursing and pumping together.

Nursing Basics

2007-11-02T12:42:00.000-07:00

Nursing Basics

Got breastfeeding issues? Get advice from the experts -- moms who got it right. Paid pros, like lactation consultants, are great, but sometimes mom-to-mom tips ("this worked for me") are the ones that really click.

Avoid comparisons. I think the biggest mistake nursing mamas make (I did this too) is compare themselves to what other nursing mamas are doing. Each nursing relationship is unique. I expected my nursing experience to be like my sister's and we are worlds apart: she had too much milk, I had too little.

Trust yourself. Before you quit, give yourself time (6 to 8 weeks) to adjust to breastfeeding.

Keep well hydrated. Get a water bottle with a straw (my hospital gave me one), and keep it filled to the brim. You never know when you'll get thirsty, and it might not be a convenient time [like while you're nursing] to get more water.

Get a Boppy. I love my Boppy. I still use it for my 9-month-old. To me, it just makes it easier to have one hand free while you nurse.

Your pump can help with problems. If you have inverted nipples, I found that pumping a few minutes to draw them out helped.

Keep at it even if you have a cold. Your breast milk will [help] keep your child from catching your cold. I learned this from my midwife and after trying it during the winter months when I got sick. And even when my baby did get a cold, I found it was very short lasting.

If you need to, supplement. You can do both -- breast feed and formula feed. It doesn't have to be only breast milk, but every drop your child gets is beneficial.

Don't worry if your baby looks tiny. My doctor told me babies don't start looking chubby until they're into their 8th pound. It took us 6 weeks to get there.

Practice nursing in public. I feel uncomfortable about nursing in public, so my plan is to buy a nursing camisole to cover my tummy and practice in front of a mirror so that I know what people can and can't see. As for other people giving me unpleasant looks, I don't plan on looking up! I will just look lovingly at my daughter.

Diaper Check

The scoop on poop. My pediatrician said after one month, breastfed babies may go up to 10 days without a poop and that is normal. However, in the first month you should see dirty diapers more often. Obviously, they don't magically hit one month and start going longer stretches, but those are the general guidelines. My daughter is 3 months old and usually goes every day, but occasionally goes 36 hours and then has a massive blowout!

Seedy is good. If her poopy diaper [looks like it has] seeds in it, that's leftover hind milk that her body doesn't need. Be happy. Your baby is well fed.

Don't worry if the poop comes in different colors. When I called the pediatrician about my son's stool having different colors, I was told that anything in the yellow, brown, or green hues is not a problem.

How wet is wet? To tell if my daughter's diaper was wet enough, I used to pour 4 tablespoons of water into a clean diaper. That's how I was told I could tell what a wet diaper felt like.

Baby Bottle Toxic or Not?

2007-10-20T10:09:00.000-07:00

Your baby's bottles may not be as safe as they seem. According to a new report from the National Institute of Environmental Health Sciences, certain types of plastic bottles contain a potentially dangerous chemical called bisphenol A (BPA), which has been linked to a number of health conditions in animals, including early onset of puberty, increased diabetes risk, hyperactivity, and certain cancers. Freaked out a little? So were we. Because it can be downright scary and confusing to digest these health risks (especially amid conflicting statements from the plastics industry), we tapped expert researchers to understand the real deal. Here, answers to your major concerns:

Q. Why the sudden bad rap for bottles?

A. Here's what we know for sure: BPA is a hormone-disrupting chemical found in hard, clear plastic baby bottles; over time, it can seep into the containers and into your baby's milk. Here's what we don't know: "We haven't yet found definitive long-term health consequences in people," says Rebecca Roberts, PhD, an associate professor of biology at Ursinus College in Collegeville, Pennsylvania, who studies BPA. Yet there are enough tangible risks -- especially for young babies and children, because they're still developing -- to be concerned. "I'm a mom too, and I believe it's important to balance your lifestyle with what the science says," Roberts says. "I can't say that my kid lives a completely BPA-free life, but I can minimize her contact."

Q. How can I tell if the bottles we use contain BPA?

A. Flip them over, says Roberts. Often, polycarbonate plastics -- the ones that contain BPA -- are marked by the recycling symbols #7 or PC. But the absence of these marks is not a guarantee of safety -- if the bottle is hard and clear, check with the manufacturer to be sure.

Q. What can I do to reduce my baby's exposure?

A. Consider BPA-free alternatives, like glass or softer, cloudy-looking plastic bottles (check out our finds below). "And if you are using bottles made with BPA, try not to microwave them or put them in the dishwasher," says Roberts, since heat can break down the plastic and trigger the chemicals to leach more readily. Also, toss bottles when they start to look scratched -- another sign of plastic degrading. According to one recent report, BPA may leach after as few as 50 to100 washings.

Q. Are there any other sources of BPA that could affect my baby?

A. There is some evidence that BPA is found in the lining of metal cans, including ready-to-feed formula. "To lessen the risk, it's best to opt for powdered formula, which is usually not sold in metal cans," says Sonya Lunder, MPH, an analyst at the Environmental Working Group. In a paper separate from the NIEHS study, the Washington, D.C.-based nonprofit found detected some BPA in liquid formula packaged in steel cans from companies including Enfamil and Similac. (Even though powdered formula containers may look like they're metal, most are actually made from a very stiff paperboard material). But if you're not sure whether your container is safe, then hold a magnet up to it, says Lunder. "If it sticks, then the can is metal and you should try to avoid it."

Q. I'm pregnant. Should I be worried?

A. BPA isn't just a baby bottles issue, says Phillip Landrigan, MD, a Parents advisory board member and a professor of pediatrics and community and preventive medicine at Mount Sinai School of Medicine in New York. "The chemical can cross the placenta, so if you're exposed during pregnancy, there's a chance it can impact your developing fetus." The best ways to protect your health while you're expecting: Avoid heating and dishwashing food containers made from polycarbonate (flip the storage container and look for the recycling symbols #1, #2, or #5 instead -- all safer forms of plastic) and Nalgene water bottles. "Luckily, BPA is not everywhere," says Roberts. "And there are plastic alternatives that are totally fine for moms and babies to use."

Help for making sure baby gets better.

2007-10-19T00:16:00.000-07:00

Help for making sure baby gets better.

When you're giving medication to your baby, make sure to follow all of your doctor's directions as well as these additional safety tips:

Take the whole course of an antibiotic as prescribed, even if your child seems cured after a few days.
Don't reuse a prescription left over from a previous illness, even if you suspect it's another bout of the same sickness.
Measure medicine carefully -- even the difference of a mere milliliter can overdose a baby -- and use an appropriate dosing device rather than a kitchen spoon.
Don't call medicine "candy."
Don't forcibly squirt medicine down the back of your child's throat. A portion can get into the lungs, causing her to gag.
Call your doctor if the medicine doesn't seem to be working, your child's condition worsens, or you notice unexpected side effects.

Understanding Birth Defects

2007-10-06T16:16:00.000-07:00

Understanding Birth Defects

The vast majority of babies born in this country are healthy. But if your child is one of the 3 in 100 infants born with a congenital (acquired after conception) or hereditary birth defect, how can you ensure her long-term health?

While some defects are treatable with drugs or surgery, it's usually your family's efforts to create a positive environment for your child that help minimize the disability.

First Steps

The first thing you should do if your child is diagnosed with a birth defect is get a second (or more) opinion. Start with your pediatrician or obstetrician, who can refer you to appropriate specialists. In addition to appointments with specialists, you should also keep up with regularly scheduled well-baby visits, because many birth defect complications can be treated through early detection and intervention.
Here are some of the most common birth defects in the U.S. and the impact they may have on your baby and you.

9 BIRTH DEFECTS AND TREATMENTS

FRAGILE X SYNDROME
SPINA BIFIDA
DOWN SYNDROME
BABY CLEFT LIP
PKUPHENYLKETONURIA
CLUBFOOT
SICKLE CELL DISEASE
INFANT CONGENITAL HEART DEFECTS
UNDEVELOPED LIMBS

Fragile X Syndrome

2007-10-06T16:10:00.000-07:00

A Chromosomal Birth Defect

Prevalence:

Fragile X syndrome primarily affects males (1 in 1,500). Although 1 in 1,000 females is a carrier, only one in three shows outward signs of having the defect, including intellectual impairment. The range of retardation varies from mild to severe.

Symptoms:

The physical characteristics of Fragile X syndrome may include large ears, an elongated face, poor muscle tone, flat feet, large testicles, overcrowded teeth, cleft palate, heart problems, and autistic-like tendencies. Affected children may also suffer seizures.
However, many children with Fragile X syndrome appear to be physically normal at birth, so a diagnosis may not be made until the ages of 18 months and 2 years. At that time, a lack of language development coupled with other developmental delays usually prompts testing.

Treatment:

As with Down syndrome, children with Fragile X syndrome can be expected to do most things that any young child can do, although they also generally learn these things later than unaffected children. And, as with most of these birth defects, early-intervention programs begun in infancy can help maximize the child's development.

Down Syndrome

2007-10-06T16:06:00.000-07:00

Chromosomal Birth Defects

Two of the most common abnormalities, Down syndrome and Fragile X syndrome, are also frequent causes of mental retardation. Both can be diagnosed before birth. While neither defect is curable, early intervention allows a child to develop to his full potential.

Down Syndrome

Prevalence:

Though Down syndrome occurs in 1 in 800 births overall, the incidence is much higher in older mothers.

Symptoms:

A child with Down syndrome generally has characteristic physical features, including slanted eyes; small ears that fold over at the top; a small mouth, which makes the tongue appear larger; a small nose with a flattened nasal bridge; a short neck; and small hands with short fingers.
More than 50 percent of children with this defect have visual or hearing impairments. Ear infections, heart defects, and intestinal malformations are also common among children with this defect.

Though children with Down syndrome have some degree of mental retardation, most can be expected to do many of the same things that any young child can do -- including walking, talking, and being toilet trained -- although generally they learn how to do so later than unaffected children.

PKU(phenylketonuria)

2007-10-06T15:48:00.000-07:00

A Biochemical Birth Defect

Prevalence:

PKU (phenylketonuria) is an inherited metabolic disorder that occurs in 1 in 15,000 births (less commonly among African-Americans and people of Jewish descent).

Detection:

All babies in the U.S. are tested for the disease soon after birth.

Symptoms:

A child with PKU is missing a crucial enzyme that breaks down a protein called phenylalanine that is found in many goods. If PKU is left untreated, this protein can rise to high concentrations in the body and cause mental retardation.

Treatment:

Children born with PKU can live a normal life if put on a strict diet. Usually started before the fourth week of life, this diet is low in foods that contain phenylalanine, including breast milk and cow's milk. Instead, an affected child must be fed a special formula.
As the baby gets older, however, she can eat certain vegetables, fruits, and grain products but usually must avoid cheese, meat, fish, and eggs. Regular blood tests of phenylalanine levels can help determine what an affected child can and can't eat.

Sickle-Cell Disease

2007-10-05T17:55:00.000-07:00

Biochemical Birth Defects

Sometimes certain substances essential to a baby's proper body functioning are either abnormal or completely absent. Without intervention, deficiencies like the following can be devastating (and often even fatal) because they affect many bodily systems.
Sickle-Cell Disease

Prevalence:

Sickle-cell disease occurs in around 1 in 625 births, mostly affecting African-Americans and Hispanics of Caribbean ancestry.
Detection: Because of its prevalence, 30 states require that newborns be given the blood test that detects the disorder.

Symptoms:

The disease can cause debilitating bouts of pain and damage to vital organs and can sometimes be fatal. Sickle-cell disease affects the hemoglobin (a protein inside the red blood cells) in such a way that the cells become distorted: Instead of their normal, round shape, they look like bananas or sickles (hence the name).

These misformed cells then become trapped in and destroyed by the liver and spleen, resulting in anemia. In severe cases, an affected child may be pale, have shortness of breath, and tire easily. The episodes of pain, called crises, happen when the cells become stuck, blocking tiny blood vessels and cutting off the oxygen supply to various parts of the child's body.

Another complication of sickle-cell disease, noticeable mostly in infants and young children, is vulnerability to severe bacterial infections. Two weapons against this risk are immunization (the usual vaccines, as well as pneumonia and flu shots) and daily preventative penicillin treatments.

Treatment:

Although the disease can't be cured, a number of new therapies that reduce the severity and frequency of crises are being studied. Acupressure is very effective

baby Missing or Undeveloped Limbs

2007-10-05T17:51:00.000-07:00

An Anatomical Abnormality

Causes:

Unfortunately, the cause of this birth defect is largely unknown. Some experts believe that maternal exposure during pregnancy to a chemical or virus that only mildly affects the mother might be possible causes.

Treatment:

When a child is born with a limb anomaly, the doctor refers the parents to an orthopedic specialist and a physical therapist. The child is then fitted with a prosthesis (artificial body part) as soon as possible so that he becomes comfortable with it early on.
He will also undergo intensive physical therapy so that he learns to use the prosthesis much as other children learn to control their body parts.

Spina Bifida

2007-10-05T17:48:00.000-07:00

An Anatomical Abnormality

Prevalence:

Spina bifida occurs in about 1 in 2,000 births, most frequently among Caucasians of European extraction.

Causes:

It's caused by a malformation of a neural tube (the embryonic structure that develops into the brain and spine) that prevents the backbone from closing completely during fetal development. Some cases of neural-tube defects can be detected through tests given to the mother during pregnancy. When one is suspected, the baby usually is delivered by cesarean section so specialists can be on hand during and after the birth.

Symptoms:

Spina bifida ranges in severity from practically harmless to causing leg paralysis and bladder- and bowel-control problems.

Treatment:

In the most severe cases, the baby is operated on within 48 hours of birth (or in-utero through a new technique that is not yet widely available). Parents then learn how to exercise the baby's legs and feet to prepare her for walking with leg braces and crutches. Some children will eventually need to use a wheelchair. The child will also work with specialists in orthopedics and urology.

Baby Cleft Lip or Palate

2007-10-05T17:44:00.000-07:00

An Anatomical Abnormality

Prevalence:

Cleft lip or palate appears in about 1 in 700 Caucasian babies, more often among Asians and certain groups of Native Americans, and less frequently among African-Americans.
Causes: The exact cause is hard to determine, but it's likely that genetic and environmental factors interact to prevent either the hard palate (the roof of the mouth), the soft palate (the tissue at the back of the mouth), or the upper lip, all of which normally are split early in fetal development, from closing.

Symptoms:

The cleft can be mild (a notch on the upper lip) or severe (involving the lip, the floor of the nostril, and the dental arch). A child with a cleft palate usually needs a speech pathologist. Language development can be affected not only by the structure of the lip and palate but also by the side effects of middle-ear infections, which are common in babies and toddlers with this defect (probably because their ears don't drain properly).

Babies with a cleft palate may also need help with feeding. (Those with a cleft lip generally don't have problems in this area.) Because they have trouble sucking, they must be fed in a sitting position with a special bottle. Depending on the severity of the condition, mothers who breastfeed may have to express milk and bottlefeed baby until the cleft is repaired.

Treatment:

Surgical repair for a cleft lip should be done by about 3 months of age. Surgery to repair a cleft palate, which restores the partition between the nose and the mouth, is usually done later -- between 6 and 12 months of age -- to allow for some normal growth of the child's face.
Though follow-up treatment is sometimes necessary, repair of a cleft lip or palate almost always leaves the child with only minimal scarring and a face that looks like that of most other children.

Clubfoot

2007-10-05T17:41:00.000-07:00

An Anatomical Abnormality

Prevalence: Clubfoot occurs in approximately 1 in 400 newborns -- affecting boys about twice as often as girls -- and includes several kinds of ankle and foot deformities. The exact cause of clubfoot isn't clear, but it's probably a combination of heredity and environmental factors that affect fetal growth.

Symptoms:

Clubfoot can be mild or severe and can affect one or both feet. Mild clubfoot is not painful and won't bother the baby until he begins to stand or talk.

Treatment:

For a mild case, treatment starts immediately after diagnosis and involves gently forcing the foot into the correct position and helping the child do special exercises.

Often, however, the baby needs more drastic treatment, such as plaster casts, bandaging with splints followed by time in special shoes, or surgery followed by exercises. The process may take three to six months, which checkups for several years after.

Infant Congenital Heart Defects

2007-10-05T17:39:00.000-07:00

An Anatomical Abnormality

Prevalence: Congenital heart defects occur in about 1 in 110 births and have a variety of causes, including genetic abnormalities or a mistake during fetal development. Some may be so mild that they have no visible symptoms.

Detection: In such cases the doctor usually discovers the problem when she detects an abnormal heart sound -- called a murmur -- during a routine examination. Some murmurs are meaningless; further tests are usually required to determine whether your baby's is due to a heart defect.

Serious heart defects are outwardly detectable and, if left untreated, can cause congestive heart failure, in which the heart becomes incapable of pumping enough blood to the lungs or other parts of the body.

Symptoms:

Rapid heartbeat
Breathing difficulties
Feeding problems (which result in inadequate weight gain)
Swelling in the legs, abdomen, or about the eyes
Pale grey or bluish skin

Treatment: Most heart defects can be corrected or at least improved through surgery, drugs, or a mechanical aid like a pacemaker.

Infant Anemia

2007-10-05T17:28:00.000-07:00

The most common cause of anemia in babies is iron deficiency. This usually can be corrected pretty easily with supplemental iron. Supplements are quite safe at that age, at the appropriate dose, which is about 3mg of iron per kg of body weight. The iron drops are usually given for about a month and then the blood test is repeated.

If the anemia isn't much better, it's time to consider reasons other than iron deficiency for his anemia. He may just have a normal hgb at that level, for instance, and not need any treatment at all.
If the anemia has improved, kids usually stay on the iron for another two months or so. He should also have a careful physical, if he did not have one recently, to be certain that his development is proceeding on course.

Iron in the diet is great, but forcing kids to eat, pushing them, or even coaxing them with fun airplane noises usually does not improve eating. Offer foods, but if he is happy, growing well, and making plenty of wet diapers, it's okay not to take much in the way of solids. Kids get most of their nutrition at that age from what they drink, not what they eat. The solids are mostly for the experience.

Baby Sleep Problems and Solutions 1

2007-10-04T14:27:00.000-07:00

The Rocker

Sleep Scenario #1

My baby is 5 months old. I've always rocked her to sleep, but I'd like to be able to lay her down and have her fall asleep on her own. How can I make this happen without a lot of trauma and tears for either of us?

In order for a baby to transition from falling asleep while rocking in your arms to falling asleep on her own, she has to master two smaller skills -- the ability to fall asleep someplace other than in your arms, and the ability to fall asleep without being rocked, explains Ann Douglas, author of Sleep Solutions for Your Baby, Toddler, and Preschooler (Wiley).

If you aren't comfortable with making your baby learn to put herself to sleep "cold turkey," you can try substituting what Harvey Karp, MD, author of The Happiest Baby on the Block (Bantam) and an American Baby advisor, calls a new sleep association. From being inside your body, babies are born accustomed to drifting off to sleep amid noise, tactile stimulation, and rocking. Gradually replace rocking with white noise (you can play a CD), Dr. Karp recommends. If you play the sounds while you're rocking the baby to sleep for four or five consecutive nights, she will begin to create a new association with sleep, and her transition from falling asleep in your arms to falling asleep in the crib will be easier, Dr. Karp says. "The idea is to create other sleep associations that don't require your presence to help the baby fall asleep," he adds.

Be prepared for your baby to put up a big fuss the first few times you lay her down awake. Some sleep-training techniques instruct parents not to pick up a crying baby but to come into the room at set intervals (every five minutes, for example) and talk to her in a reassuring voice.

But that approach doesn't work for all babies or parents. Christine George, of Lansing, Michigan, tried that method with her 6-month-old, Kayleigh, but the crying didn't stop, even after 10 or 15 minutes. Instead, Kayleigh became more and more upset until she was screaming, red faced, and gagging. "After two nights of becoming almost as upset as my baby was," George says, "I decided that technique just wasn't going to work for me."

What did work? "We'd walk around the room with her for a few minutes until she was drowsy, and when we laid her in the crib, we'd gently bounce the mattress with one hand while pressing her belly with the other hand and saying 'Shhhh' for a minute or two until she fell asleep," George says. "After a while, we were able to do it without the hand on the belly, and then without the bounce, and finally we were able to lay her down awake and she'd fall asleep." The process took two weeks.

Remember that there's no one-size-fits-all approach, advises Claire Lerner, LCSW, an American Baby advisor and the director of parenting resources at Zero to Three, the National Center for Infants, Toddlers, and Families. "With some babies, you can pat them or just sit there so they can see you, but for a lot of babies that's just confusing," she says. But even if you choose to walk away from her bed, the crying isn't likely to last more than a few nights. "The more consistent you are, the quicker she'll learn," Lerner says.

Chickenpox for Baby

2007-09-26T13:54:00.000-07:00

What Is Chickenpox?

Chickenpox is one of the most common childhood illnesses. Before the vaccine was approved in March, 1995, there were 4 million cases of it appearing in the United States every year. In fact, 95 percent of adults in America today had chickenpox before the age of 18. It occurs most often in the late winter/early spring and in children between the ages of 6 and 10.

Chickenpox is caused by Varicella zoster virus and is highly contagious. About 90 percent of people who never had chickenpox (or the vaccine) will catch it if a family member has it. A person with chickenpox is contagious from one to two days before the rash starts until about five days after the rash appears. It can be spread by direct contact (through lesions or sores) or through the air. Children with chickenpox have to stay home from childcare or school until they are no longer contagious.

A child who catches chickenpox may not show symptoms for 10 to 21 days after being exposed to the virus. At that point, the characteristic symptom usually appears -- an itchy rash, which usually develops first on a child's scalp and body, and then spreads to his face, arms, and legs over the next three to four days. In total, a child with chickenpox will have 250 to 500 itchy blisters that dry up into scabs two to four days later.

While the rash is the most well-known symptom of chickenpox, it's not the only one. Here are some other symptoms that often accompany chickenpox:

A mild fever for one or two days before the rash appears

General malaise
Coughing
Fussiness
Lack of appetite

Once someone has had chickenpox, the virus stays in her body permanently. This is usually a form of immunity -- she will probably never suffer from chickenpox again. But in about 10 to 20 percent of the population, the virus will reappear later in life (usually over the age of 50) and cause shingles. Shingles typically causes numbness and itching or severe pain in various areas of the skin. Within three to four days, clusters of blister-like sores develop and last for two to three weeks.

Hearing Loss Babies

2007-09-24T15:11:00.000-07:00

Hearing loss is surprisingly common in babies -- but a shocking number of children aren't diagnosed or treated until much too late.

The Most Common Birth Defect

Beth Trama, of Smithtown, New York, was watching her son, Luca, sleep peacefully in the hospital nursery, when the newborn next to him let out a loud, high-pitched scream. Luca didn't wake up. Trama couldn't believe that the noise didn't startle him, but she assumed he'd just gotten used to being with all those crying babies -- until he failed his hearing screening the next day.

You're probably surprised to find out that hearing loss is the most common birth defect. Every day, about 33 babies are born in the U.S. with a hearing impairment. But the news hasn't gotten through to parents -- in fact, only 1 percent of new and expectant moms ranked hearing loss as their top concern about their child's health, according to a survey by the Alexander Graham Bell Association for the Deaf and Hard of Hearing, in Washington, D.C.

A Recessive Gene

Many parents figure their baby isn't at risk if they don't have a history of deafness in their family. However, about 90 percent of deaf children are born to hearing parents. Deafness can be caused by a dominant gene -- meaning one or both parents are deaf -- or by a recessive gene, so a child can inherit the trait even if no family members are hearing-impaired. That's what happened to Luca. After his diagnosis, doctors discovered that both of his parents had a recessive gene for a genetic disorder that damages the hair cells in the inner ear so they can't carry sound to the auditory nerve. As a result, Luca is severely deaf in both ears.
Hearing loss can also be caused by many nonhereditary factors, including infections, prematurity, severe jaundice, or a lack of oxygen during delivery, says Ellen M. Friedman, MD, chief of pediatric otolaryngology at Texas Children's Hospital, in Houston. Unfortunately, most of these causes aren't preventable.

2007-09-21T20:39:00.000-07:00

PAEDIATRIC DISORDERS

Children are the gift of god to parents. They need care, affection and sympathy. It is the duty of parents to take care of every problem of their child. When the children are diseased, it is a difficult situation for the parents. The paediatric branch of medical science deals in child health. Though the diseases are the same, the treatment, management and dosage differ. There are several diseases which occur in childhood only. So we go to paediatricians for the treatment of our children because up to the age of twelve, it is the paediatrician who looks after the ailments of our child. Hence the little of this site Paediatric Disorders.

This site will give you all the information about the paediatric disorders which makes the parents suffer, and good remedies for treating those paediatric disorders.children are the gift of god and its our obligation to protect them from the paediatric disorders.

PERMATURITY

BABY MASSAGE

BABY BATHING

BABY CRY AND SLEEP

BABY GROWTH

BABY DIET

INFANT HEIGHT

BABY WEIGHT

INFANT DENTAL DEVELOPMENT

INFANT DENTAL COMPLICATIONS

INFANT WEEPING

INFANT NASAL BLOCKAGE

PREVENTION OF ACCIDENTS AND FIRST AID

SIDS Q&A

2007-09-20T20:38:00.000-07:00

SIDS Q&A

The memory of losing her infant son, Colton, is still unbearable to Kristen Marr nearly seven years later. "He was 2 months old and in perfect health when I put him down on his back for a nap," she recalls. But when she tiptoed into the nursery of her home in Crofton, Maryland, to check on him, Colton had stopped breathing. Marr dialed 911 and tried to perform CPR on her infant. But it was too late. Doctors later concluded that Colton was a victim of sudden infant death syndrome (SIDS). While its incidence has dropped by half since the launch of the Back to Sleep campaign in 1994, SIDS is still linked to about 2,500 baby deaths every year. And even taking the right precautions (as Marr did) doesn't guarantee that your child will be protected. But here's some reassuring news: Recent research is revealing more ways than ever to reduce your child's risk. Are you doing everything you can to fend off SIDS? Here are answers to your top questions.

Q: What causes infants to stop breathing while they sleep?

A: Experts believe SIDS victims have an immature arousal center in the brain. Put simply, they can't wake themselves up when they're having trouble breathing. Infants who sleep on their stomach are particularly vulnerable to SIDS. One theory is that this position increases the likelihood that they will re-inhale oxygen-depleted air. "The peak danger is between 2 and 4 months," says Marian Willinger, Ph.D., special assistant for SIDS at the National Institute of Child Health and Human Development, in Bethesda, Maryland. However, you should continue to safeguard your child until he turns 1.

Q: Who's most at risk?

A: Three out of five SIDS victims are boys. African-American and Native American infants are two to three times more prone to the syndrome. Other groups at increased risk include preemies, low-birthweight babies, and infants who are exposed to cigarette smoke.

Q: Is putting my baby down on her back really that important?

A: It's vital. Back-sleeping increases a baby's access to fresh air and makes her less likely to get overheated (another factor linked to SIDS). But not all new mothers are getting the message: Eighteen percent of Parents readers say they usually put their infants to sleep on their stomach, and another 13 percent do so some of the time. "Some exhausted new parents may do it out of desperation, because infants tend to sleep better and more deeply on their stomach," says Parents advisor Jodi Mindell, Ph.D., author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep. "But having your baby sleep on her tummy is a no-no."

Q: I put my child to sleep on his back at night, but can I let this rule slide for a short nap?

A: It's not worth the risk. Babies who normally sleep on their back are 18 times more likely to die of SIDS when placed down on their tummy for a snooze. "Infants seem to have difficulty adjusting to the change," says Rachel Moon, M.D., a SIDS researcher at the Children's National Medical Center, in Washington, D.C.

Q: Is side-sleeping safe?

A: No. Studies show that putting a baby down on her side rather than on her back doubles the SIDS risk. "It's easier for an infant to roll onto her tummy from her side than from her back," says John Kattwinkel, M.D., chair of the American Academy of Pediatrics (AAP) Task Force on SIDS. "And she may not yet have the skills to roll back in the other direction."

Q: My baby has a flat spot on his head from sleeping on his back. Will it go away?

A: That depends. Flattened-head syndrome, or positional plagiocephaly, occurs when the back of an infant's pliable skull is reshaped from constantly lying in the same position. By some estimates, the incidence has jumped sixfold during the past decade. Yet back-sleeping isn't entirely to blame. "This condition is preventable," says John Persing, M.D., a craniofacial specialist at Yale-New Haven Hospital, in Connecticut. "Most babies with this problem spend way too much time on their back when they're awake." To correct (or prevent) a flat spot, give your baby several supervised "tummy time" sessions every day. You can also position your baby's head when you put him down to sleep -- one night to the left, the next night to the right -- to help balance the shape of his head. And don't let your child spend too much time in car seats, bouncy seats, or infant swings. If the flattening doesn't show significant improvement by the time he's 6 months old, consult a pediatric craniofacial specialist.

Q: I'm worried about my baby getting cold. Is it safe to cover her with a blanket?

A: Wait until her first birthday. Blankets, pillows, comforters, and stuffed toys can hinder your child's breathing; even soft or improperly fitting mattresses can be dangerous. If you're worried that your little one may get chilly, swaddle her in a receiving blanket or use a sleep sack. According to a Belgian study, swaddling helps fussy infants sleep better on their back and may protect them from SIDS by causing them to startle more easily. But make sure you don't overheat your baby. "A nursery that's too warm substantially increases an infant's SIDS risk," says Warren Guntheroth, M.D., professor of pediatrics at the University of Washington, in Seattle. Set the thermostat at 68 degrees, don't put the crib near a radiator, and dress your child in light layers that you can remove easily if she gets hot.

Q: Is it dangerous to give my baby a pacifier?

A: Not at all. Binkies actually reduce the risk of SIDS, possibly by preventing babies from falling into an extremely deep sleep. The AAP now recommends that you consider giving your child a pacifier at night and for naps during his first year. Note: If you're breastfeeding, don't introduce a Binky until your infant is 1 month old and nursing well.

Q: My baby has started to flip onto her stomach during the night. How can I stop this?

A: You can't -- but don't worry. "Once a baby can roll over by herself, her brain is mature enough to alert her to breathing dangers," says Dr. Moon. "And by the time she's 6 months old, her improved motor skills will help her to rescue herself, so the SIDS risk is greatly reduced."

Q: My baby sleeps better in my bed. What's the big danger of co sleeping?

A: Actually, there are lots of them. Your infant could be suffocated by a pillow or a loose blanket. His air supply may be cut off if you or your spouse inadvertently rolls over onto him. And he could be strangled if his head gets trapped between the headboard and mattress.
Despite numerous studies that confirm the heightened SIDS risk caused by co sleeping, many moms continue to do it. According to a parents.com poll, 52 percent of readers do it all or some of the time, citing the added convenience for nighttime feedings and the security of having their infants next to them.

If you decide to co sleep, don't put your baby right in the bed. Instead, get a co sleeping crib that clamps onto the frame of your bed. Or you might simply try moving your baby's crib into your room. Several studies show this sleeping arrangement reduces the SIDS risk (presumably because you're more likely to hear your baby if he's in distress).

When Your Baby Puts Everything in His Mouth

2007-09-19T20:40:00.000-07:00

Why baby puts things in his mouth -- and how to keep them out!

Babies putting things in their mouths, otherwise known as mouthing, is not only normal, but also signals a growing interest in the world around them. In the first year, children explore their surroundings through their senses -- seeing, touching, hearing, smelling, and tasting. The more they explore, the more they learn.

While your baby is learning to master his hand movements -- reaching, grabbing, and swatting -- he's not yet so adept at using his fingers. So when a baby grasps what he desires and wants to investigate further ("Is it soft or hard? Can I eat it? Does it make a sound?"), this often means putting it in his mouth. Mouthing helps babies learn all about different shapes and textures. They also learn what feels good and tastes good, and what doesn't -- so your child will only mouth a wool blanket once.

Could he choke?

Although mouthing is a positive experience for your child, you want to ensure his safety. To reduce the risk of choking, pediatricians recommend that children be allowed to play only with objects that are too big to fit all the way into their mouth. One easy way to check this is to make sure a toy or object can't fit through the opening of a toilet-paper tube. If it does, your child can choke on it, and the item is not safe. Also, be sure that an object is smooth enough not to scratch your child and doesn't have pieces that can break off. Take a few moments to do an inspection of your home at your child's eye level to identify any unsafe objects he may be tempted to put in his mouth.

What about all the germs?

Rest assured that when your baby picks up and licks the ball that rolled across the floor, there is little chance it will make him sick (though we wouldn't recommend doing that). Kids get sick from viruses and bacteria, not dust. So make sure he is not sharing toys with a child who is sick and can pass on germs. (Washing hands and toys frequently is also key.) That said, group play is very hands-on at this age. Children tend to bump into one another, touch one another's faces, and give kisses. So while it's smart to be cautious, parents simply can't protect their children from everything -- germs included.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Fever and Babies

2007-09-14T13:36:00.000-07:00

It's hard to keep your cool when your kid is burning up. We asked doctors what you should (and shouldn't) do the next time it happens.

Before You... Panic

Remember: A fever is not an illness. It's usually just a sign that your child's immune system is fighting off a bacterial or viral infection, says Michael Devon, MD, a pediatrician in private practice near Philadelphia. Most of the bugs that cause a fever -- such as a cold, the flu, a stomach virus -- aren't dangerous and are treatable at home.
Check your child's other symptoms. How she acts and feels is usually a better indicator of how sick she is. (In fact, if your child has a high fever that doesn't mean she's sicker than if she has a low-grade one.) "If your child is lethargic, irritable, has a sore throat, ear or stomach pain, or pain when she urinates, call your doctor," says Dr. Devon. (Can't find any obvious source of infection? That also warrants a call.) And always get help immediately if you have a feverish baby under 3 months old, no matter what her symptoms are. Infants that young are more susceptible to certain types of infections, so your pediatrician needs to rule out serious illnesses right away.

Before You... Take Your Child's Temp

Ditch your glass thermometer. Those old-school thermometers contain mercury, a potent toxin that affects the brain, spinal cord, liver, and kidneys, and can cause learning disabilities. If it breaks, you risk exposing your family to mercury's harmful vapors. Still have one lurking in your medicine cabinet? Don't just toss it into the trash. Take it to your pediatrician (she can dispose of it safely), or drop it off at your local hazardous-waste collection site.

Pick the right method. For babies, you'll get the most precise reading using a digital rectal thermometer; you can switch to an oral one when your child turns 3. An ear thermometer, although it's fast and convenient, can actually be deceptively tricky to use: You have to place it correctly in the ear canal for an accurate result. (Too much earwax can throw off the reading as well.) Underarm and pacifier varieties are also less reliable than the gold-standard rectal and oral thermometers.

Perfect your technique. To take a rectal temp, first dab petroleum jelly on the bulb of the thermometer. Place your baby belly-down on your lap or on a bed or changing table, then gently insert the bulb 1/2 to 1 inch into your child's rectum. Loosely hold the thermometer in place with two fingers until it beeps. To get an accurate reading using an oral thermometer, wait at least 15 minutes after your child has had anything hot or cold to eat or drink before you take his temperature.

Before You... Give Fever-Reducing Meds

Realize that they're not cures. The main reason to give your child acetaminophen or ibuprofen is to make her more comfortable -- not to "break" the fever. Fever is actually a good thing, since it helps the body fight infection. Most illness-causing germs thrive at a person's core body temperature (98.6 F.), so when the immune system detects an infection, it responds by cranking up the body's thermostat to help kill the germs. Just don't expect an immediate recovery. "At most, the meds will bring a fever down a degree or two -- just enough to make your child feel better," says Ari Brown, MD, a Parents advisor and author of Baby 411.
Choose the right fever-reliever. Give acetaminophen to babies under 6 months; ibuprofen isn't approved for kids that young because its safety hasn't been established. For older kids, ibuprofen seems to bring fever down faster, according to a research review in the Archives of Pediatrics & Adolescent Medicine. But since acetaminophen is less likely to cause stomach upset, it may be a better bet for kids with a sensitive tummy.

Once you've chosen a medication, stick with it. Though a recent Archives study found that alternating doses of acetaminophen and ibuprofen is more effective than using just one, some experts warn that mixing meds can be confusing and increase the risk that you'll overmedicate your child.

Read all medication labels carefully. If you're giving your child over-the-counter cold medicine, make sure that it doesn't contain acetaminophen or ibuprofen if she's already taking medication for fever. Otherwise, you could end up giving your child a double dose, says Dr. Devon. And you should never "eyeball" the dose; follow the instructions on the bottle. "Choose the amount that matches your child's current weight, and use the dropper that came in the package," says Dr. Brown. Because fever medications are sold in different strengths, the dropper for one bottle might not be right for another.

What If My Child Has a Seizure?

About 4 percent of children under age 5 have fever-induced seizures (febrile seizures), which are often caused by a sudden spike in body temperature. They seem scary -- your child may lose consciousness, shake, or stiffen -- but they're usually harmless. Most febrile seizures end in a minute or two, though some last just a few seconds or for more than 10 minutes.
If your feverish child starts convulsing, place her on a soft surface and roll her onto her side so she won't choke. Never put anything in her mouth or try to hold her down. When the seizure ends, call your pediatrician -- if this is the first time it's happened, she needs to be evaluated right away. "Once your child has been diagnosed with febrile seizures, you can relax a bit if it happens again -- as long as you know why she has a fever," says Dr. Brown.

What's Hot, What's Not

Your child officially has a fever when the thermometer reads 100.4 F. and above, according to the American Academy of Pediatrics. When it warrants a call to your doctor, however, varies by age:
Age
When to Call
Under 2 months
100.4° F
3 to 6 months
101° F
Over 6 months
103° F

Baby Healthy meal Plan

2007-09-13T15:28:00.000-07:00

Make a healthy meal plan for your child.

These are general feeding recommendations meant to assist parents in planning healthy meals.

Birth to 4 months:

5-10 feedings of breast milk or 16-32 oz. of infant formula

4 to 6 months:

4-7 feedings of breast milk or 26-40 oz. of infant formula

Infant cereal (rice, oatmeal, or barley) and infant juice can be introduced.

6 to 8 months:

3-4 feedings of breast milk or 24-32 oz. of infant formula

Strained mashed food, including cooked vegetables (avoid corn and peas), such as carrots and green beans, and fresh or cooked fruit

Infant juices in a cup

8 to 10 months:

3-4 feedings of breast milk or 16-24 oz. of infant formula

Cereal and bread-type foods (2-3 servings daily): infant cereal, Cream of Wheat, oatmeal, toast, bagels, crackers

100 percent juice (4 oz. daily): orange, tomato, pineapple, or infant juices

Cooked or mashed vegetables (1-2 servings daily)

Ripe fruit (fresh or cooked) (1-2 servings daily)

Meat, chicken, fish, egg yolk, plain yogurt, beans, cottage cheese (1-2 tbsp. daily)

10 to 12 months:

3-4 feedings of breast milk or 16-24 oz. of infant formula

Cereal, breads, all varieties of unsweetened cereal, rice, noodles, crackers, spaghetti (2-4 servings daily)

Vitamin C-rich juice (4 oz. daily): orange, grapefruit, pineapple

Cooked or raw vegetables (1-2 servings daily)

Fresh or cooked fruit (1-2 servings daily): ripe peaches, pears, and oranges are good choices

Protein-rich food (1-2 tbsp. twice a day): lamb, beef, pork, fish, poultry, eggs, cheese, yogurt, beans, tofu, peanut butter

12 to 24 months:

Cow's milk and cow's milk products can replace some or all of the formula or breast milk feedings after 1 year of age

2-3 feedings of breast milk or 16-24 oz. of formula or 2-4 servings of milk or other calcium-rich food: yogurt, cottage cheese, tofu, green leafy vegetables.

Cereal, bread, rice, pasta, noodles (4 or more servings about 1/3 of an adult-size portion)

Vitamin C-rich juice (4 oz. daily)

Vegetables, raw or cooked (2 or more servings)

Fruit (2 or more servings) -- offer at least one citrus fruit daily

Meat, fish, or poultry, eggs, nut butters; beans; tofu (2 servings daily, each portion at least 1/2 ounce)

Absent Penis

2007-09-12T12:16:00.000-07:00

Introduction

"It's a boy!"
When we first glimpse our children in the delivery room, their sex is one of the immediate things we notice. It's also one of the first things we report to family and friends. In the last generation, many of us have seen evidence of our children's sex on ultrasound even before they were born, but still at the birth, we look to see.
How disconcerting to parents when a boy's penis seems to disappear, either at birth or shortly thereafter. The good news is that the outlook is bright.

What is it?

When a penis appears absent or too small, we call the condition inconspicuous penis. I've seen this in a great many boys. Several very different situations are lumped into this category. I will describe webbed penis, concealed penis, trapped penis, micropenis, and absent penis

Who gets it?

Boys can be born with a webbed penis, or the condition can result from an overexuberant circumcision where adhesions form between the scrotal skin and the penile skin. Webbed penis usually causes no problems (unless a routine circumcision is later performed).
Some children are born with a concealed penis (also known as buried penis or hidden penis), and for some it happens after circumcision. It is common in infants and toddlers, and occasionally seen in older children and obese adolescents.

Children are not born with trapped penis; circumcision causes it. Routine circumcision of a webbed penis or circumcision when there is significant scrotal swelling (from a hydrocele or hernia) can lead to trapped penis.

Micropenis is a hormonal problem that takes place sometime after 14 weeks' gestation when the penis has already formed.
Absent penis, or penile agenesis, is very rare, occurring in fewer than one in 20 million boys.

What are the symptoms?

A webbed penis is a normal-size penis where the skin of the scrotal sac extends partway up the shaft of the penis.
A concealed penis is a normal-size penis that lies hidden in the pubic fat pad. This condition is also called buried penis or hidden penis. Often the penis can be easily exposed by gently pulling on it or by pressing down on the surrounding fat pad.

A trapped penis is a normal-size penis that is partially stuck in the pubic fat pad. Scarring or adhesions trap the recessed penis in the fat pad. This condition can predispose children to urinary tract infections or urinary retention. Surgery is usually wise.

All of the above conditions have a penis of normal size. In determining size, the stretched penile length is far more important than the relaxed length. To evaluate penis size, stretch the penis gently and measure from the bone at the base all the way to the tip. Be sure to depress the surrounding fat pad to get all the way to the base. Here are the normal values:

Average Stretched Penile Length
(Adapted from Feldman KW, Smith DW. Journal of Pediatrics. 1975; 86:395)

:Age

Mean +/- 1 SD (inches)
Mean - 2.5 SD (inches)

0-5 months
1.5 +/- 0.3
0.75

6-12 months
1.7 +/- 0.3
0.9

1-2 years
1.9 +/- 0.3
1.0

2-3 years
2.0 +/- 0.4
1.1

3-4 years
2.2 +/- 0.4
1.3

4-5 years
2.2 +/- 0.4
1.4

5-8 years
2.4 +/- 0.4
1.5

8-11 years
2.5 +/- 0.4
1.5

Adult
5.2 +/- 0.6
3.7

Micropenis is a penis that is more than 2.5 standard deviations below the average size for age. In a newborn, a stretched penile length less than 3/4 inch (1.9 cm) is considered a micropenis.
In absent penis, or penile agenesis, the scrotum and testicles usually form normally, but the penis doesn't form at all.

How long does it last?

Without treatment, a webbed penis is unlikely to get better as the child grows.
If the concealed penis can be easily exposed by gently pulling on it or by pressing down on the surrounding fat pad, the situation will usually correct itself over time.
In a trapped penis, scarring or adhesions trap the recessed penis in the fat pad. This condition can predispose children to urinary tract infections or urinary retention.
In micropenis, if the penis grows when a three-month trial of testosterone is given, the outlook is good for normal adult penis size and function.
Absent penis is a permanent condition, although treatment can greatly improve the situation

How is it diagnosed?

When a boy has an inconspicuous penis, the parents' concerns are quite understandable. The penis should be promptly examined and measured, and the parents should be clearly told whether it is normally formed and of normal size. Whenever any question remains, a pediatric urologist is the best person to evaluate the penis and recommend a plan. Consulting a urologist is all the more appropriate when new concerns arise as the boy grows.

How is it treated?

Sometimes surgery is needed for inconspicuous penis, sometimes medical treatments, and often nothing at all.

A webbed penis sometimes requires surgery. Results with surgery, however, are excellent.
Sometimes surgery is needed for concealed penis. Either way, social, urinary and erection results are excellent.

Surgery is usually wise for a trapped penis.

In micropenis, hormone levels need to be checked. A boy's chromosomes should also be checked to see if there is an underlying genetic syndrome. An MRI may be needed to look at the hormone-secreting glands. A trial of testosterone treatment may solve the problem.

If micropenis does not respond to testosterone stimulation, the difficult question of reassigning gender arises. This decision has been made even more difficult by the conflicting and changing recommendations of experts in the field.

At one time, gender reassignment was the routine choice, even though it involves castration, surgical reconstruction, estrogen supplements, and huge emotional issues for the child and family. Many people base their opinions on the case of a baby boy whose penis was accidentally amputated during circumcision. When he was 22 months old, he was castrated and reassigned a female sex. He had surgery to make his genitals appear female. He was raised as a girl. At puberty, he was given estrogens to promote breast growth. Reports said that he had a very good adjustment to the female sex, but it later became clear that from an early age he had rejected the idea that he was a girl. During his teen years, he insisted on switching back to living as a man. He later married as a man.

Recent long-term studies of micropenis have found that even if the penis remains small, most boys raised as boys end up as sexually active, heterosexual males who stand to urinate, have a strong male identity, normal erectile function, and who enjoy sex. Their partners also report sexual satisfaction. Unfortunately, teasing by peers can be a real problem. A penile prosthesis may help.
Adults who have themselves had intersex issues argue strongly against reassignment before the child is old enough to choose. Their opinion should be listened to carefully.

Treating absent penis presents many challenges. A team including a geneticist, endocrinologist, urologist, pediatrician, and mental health experts should be involved.

How can it be prevented?

Often inconspicuous penis cannot be prevented. Avoiding inappropriate circumcisions can reduce the risk of an inconspicuous penis.

Shaken Baby Syndrome

2007-09-11T14:24:00.000-07:00

What is Shaken Baby Syndrome?

Shaken baby syndrome is a type of inflicted traumatic brain injury that happens when a baby is violently shaken. A baby has weak neck muscles and a large, heavy head. Shaking makes the fragile brain bounce back and forth inside the skull and causes bruising, swelling, and bleeding, which can lead to permanent, severe brain damage or death. The characteristic injuries of shaken baby syndrome are subdural hemorrhages (bleeding in the brain), retinal hemorrhages (bleeding in the retina), damage to the spinal cord and neck, and fractures of the ribs and bones. These injuries may not be immediately noticeable. Symptoms of shaken baby syndrome include extreme irritability, lethargy, poor feeding, breathing problems, convulsions, vomiting, and pale or bluish skin. Shaken baby injuries usually occur in children younger than 2 years old, but may be seen in children up to the age of 5.

Is there any treatment?

Emergency treatment for a baby who has been shaken usually includes life-sustaining measures such as respiratory support and surgery to stop internal bleeding and bleeding in the brain. Doctors may use brain scans, such as MRI and CT, to make a more definite diagnosis.

What is the prognosis?

In comparison with accidental traumatic brain injury in infants, shaken baby injuries have a much worse prognosis. Damage to the retina of the eye can cause blindness. The majority of infants who survive severe shaking will have some form of neurological or mental disability, such as cerebral palsy or mental retardation, which may not be fully apparent before 6 years of age. Children with shaken baby syndrome may require lifelong medical care.

What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS), and other institutes of the National Institutes of Health (NIH), conduct research related to shaken baby syndrome in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to treat and heal medical conditions such as shaken baby syndrome.

Prevention of Accidents and First Aid

2007-05-25T08:39:00.000-07:00

Prevention of Accidents and First Aid

Children will always have accidents no matter how careful you are. They are especially likely to injure themselves when they first become mobile. You can help prevent unnecessary accidents by following the safeguards listed :

• Keep small hard objects and pieces of food away from the baby. Check all toys to be sure that nothing could be bitten or pulled off which might cause choking.

• Before the baby crawls, check your home for unguarded fires, trailing or dangling electrical cords, unsafe electrical sockets (use power outlet guards), breakable (especially glass) objects which are within reach of a crawler.

• All children's clothing should be fireproof.

• Fix guards to reachable windows and staircases.

• Keep all medicines and poisons out of reach and locked up.

• Have childproof doors on all low cupboards.

• Check water hazards. All fish ponds and pools should be absolutely inaccessible. Never leave the baby alone in or near a bath containing water.

• Guard against scalds : Turn saucepan handles in to the stove, never drink hot drinks while holding a baby, don't use a table cloth when serving hot drinks, keep your hot water temperature as low as practical. Safety taps are available for the bath.

• Project your baby from sunburn with creams and hats.
Learn and practise how to give artificial respiration and external heart compression. Every home should have instructions for these life saving resuscitation procedures and all adults and older children in the household should know what to do in an emergency.

FIRST AID

Every parent will need to give first aid to children many times. Fortunately injuries are usually minor but it is best to be prepared for all kinds of emergencies.
You'll be surprised at what you can do in an emergency and it's important to know that you've done the best you can. Remember that help is only a phone call away. Write clearly the phone numbers of nearby doctors, the ambulance, the nearest Poisons Information Centre and some reliable neighbours on an adhesive label and attach it to the phone or close to it.

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First Aid Kit 2

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First Aid Kit

Every home should have a well stocked first aid kit. You can make up your own quite inexpensively. A shoe box strengthened with contact paper or a plastic two litre icecream tub makes a good container. The kit should contain :

• Sterile pads and dressings, including paraffin-soaked dressings

• Adhesive dressing of various sizes as well as one or two rolls of adhesive bandage

• Crepe and cotton bandages

• Small roll of cotton wool

• Safety pins

• Antiseptic lotion and tincture (Betadine, Savlon etc.)

• Scissors, blunt ended tweezers, sharp ended (splinter) tweezers

• Analgesic tablets and mixture (Aspirin or Paracetamol)

• Local anaesthetic cream or jelly or a small bottle of kitchen vinegar (for stings)

• Thermometer

• One metre square of cotton fabric (for sling, or pad for bleeding injuries)
Keep the kit out of children's reach but easily accessible. A similar kit should be kept in the car.

Burns and Scalds

If clothing catches fire, roll the child on the floor or in a carpet or blanket to put out the flames. Call for help. Flood the burnt or scalded area with cold water for at least five minutes. Don't remove adherent clothing. Don't apply any antiseptics or creams. Cover the burnt area with a clean handkerchief or sheet and take your child straight to your doctor.

Bites and Stings

Sandflies, mosquitoes and various other insects can bite. Wash and dry the area. Apply a cold compress if swollen. If itchy, dab with Calamine lotion, Eau de Cologne or Vinegar.

Apply a dressing to prevent scratching and infection. Seek medical advice if the victim shows any signs at all of an allergic reaction (excessive swelling, difficulty with breathing, vomiting, generalised skin rash).

Animal and human bites :

Stop bleeding, wash and dry wound, apply a dressing and take the child to the doctor or hospital without delay.

Snake, spider and dangerous insect bites :

Kill the biter, if possible, in case identification is necessary. Ring the ambulance or someone to drive you to emergency medical care. While waiting to go, bandage the bitten part (if a limb) firmly, starting 20 cm above and continuing 20 cm below the bite. Immobilise the limb with a splint. These measures help to prevent spread of venom. Watch breathing and pulse carefully. If either stops, give appropriate resuscitation.

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Firs aid 3

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Bleeding

Bleeding from wounds can usually be stopped by direct, firm pressure. Use a handkerchief or towel. Add pads as they become soaked. Don't remove soaked pads. When bleeding stops or eases, apply a pressure bandage and seek medical help as soon as possible.

Fits

Quickly clear the surroundings of any injurious objects. Call for help. Loosen any tight clothing around neck and waist. Most convulsions don't last long. When the jerking movements have stopped, lay the child on a soft bed or couch, cover with a warm blanket if cold, or sponge with cool water if hot. Watch breathing. If breathing stops, begin artificial respiration until help comes.

Drowning

Drowning can occur quickly and quietly in a very small amount of water. Call for help. Drain water from lungs by hanging the baby over your knee for about 10 seconds. Then start heart and lung resuscitation and continue until help comes or you get to the hospital.

Electrocution

Turn off the current. Call for help. Start heart and lung resuscitation at once and continue until help comes. Never attempt" to pull anyone away from a live current as you risk electrocution yourself.

Choking

Call for help. Hold the child's head down and give several firm slaps between the shoulder blades. Repeat in a few seconds if necessary. Remove any obstruction in the mouth but don't put your fingers down the child's throat — you may push the obstruction further down. If he doesn't cough up whatever is obstructing breathing, stand behind the child and place your arms around his middle, hands between his navel and ribs. Grip the fist or one hand with the other and-squeeze upwards firmly three or four times. Repeat if necessary. If this fails, hold him firmly by the feet and swing him round and round. If choking continues, take the child to a doctor or hospital as quickly as possible.

Head Injuries

Head injuries must always be taken seriously. Anyone who loses consciousness, even momentarily, after a blow on the head should be checked by a doctor. If the infant remains conscious, keeps a good colour and stops crying in reasonable time, he'll probably be all right. After any head injury, watch the child carefully for the next few days. If headache, drowsiness, vomiting, eye disturbances or lack of coordination develop, seek medical help without delay.

Fractures

The only first aid required is to minimise motion of the fractured parts to lessen the excruciating pain. Splinting the fractured part does this. A splint can be anything which is stiff. Usually the most common material used is a piece of broad wood. The splint should ideally by supporting the joints before and the joint after the fracture, in addition to the fractured site. For example, in a suspected fracture of the forearm, the splint should extend beyond the wrist (i.e. the joint before) and the elbow (i.e. the joint after the fractured part). Don't try to move them. Instead put the splint parallel to the fractured part and bandage together with clothes. For practical purposes, even three handkerchiefs, one each tied around the two ends and one in the middle will suffice. During transport to the hospital, take care that the fractured part is kept as motionless as possible and not jostled too much.

And finally as a matter of abundant caution, in any case of a trauma, while handling the patient, take great care that you don't extend or flex his neck and the spine, i.e. the backbone, should not undergo any motion (flexion, extension or rotation). In other words, the patient should be lifted by at least 4 persons in the same state that he was lying on the ground, particularly avoiding any motion of the neck or backbone relative to the rest of the body. Otherwise it can lead to an injury of the spinal cord and result in paralysis.

Poisons

Try to estimate how much poison the child has consumed. Take the remains of the poison with you to hospital. It is a good idea to keep syrup of Ipecac (available at your chemist) on hand. This can reduce vomiting. However some poisons make vomiting dangerous as they can burn the gullet and throat. Do not induce vomiting for poisoning which involves petroleum products (paraffin, petrol, liquid furniture and car polish, benzene, lighter fuel, turpentine and dry cleaning fluids), strong acids (nitric, sulphuric, hydrochloric), strong alkalis (bleach, ammonia, washing soda, caustic soda) and oil. based paint or insect sprays. Pesticides such as dog and flea rinses are particularly dangerous. In these cases give the child a drink of milk or water to help dilute the poison.

If the child has swallowed pills from a container and you are unsure how many or how dangerous they may be, induce vomiting. It only takes five quinine pills to kill a 2-year-old. If you cannot get through to the Poisons Information Centre or contact a doctor, take the child to a hospital making sure you take a sample of the poison with you, if possible.

Resuscitation Methods

Expired Air Resuscitation (EAR). Shake or shout at the patient to determine whether she is consious. If unconscious, roll her onto her side and clean out any foreign material from her mouth. Move patient onto back. Tilt head backwards.
Infants' head should not be tilted backwards. To keep the airway of an unconscious infant open, the forehead should be held and the point of the chin supported.
Look for movement from the chest and abdomen. Listen and feel for movement from the mouth and nose of the patient.

If there is no sign of breathing, take a breath and place your mouth completely over the patient's open mouth. Seal the nose with your cheek or fingers. For infants, place your mouth over the mouth and nose to seal it off.
Blow five gentle breaths watching the lower chest rise. With infants give little puffs, keeping the patient's jaw upwards and forwards. Vigorous blowing can damage an infant's lungs so take great care. Listen and feel for air leaving the mouth. Breathing should be about 20 per minute (one breath every 3 seconds).

When breathing restarts, roll the patient onto her side. Should breathing become irregular again recommence artificial respiration.
Cardiopulmonary Resuscitation (CPR) : Compression should be applied to the middle of the sternum of the patient when there is no pulse. The resuscitator should carefully feel around the bottom of the ribs to where they meet at the midline. One index finger should be placed on this point, the other hand should be positioned just touching the index finger.

Place the heel of the hand on the midline of the person's sternum, with the finger pointing across the chest and exerting no pressure on the chest.
The second hand should be placed over the first and held, either by the finger holding the other or the thumb holding the wrist. The compression should be vertical and there must be no pressure exerted on the chest except through the need of the lower hand. The upper end of the sternum should be found by feeling the groove between the collar bone.
One hand should be used to compress the centre of the sternum to a depth of about 2.5 cm. For infants, two fingers should be used to compress the centre of the sternum to about 1.5 cm or to a depth assessed for the individual patient by an experienced resuscitator.

For a single resuscitator, two breaths of EAR followed by one compression should be given within 10 seconds. A minimum of six cycles should be completed each minute. For two resuscitator CPR, the victim should receive 100 uninterrupted compressions each minute, counting with 20 breaths at intervals of 5 compressions.

Vaccines and Immunisation

2007-05-25T08:33:00.000-07:00

Vaccines and Immunisation

Many infectious diseases, including most of the common viral infections, occur only once during a person's lifetime. The reason is that the antibodies produced in response to the disease remain afterwards, prepared to repel any future invasion as soon as the first infectious germs appeared. The duration of such immunity varies, but it can last a lifetime.

Protection against many infections can now be provided artificially by the use of vaccines derived from altered forms of the infecting organism. These vaccines stimulate the immune system in the same way as a genuine infection, and provide lasting, active immunity. Because each type of microbe stimulates the production of a specific antibody, a diffferent vaccine must be given for each disease.

Another type of immunisation, called passive immunisation, relies on giving antibodies.

Why They Are Used

Some infectious diseases cannot be treated effectively or are potentially so serious that prevention is the best treatment. Routine immunisation not only protects the individual but may gradually eradicate the disease completely, as has been achieved with smallpox.
Newborn babies receive antibodies for many diseases from their mothers, but this protection lasts only for about three months. Most children between the ages of 2 months to 15years are routinely vaccinated against common childhood infectious diseases. In addition, travellers to many under developed countries, especially those in the tropics, are often advised to be vaccinated against the diseases common in those regions.

Effective lifelong immunisation can sometimes be achieved by a single dose of the vaccine. However, in many cases, reinforcing doses, commonly called booster shots, are needed later to maintain reliable immunity.

Vaccines do not provide immediate protection against infection and it may be up to four weeks before full immunity is able to develop. When immediate protection from infectious disease is needed— for example, following exposure to infection — it may be necessary to establish passive immunity with immune globulins.

How They Work

Vaccines provoke the immune system into creating antibodies that help the body to resist specific infectious diseases. Many vaccines (known as live vaccines) are made from artificially weakened forms of the disease-causing germ.

Common Vaccinations

Most vaccinations are given during infancy and childhood as part of a routine immunisation schedule. Most are given by germs and are effective in stimulating sufficient growth of antibodies. Other vaccines rely either on inactive (or killed) disease-causing germs, or inactive derivatives of these germs, but their effect on the immune system remains the same. Effective antibodies are created, thereby establishing active immunity.

How They Affect You

The degree of protection varies among different vaccines. Some provide reliable lifelong immunity; others may not give full protection against a disease, or the effects may last for as little as six months. Influenza vaccines usually protect only against the variety of virus causing the latest outbreak of flu. New varieties appear during most years. Those people at particular risk through their work or travel can have additional immunisation in adulthood. Any vaccine may cause side-effects but they are usually mild and soon disappear. The most common reactions are a red, slightly raised, tender area at the site of injection and a slight fever or a flu-like illness lasting for one or two days.

Risks And Special Precautions

Serious reactions are rare and, for most children, the risk is far outweighed by the protection given. Children who have had fits may be advised against vaccinations for pertussis (whooping cough) or measles. Children who have any infection more severe than common cold will not be given any routine vaccination until they have recovered.

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Disease

2007-05-25T08:32:00.000-07:00

Disease
Age at which Vaccination is given
Diphtheria

2 months, 3 months, 4 months, 3-5 years, Booster on leaving school
Tetanus

2 months, 3 months, 4 months, 3-5 years, Boosters on leaving school and every 10 years thereafter
Pertussis (whooping cough) 2 months, 3 months, 4 months
Polio

2 months, 3 months, 4 months, 3-5 years, Boosters on leaving school
Haemophilus influenzae type b (hib)

2 months, 3 months, 4 months
Rubella (German measles) 12-15 months and 3-5 years
Measles

12-15 months and 3-5 years
Mumps

12-15 months and 3-5 years

Tuberculosis (BCG) (Bacille Calmette-Guerin)
6 weeks or 10-14 years
Influenza

People of any age who are at risk of serious illness or death if they develop influenza

Hepatitis A
Single dose for people of any age who are at risk. Booster 6-12 months after initial shot. Boosters every 10 years if needed

Hepatitis B
3 inoculations at any age, with the second and third shots 1 and 6 months after the first. Booster after 5 years if needed

Pneumococcal pneumonia

Single dose for people of any age who are at risk
Meningococcal meningitis
Single dose for people of any age who are at risk

BCG (Bacille Calmette-Guerin) — Vaccine used to prevent children from Tuberculosis(TB).

OPV (Oral Polio Vaccine) — Vaccine given to children upto 5 years of age to make them immune from Polio.

DPT (Diphtheria, Whooping cough and Tetanus) — A combined vaccine that makes children immune from Diphtheria, Whooping cough and Tetanus.

MMR (Measles, Mumps and Rubella) — Vaccine used to prevent children from Measles, Mumps and Rubella.

HIB — Haemophilus influenza type b does not affect the children inoculated by this vaccine.

TT — Used to provide immunisation from Tetanus.
Live vaccines should not be given during pregnancy because they can affect the developing baby, nor should they

be given to people whose immune systems are weakened by disease or drug treatment. It is also advisable for those taking high doses of corticosteroids to delay their vaccinations until the end of drug treatment.

IMMUNE

Immune Globulins

2007-05-25T08:29:00.000-07:00

The risk of high fever following the DPT (combined diphtheria, pertussis, and tetanus) vaccine can be reduced by giving Paracetamol at the time of vaccination. The pertussis vaccine may in rare cases cause a mild fit, which is brief, usually associated with fever and stops without treatment. Children who have experienced such fits recover completely without neurological or developmental problems.

Immune Globulins

Antibodies, which can result from exposure to snake and insect venom as well as infectious diseases, are found in the serum of the blood (the part remaining after the red cells and clotting agents are removed). The concentrated serum of people who have survived diseases or poisonous bites is called immune globulin, and, given by injection, it creates passive immunity. Immune globulin from blood donated by a wide cross-section of donors is likely to contain antibodies to most common diseases. Specific immune globulins against rare diseases or toxins are derived from the blood of selected donors likely to have high levels of antibodies to that disease. These are called hyperimmune globulins. Some immune globulins are extracted from horse blood following repeated doses of the toxin.

Because immune globulins do not stimulate the body to produce its own antibodies, their effect is not long-lasting and diminishes progressively over three or four weeks. Continued protection requires repeated injections of immune globulins.
Adverse effects from immune globulins are uncommon. Some people are sensitive to horse globulins, and about a week after the injection they may experience a reaction known as serum sickness, with fever, a rash, joint swelling and pain.

This usually ends in a few days but should be reported to your doctor before any further immunisation.

Travel Vaccinations

These are not normally necessary for travel to Western Europe, North America, Australia, or New Zealand (although you should make sure that your tetanus and poliomyelitis boosters are up-to-date). Consult your doctor if you are visiting other destinations. Check that children travelling with you have had the full set of routine childhood vaccinations as well as any that are necessary for the areas in which you will be travelling.
If you are visiting an area where there is yellow fever, an International Certificate of Vaccination will be needed. You may also need this certificate in the future. Many countries that you might want to visit require an International Certificate of vaccination if you have already been to a country where yellow fever is present.

You are at risk of other infectious diseases in many parts of the world, and appropriate vaccinations are a wise precaution. For example, there is a zone called the "Meningitis Belt" that runs across northern India, Nepal, Bhutan, and Pakistan, and continues across Africa from the Sahara down to Kenya. Anyone intending to visit this zone should have meningococcal vaccine A and C. Visitors to Saudi Arabia at certain times of the year may also be required to have had the meningitis group A and C vaccine.

You may need extra vaccinations if you are backpacking or planning to stay for a long time. For example, hepatitis A vaccine would be sensible for anyone travelling to a developing country, but a long-stay traveller should consider having the hepatitis B vaccine and BCG(tuberculosis) as well. Anyone travelling into remote areas is recommended to have rabies vaccination.
All immunisation should be completed well before departure as the vaccinations do not give instant protection.

BCG needs 3 months, and some, for example typhoid, needs more than one dose to be effective.

Travel Immunisation

The immunisations needed before travelling depend on the part of the world you intend to visit, but some diseases can be contracted almost anywhere. Make sure that you have been immunised against tetanus and polio and have had boosters if necessary. Ask you doctor or pharmacist for the most up-to-date information on vaccination for specific areas.

Useful Biochemic Combinations

2007-05-25T08:28:00.000-07:00

Useful Biochemic Combinations

There are 28 combination compounds of biochemic remedies which are detailed hereunder with main symptoms for which each one should be used. These combinations are numerically numbered.

Before purchasing any biochemic combination, make sure that only products of standard homoeo companies are purchased (e.g. WSI, SBL, Ralson, Baksons, Bioforce etc.)

Biochemic Compounds

Number-1 Anaemia
Number-2 Asthma
Number-3 Colic
Number-4 Constipation
Number-5 Coryza
Number-6 Cough, Cold and Catarrh
Number-7 Diabetes
Number-8 Diarrhoea
Number-9 Dysentery
Number-10 Enlarged Tonsils
Number-11 Fever
Number-12 Headache
Number-13 Leucorrhoea
Number-14 Measles
Number-15 Menstruation Troubles
Number-16 Nervous Exhaustion
Number-17 Piles
Number-18 Pyorrhoea
Number-19 Rheumatism
Number-20 Skin Diseases
Number-21 Teething Troubles of Children
Number-2 2 Scrofula
Number-23 Toothache
Number-24 Tonic for Nerves and Brain
Number-25 Acidity, Flatulence and Indigestion
Number-26 Easy Delivery/Parturition
Number-27 Lack of Vitality
Number-28 General Tonic

Dosage for children and adults have been mentioned on each combination but in emergent situations like cholera, diarrhoea, colic, flatulence, fever etc. dosage may be repeated with greater frequency but quantity of dose will, however, remain the same. In case of any confusion or difficulty consult a Homoeopathic physician.

Biochemic Combination No. 21 (Teething Troubles)
This is the mostly used Biochemic Combination

These tablets help to build up general health of the baby and also keep him free from most of the health problems which normally occur during dentition period. It is a combination of Ferrum Phos and Calcarea Phos which in combined form, proves more effective and efficacious due to addition of Ferrum Phos. Mothers generally prefer to use Calcarea Phos but, in our view, this combination should be preferred in comparison to single use of Calcarea Phos. These tablets can be used regularly, from the anticipated time of cutting teeth until your child can be relieved from the agony of dentition problems.

AYURVEDIC TREATMENT

Treatment by Ayurveda

2007-05-25T08:27:00.000-07:00

Treatment by Ayurveda

Ayurveda is a well established science which is non harming to children.

Cough

If cough is dry and sputum is difficult to expel, mix 125 mg each of parched and pulverised powder of Alum and Borax and mix with honey which the child should lick (give this 3-4 times daily). It will moisten and loose the phlegm and help it to expectorate, normalise respiration and relieve cough. It is also useful in tonsillitis.
If phlegm is white, give parched Borax powder and Abhrak Bhasma 15-20 mg (mixed with honey) 3-4 times daily. Anand Bhairava Rasa (15-20 mg) may also be given for the same purpose (2-3 times daily).

Fever

Ayurveda is an ancient Indian science providing treatment by herbs and refined chemicals.
Praval Bhasma — 50-60 mg (for children aged 1-2 years) with milk will quell general fever but, when fever is due to cough, cold and dyspepsia, give 15 mg with milk. Fever due to heat can be brought down by Paracetamol (lA-l/2 Tsp) — Paed. dose — or 50-100 mg of Aspirin (soluble). If 15-25 mg of Abhrak Bhasma is given Vz-l hour before anticipated time of fever, it won't let fever surface — it will also relieve symptoms of cough. Septrin tablets of Baidyanath are also good.

Pain in Ribs

Prepare a liniment/rubbing oil by mixing Heeng (Asafoetida) and Garlic. Massage this oil over the affected rib-area 2-3 times daily. In addition give also Abhrak Bhasma (5-10 mg) with Milk or Honey. It will not only alleviate pain but also remove swelling.

Pain in the Ear

Fry 4-5 cloves of Garlic and 25-30 gms of Heeng in Mustard oil. Boil and let it cool down. Drop 2-3 drops in the painful ear. Alternatively 3-4 drops of doctor's brandy (slightly heated in winter) should be inserted into the painful ear. Even 2-3 drops of turpentine oil used as ear-drops or extracted juice of Onion and some Alum (red colour) should be mixed together to yield the relieving effect. But do not probe anything into the ear, as it (it is better to consult an ENT specialist) may cause infection and aggravate pain.

Abdominal/Stomach pain

This is also known as colic. Mix Heeng, fried Harar and table Salt with Milk or Honey or apply Amritdhara locally over navel and adjoining area. It can also be given in 2 drop doses with a lump of sugar or mixed with milk. As a supportive measure, the child should be laid on his stomach side and gently patted — it will help expel trapped wind and provide relief to the child.

Stomatitis

This condition arises due to reddening of mucus surface in the mouth when the child refuses to be fed and cries when any attempt is made to feed him. There may also be white patches on sub mucus portion. Mix parched Alum, Papparia Katha, and powder of Cardamom with Honey and apply over the infected site or else parched Suhaga, Alum powder or Katha and Kabab cheeni should be mixed with Honey or Ghee (pure) and applied locally, as indicated above.

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Pain in Eyes and Redness

2007-05-25T08:26:00.000-07:00

Pain in Eyes and Redness

We are of the opinion that most of the children are quite sensitive to ayurvedic medicines if used as eye drops. Pure Rose water is, by far, the best effective and harmless remedy — drop 1-2 drops into each eye, 3-4 times daily and also wash the eyes with a weak lotion of Boric acid. Some people suggest use of Alum with Rose/plain water but we shall advise you to get in touch with an ayurvedic physician for proper and harmless treatment.

Diarrhoea

Try Nar Kachoor — 15-20 gms and mix it with mother's/ cow's milk and serve thrice daily — will stop green loose motions or try 125 mg Kamaraja Rasa with milk or substitute this with Praval Bhasma (125 mg) with milk and honey (equal quantity of both) and give either of the combinations 6 hourly.
If the above mentioned combinations fail to yield any relief, give 15-25 mg of Anand Bhairava or Sanjeevani by mixing with honey and mother's or cow's milk. It will stop loose motions quite quickly. Consult your ayurvedic physician about Rasa Peepari for this disorder. In any case, try to maintain sodium-water-balance in the body and give only boiled water (when it has cooled) or juice of Pomegranate (1-2 tsp thrice).

Constipation

It is considered as the chief causative of a host of other diseases. Constipation has direct effect on metabolism. Unsuitable, stale, putrid diet is held to be responsible for this problem. Mix powders of Alua Usari Revand 6 gms each, fried Heeng 2 gm and prepare a thick paste so that pills of 10-15 mg could be processed. Give one such pill to the infant with mother's milk — it will expel trapped milk and ease constipation or give powder of parched Suhaga 1 gm, Usari Revand 500 mg and serve with milk to regulate bowels or give 10-15 mg of Anand Bhairava Rasa with water or milk.

Worms

Extracted juice of fresh Onion (1 gm) + 10-15 mg of Heeng should be given with water in the morning and evening — it will expel worms. Apply locally paste of roots of Indrayan and Bakayan over the stomach, to derive desired benefit, or prepare a paste of roots of Vaya Vidang and Kabela, adding some amount of fried Heeng. Before ^giving this compound, give jaggery (Gur) first. It will also expel worms. Some people suggest taking of two half-cut pieces of ripe tomato, with a sprinkling of black pepper powder, in the morning on empty stomach.

To Restore Free Flow of Urine

This is a dangerous condition and must not be handled by a layman but by a specialist only. The medicines suggested should serve as a guideline only and not used without proper guidance and monitoring of a specialist. When no urine is passed, it is still a graver situation and calls for immediate hospitalisation. Parents who are syphilitic or had been so but had not been declared 'Negative' should be extra careful. Generally, retention of urine is attributed to some obstructive pathology like stone in the urinary tract, some urinary infection. Without going into clinical details, use of catheter is the only possible alternative or consult some surgeon but do not leave anything to chance. If urinary flow is not free and urine is expelled in drops, with much pain and tenesmus or blood/pus is also passed, it points to some sort of obstruction in the urinary passage. Scanty urine in summer or during diarrhoea or when water intake is not sufficient to meet even body's normal demands, such situations may occur.

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Formulations to Cure Marasmus

2007-05-25T08:24:00.000-07:00

Formulations to Cure Marasmus

(1) Majeeth 60 gms, Chaleera Sugandh wala and Nagarmotha (each 22-25 gm), Haldi 25 gms, Laung, Saunth Taj, Jaiphal, Daru Haldi, sliced pieces of Ginger, Peepal-6 gms each, Kachoor 50 gms, Sandalwood powder, Lai Chandan 12 gms each, Kapur (Camphor) 3 gms— boil all the mentioned ingredients in water (in 1.25 litres), When the water content is reduced to 1 kg, mix 1/2 litre Til oil to it and boil until entire quantity of water evaporates and only oil is left behind. After this, mix in Lai Ratna jyot in the oil and remove from fire. After removing from fire put in 4-6 tablets of Camphor and when the liquid cools down, bottle the contents and secure with a cork or stopper. The prepared oil is said to remove fever, pains and aches in the body, shrivelling of skin, weakness and will make muscles arid bones healthy, tough and full of strength.

(2) Mulethi 6 gms, Ilayachi, Dalchini, Tulsi leaves (2 gms each), Banshlochan 3 gms, Kesar 2 gms, Mishri (sugar candy) equivalent to half the weight of above-mentioned ingredients — all the ingredients may be ground and reduced to paste form in juice of Tulsi leaves. Prepare pills of 125 mg each. A pill may be dissolved with mother's milk and given to the infant 3-4 times daily to get rid of infantile marasmus.

(3) Root of Patharchata 500 mg may be rubbed in mother's milk and 300 mg Black pepper powder added to it. It should be served to a child for 3 days ( one dose daily) and is said to cure marasmus.

Note : Quantities mentioned above and down below or in other cases are simply indications only and may be adjusted in consultation with an Ayurvedic physician as also frequency of dosage.

SOME OTHER GOOD AYURVEDIC PREPARATIONS FOR CHILDREN
Bal Sanjeevan Ark

Saunf, Ajwain, Vaiviranta (2 gms each), Peepal, parched Borax, Nausadar, Marorh Phali, Munakka—12 gms each, Makoy 125 mg, Indra Jau — 250 mg, Sanai Mulethi, Harar, Kachoor,

Laung, Mangore, Amaltas-60gms each. Boil all the said ingredients, ( after reducing all of them into a'powder form) in 10 kgs water. When the contents are reduced to l1/^ kgs, put in Kesar 400 mg and Mishri 400 gms and boil again. Remove from fire and let it cool, after which the contents should be bottled and corked. The resultant product, so procured, is said to make weak and marasmic children stronger, removes fever, cough, stomach and digestion related disorders, including green or yellow loose stools.

Ras Peepari

Process Kajali from purified mercury and purified sulphur (6 gms) each after which add 3 gms each of powdered Heeng (fried), Peepal, Saunth, Taj Jaiphal, Kesar (fried), Suhaga, Rock (red) salt, fried Laung, Ateesa, Ajwain, Vaivaringa, Kakkarsinghi and mix with Kajali and process pills of 125 mg each. It is said to be useful when the child is suffering from cold, fever, cough, nasal discharge, flu, milk vomiting, green and loose motions, and other stomach and digestion related disorders. One pill should be dissolved in mother's or cow's milk and given 2-3 times daily. This preparation is said to serve both as a preventive and curative medicine. It will also benefit during fever (due to cold conditions and coryza and catarrh).

Bal Roga Janam Ghutti

Take an equal quantity Zahar Mohra Salai, Hajrul yahood, Dariyai Narial, Yellow Harhar, Banshlochan, Peepal, Ilayachi, Jaiphal, Kesar, Gulab ke phool and finely pound all the ingredients. Process pills to the weight of 10-15 mg. Dissolve a pill in mother's milk and give evening and morning. It is said to be beneficial in fever, (intense) thirst, loose motions, vomiting of milk and other diseases which are specifically attributed to infancy stage. Some good Ayurvedic companies are preparing it. You can purchase from market also.

Homoeopathic Treatment

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Homoeopathic Treatment

What is Homeopathy suitable for ?

Most complaints respond well to homoeopathy. Most of the remedies are readily available over the counter from pharmacies or health shops, and are made from lactose or sucrose so they taste good to children.

What can I treat at home ?

There are many common complaints that you can treat at home using homoeopathy, including :

Colic : If your baby brings her legs up and screams a lot, try Colocynth (bitter cucumber). If she burps and possets a lot, a good remedy might be Carbo vegetabilis (vegetable charcoal). If she is furious, is not soothed by being carried and strains to fill her nappy, try Nux vomica (poison nut).

Teething : Chamomilla (chamomile) might help pain or sleeplessness from teething.

Feverish illness : If your child is pale, Aconite (monkshood) may help if given early in the illness. If she is very hot and red, Belladonna (deadly nightshade) might be better.

Gastroenteritis : As well as giving lots of fluid, you could try Arsenicum album (white arsenic) if there is both diarrhoea and vomiting. Phosphorus might be more suitable for vomiting alone, while Podophyllum (may-apple) can help diarrhoea.

Common cold : For a snuffle baby, Kali bichromicum (potassium bichromate). For a toddler with catarrh or a cold, try giving her Pulsatilla (wind anemone) tablets twice a day.

Bumps and bruises : Swelling and bruising can be relieved with Arnica cream. If there is an open cut or graze, give the Arnica in tablet form.

Night fears : Calcarea carbonic (crushed oyster shells) or Phosphorus could be worth trying.

Bed-wetting : If your child wets the bed early in the night, try Equisetum (souring rush). If she wets it later, try Lycopodium (club moss).

Colic : Distention of abdomen, use Colocynth.

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Some other good Homoeopathic remedies

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Some other good Homoeopathic remedies

Chamomilla : For colic, diarrhoea, ear infection, teething problems.

Aconite : For colds, cough, dry, sudden occurence of symptoms.

Ferrum Phos : For gradual onset of fever, throbbing pain of ear, red cheeks.

Dulcamara : For cough, cold during rainy season.

Gelsemium : For colds and influenza.

Calendula : For minor cuts.

Bryonia : For cough, cold during change of weather.

Belladona : For high rise of temperature.

Calc. Phos : For delayed teething and diarrhoea.

Hep. Sulph : For abscesses.

Colocynth : Distension of abdomen. Jelly like stools.

How do I give the remedies ?

Homoeopathic remedies come either in tablets or granules. Babies can take homoeopathic tablets crushed and mixed in a little cooled, boiled water. Give half a teaspoon at a time,
and make up a fresh solution daily. A baby on solids will usually take a crushed tablet or granules off a spoon, while a toddler or child can suck the tablet whole. Initially use in 30 potency only.

How long does treatment last?

Some treatments for minor ailments may only need a single dose, although if your child has long-term problems she may need to continue treatment for months. However, with homoeopathy it is usual to stop the treatment as soon as improvement occurs — unlike conventional drugs.

When should I see the doctor ?

Always see the doctor if your child's symptoms persist, if symptoms change, or if this could be due to a serious illness. You may even consult the authors.

Anti-fungal Drugs

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Anti-fungal Drugs

We are continually exposed to fungi — in the air we breathe, the food we eat and the water we drink. Fortunately, most of them cannot live in the body and few are harmful. But some can grow in the mouth, skin, hair or nails, causing irritating or unsightly changes, and a few can cause serious and possibly fatal disease. The most common fungal infections are caused by the tinea group. These include tinea pedis (athlete's foot), tinea corporis (ringworm), tinea cruris (groin ringworm) and tinea capitis (scalp ringworm). Caused by a variety of organisms, they are spread by direct or indirect contact with infected humans or animals. Infection is encouraged by warm, moist conditions.

Problems may also result from the proliferation of a fungus that is normally present in the body; the most common example is excessive growth of Candida, a yeast that causes thrush infection of the mouth, vagina and bowel. It can also infect other organs if it spreads through the body via the blood stream. Overgrowth of Candida may occur in people taking antibiotics or oral contraceptives, pregnant women, or those with diabetes or immune system disorders such as AIDS.

Superficial fungal infections—those that attack only the outer layer of the skin and mucous membranes— are relatively common and, although irritating, do not usually present a threat to general health. Internal fungal infections — for example, of the lungs, heart or other organs— are rare but may be serious and prolonged.

Because antibiotics and other anti-bacterial drugs have no effect on fungi and yeasts, it is necessary to use a different type of drug. Drugs for fungal infections are either applied topically to treat minor infections of the skin, nails, and mucous membranes or they are given by mouth or injection to eliminate serious fungal infections of the internal organs and nails.

Choice of Anti-fungal Drug

The particular drug chosen in each case depends on the precise nature and site of the infection. The usual route of administration for each drug is also indicated.

How They Work

Most anti-fungals alter the permeablility of the fungal cell's walls. Chemicals needed for cell life leak out and the fungal cell dies.

Common Drugs

Amorolfine, Amphotericin, Benzoyl peroxide, Cotrimazole, Econazole, Fenticonazole, Fluconazole, Griseofulvin, Isoconazole, Itraconazole, lucytosine, Ketoconazole, Miconazole, Nystatin, Sulconazole, Terbinafine, Tioconazole.

ANTI MALARIAL DRUG

Anti-malarial Drugs

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Anti-malarial Drugs

Malaria is one of the main killing diseases in the tropics and is most likely to affect children and people who live in or travel to such places.
The disease is caused by protozoa whose life cycle is far from simple. The malaria parasite, which is called Plasmodium, lives in and depends on the female Anopheles mosquito during one part of its life cycle. It lives in and depends on human beings during other parts of its life cycle.
Transferred to humans in the saliva of the female mosquito as she penetrates ("bites") the skin, the malaria parasite enters the bloodstream and settles in the liver, here it multiplies asexually.

Following its stay in the liver, the parasite (or plasmodium) enters another phase of its life cycle, circulating in the bloodstream, penetrating and destroying red blood cells and reproducing again. If the plasmodia then transfers back to a female Anopheles mosquito via another "bite", they breed sexually and are again ready to start a human infection.
Following the emergence of plasmodia from the liver, the symptoms of malaria occur: episodes of high fever and profuse sweating alternate with equally agonizing episodes of shivering and chills. One of the four strains of malaria (Plasmodium falciparum) can produce a single severe attack that can be fatal unless treated. The others cause recurrent attacks, sometimes extending over many years.

A number of drugs are available for preventing malaria, the choice depending on the region in which the disease can be contracted and the resistance to the commonly used drugs. In most malarial areas, Plasmodium Falciparum is resistant to Chloroquine. In all regions, three drugs are commonly used: Quinine, Mefloquine and Malarone.

Choice of Drugs

The parts of the world in which malaria is prevalent and travel to which may make anti-malarial drug treatment advisable, can be divided into six zones. Due to drug resistance, specific anti-malarials are recommended for each zone.

Zone 1 — North Africa and the Middle East: Chloroquine, and Proguanil in areas of Chloroquine resistance.

Zone 2 — Sub Saharan Africa : Mefloquine or Chloroquine with Proguanil

Zone 3 — South Asia : Mefloquine or Chloroquine with Proguanil

Zone 4 — Southeast Asia : Mefloquine in high risk areas or Chloroquine with Proguanil; Doxycycline in Mefloquine resistant areas

Zone 5 — Oceania : Mefloquine or Doxycycline

Zone 6 — Latin America, Central America : Chloroquine or Proguanil. South America : Mefloquine in high risk areas or Chloroquine with Proguanil
As prevalent strains of malaria change very rapidly, you must always seek specific medical advice before travelling to any of these areas.

RISK AND SPECIAL PRECAUTIONS

ANTI FUNGAL DRUG

Risks and Special Precautions

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Risks and Special Precautions

When drugs are given to prevent or cure malaria, the full course of treatment must be taken. No drug gives long term protection; a new course of treatment is needed for each journey.

Most of these drugs do not produce severe adverse effects, but Primaquine can cause the blood disorder haemolytic anaemia, particularly in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Blood tests are taken before treatment to identify susceptible individuals. Halofantrine can have an adverse effect on heart rhythm. Mefloquine is not prescribed for those who have had psychological disorders or convulsions.

Other Protective Measures

Because Plasmodium strains continually develop resistance to the available drugs, prevention using drugs is not absolutely reliable. Protection from mosquito bites is of the highest priority. Such protection includes the use of insect repellents, such as DEBT and mosquito nets impregnated with Permethrin insecticide, as well as covering any areas of exposed skin after dark.

Common Drugs

Artemether, Chloroquine, Doxycycline, Halofantrine, Mefloquine, Primaquine, Proguanil, Proguanil/Atovaquone (Malarone), Pyrimethamine/Dapsone (Malaprimj, Pyrimethamine/Sulphadoxine (Fansidar), Quinine.

Anti-protozoal Drugs

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Anti-protozoal Drugs

Protozoa are single celled organisms that are present in soil and water. They may be transmitted to or betwen humans through contaminated food or water, sexual contact, or insect bites. There are many different types of protozoal infection, each one causing a different disease depending on the organism that is involved.

Many types of protozoa infect the bowel, causing diarrhoea and generalised symptoms of ill health. Others may infect the genital tract or skin. Some protozoa may penetrate vital organs such as the lungs, brain, and liver. Prompt diagnosis and treatment is important in order to limit the spread of the infections within the body and, in some cases, prevent it from spreading to other people. Increased attention to hygiene is another important factor in controlling the spread of the disease.

A variety of medicines is used in the treatment of these diseases. Some, such as Metronidazole and Tetracycline are also commonly used for their anti-bacterial action. Others, such as Pentamidine are rarely used except in treating specific protozoal infections.

How They Affect You

Protozoa are often difficult to eradicate from the body. Drug treatment may therefore need to be continued for several months in order to eliminate the infecting organisms
completely and thus prevent recurrence of the disease. In addition, unpleasant side effects such as nausea, diarrhoea and abdominal cramps are often unavoidable because of the limited choice of drugs and the need to maintain dosage levels that will effectively cure the disease.

TYPES OF PROTOZOL

Types of Protozoal Disease

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Types of Protozoal Disease

Amoebiasis (Entamoeba histolytica), or amoebic dysentery, is an infection of the bowel (and sometimes the liver and other organs) usually transmitted in contaminated food or water. Its major symptom is violent, sometimes bloody, diarrhoea. Treatment is with Diloxanide, Metronidazole or Tinidazole.

Balantidiasis (Balantidium coli) is an infection of the bowel, specifically the colon, usually transmitted through contact with infected pigs. Possible symptoms include diarrhoea and abdominal pain. Treatment is with Tetracycline, Metronidazole or Diodohydroxy quinoline.

Cryptosporidiosis (Cryptosporidium) affects the bowel (and occasionally the respiratory tract and bile ducts). It is spread through contaminated food or water or by contact with animals or other humans. Symptoms include diarrhoea and abdominal pain. There are no specific drugs to treat it, but Paromomycin, Azithromycin or Eflornithine may be effective.

Giardiasis (Giardia Lamblia] or Lambliasis, affects the bowel and is usually transmitted in contaminated food or water; but it may also be spread by some types of sexual contact. Its major symptoms are generalised ill-health, diarrhoea, flatulence and abdominal pain. Treatment is with Mepacrine, Metronidazole or Tinidazole.

Leishmaniasis (Leishmania) is a mainly tropical and subtropical disease caused by organisms spread through sandfly bites. It affects the mucous membranes of the mouth, nose and throat and may, in its severe form, invade organs such as the liver. Treatment is with Paromomycin, Sodium stibogluconate, Pentamidine or Amphotericin.

Pneumocystis Pneumonia (Pneumocystis carinil) is a potentially fatal lung infection usually affecting only those people with reduced resistance to infection, such as AIDS sufferers. Symptoms include cough, breathlessness, fever and chest pain. Treatment is with drugs such as Atovaquone, Co-trimoxazole, Pentamidine and Trimetrexate.

Toxoplasmosis (Toxoplasma gondii) is usually spread via cat faeces or by eating undercooked meat. Although usually symptomless, toxoplasmosis may cause generalised ill health, mild fever and eye inflammation. Treatment is necessary only if the eyes are involved or the patient is immuno-suppressed (such as in AIDS). It may also pass from mother to baby during pregnancy, leading to severe disease in the foetus. Treatment usually consists of Pyrimethamine with Sulfadiazine, Azithromycin, Clarithromycin or Clindamycin, or during pregnancy, Spiramycin.

Trichomoniasis (Trichomonas vaginalis) most often affects the vagina, causing irritation and an offensive discharge. In men, it may occur in the urethra. It is usually sexually transmitted. Treatment is with Metronidazole or Tinidazole.

Trypanosomiasis (Trypanosoma) or African trypano-somiasis (sleeping sickness) is spread by the tsetse fly and causes fever, swollen glands and drowsiness. South American trypanosomiasis (Chagas disease) is spread by assassin bugs and causes inflammation, enlargement of internal organs and infection of the brain. Sleeping sickness is treated with Pentamidine, Suramin, Eflornithine or Melarsoprol. Chagas disease is treated with Primaquine or Nifurtimox.

Anti-viral Drugs

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Anti-viral Drugs

Viruses are simpler and smaller organisms than bacteria and are less able to sustain themselves. These organisms can survive and multiply only by penetrating body cells. In order to reproduce, a virus requires a living cell. The invaded cell eventually dies and the new viruses are released, spreading and infecting other cells. Because viruses perform few functions independently, medicines that disrupt or halt their life cycle without harming human cells have been difficult to develop.

There are many different types of virus, and viral infections cause illnesses with various symptoms and degrees of severity. Common viral illnesses include colds, influenza and flu-like illnesses,' cold sores and childhood diseases such as chickenpox and mumps. Throat infections, pneumonia, acute bronchitis, gastroenteritis and meningitis are often, but not always, caused by a virus.

Fortunately, the body's natural defences are usually strong enough to overcome infections such as these, with drugs given to ease pain and bring down fever. However, the more serious viral diseases, such as pneumonia and meningitis, need close medical supervision. Another difficulty with viral infections is the speed with which the virus multiplies. By the time symptoms appear, the viruses are so numerous that anti-viral drugs have little effect. Anti-viral agents must be given early in the course of the infection; they may also be used as a prophylactic (preventive). Some viral infections can be prevented by vaccination.

Why They Are Used

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Why They Are Used

The main area where anti-viral drugs are helpful is in the treatment of various conditions caused by the herpes virus: cold sores, encephalitis, genital herpes, chickenpox, and shingles.
Some drugs are applied topically to treat cold sores, herpes, eye infections, and genital herpes. They can reduce the severity and duration of an outbreak but do not eliminate the infection permanently. Other anti-viral drugs are given by mouth or, under exceptional circumstances, by injection to prevent chickenpox or severe, recurrent attacks of the herpes virus infections in those who are already weakened by other conditions.
Anti-viral agents are also given to prevent influenza A, as is Amantadine, a drug for Parkinsonism that also has antiviral properties.

The interferons are proteins produced by the body and involved in the immune response and cell function. Interferon alpha and beta have recently been shown to be effective in reducing disease activity in people infected with hepatitis B and hepatitis C. Further research into the anti-viral activity of these agents is under way, including their use in the treatment of central nervous system conditions, such as multiple sclerosis.

AIDS (acquired immune deficiency syndrome) is caused by infection with the human immuno deficiency virus (HIV), which reduces the body's resistance to infection by other viruses, bacteria and protozoa, and to some types of cancer.

How They Work

Some anti-viral drugs, such as Idoxuridine, act by altering the cell's genetic material (DNA) so that the virus cannot use it to multiply. Other drugs stop multiplication of viruses by blocking enzyme activity within the host cell. Halting multiplication prevents the virus from spreading to uninfected cells and improves symptoms rapidly. However, in herpes infections, it does not eradicate the virus from the body. Infection may therefore flare up on another occasion.

Amantadine has a different action : it stops the virus from entering cells. It is therefore most effective when given prophylactically, before the infection has spread widely.

How They Affect You

Topical anti-viral drugs usully start to act at once. Provided that the treatment is applied early enough, an outbreak of herpes can be cut short. Symptoms usually clear up within two to four days. Anti-viral ointments may cause irritation and redness. Anti-viral drugs given by mouth or injection can occasionally cause nausea and dizziness.

Risks and Special Precautions

Because some of these drugs may affect the kidneys adversely, they are prescribed with caution for people with reduced kidney function. Some anti-viral drugs can adversely affect the activity of normal body cells, particularly those in the bone marrow. Idoxuridine is, for this reason, available only for topical application.

Common Drugs

Aciclovir, Amantadine Cidofovir, Famciclovir, Foscarnet, Ganciclovir, Idoxuridine, Inosine pranobex, Interferon, Penciclovir, Tribavirin, Valaciclovir, Zanamivir.

Anti-Tubercular Drugs

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Anti-Tubercular Drugs

Tuberculosis is a contagious bacterial disease that is acquired, often in childhood, by inhaling the Tuberculosis bacilli present in the spray caused by a sneeze or cough from someone who is actively infected. It may also be acquired from infected cow's milk. The disease usually starts in a lung and takes one of two forms: either primary infection or reactivated infection.

In 90 to 95 percent of those people with a primary infection, the body's immune system suppresses the infection, but it does not kill the bacilli. They remain alive but dormant and may cause the reactivated form of tuberculosis. After the Tuberculosis bacilli are reactivated, they may spread throughout the body via the lymphatic system and the bloodstream.

The first symptoms of the primary infection may include a cough, fever, tiredness, night sweats and loss of weight. Tuberculosis is confirmed through clinical investigations, which may include a chest X-ray, isolation of the bacilli from the person's sputum and a positive reaction — localised inflammation to the Mantoux test, an injection of tuberculin (a protein extracted from tuberculosis bacilli) into the skin.

The gradual emergence in adults of the destructive and progressive form of tuberculosis is caused by the reactivated infection. It occurs in 5 to 10 per cent of those who have had previous primary infection. Another form, reinfection tuberculosis, occurs when someone with the dormant, primary form is reinfected. This type of tuberculosis is clinically identical to the reactivated form. Reactivation is more likely in those people whose immune system is suppressed, such as the elderly, those on Corticosteroids or other immuno-suppressant drugs, and those who have AIDS. Reactivation tuberculosis may be difficult to identify because the symptoms may start in any part of the body seeded with the bacilli. It is most often first seen in the upper lobes of the lung, and it is frequently diagnosed after a chest X-ray. The early symptoms may be identical to those of primary infection: a cough, tiredness, night sweats, fever, and loss of weight.

If left untreated, tuberculosis continues to destroy tissue, spreading throughout the body and eventually causing death. It was one of the most common causes of death in India and the disease is on the increase again. Vulnerable groups are people with suppressed immune systems and the homeless.

WHY THEY ARE USED

Why They Are Used

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Why They Are Used

A person diagnosed as having tuberculosis is likely to be treated with three or four anti-tubercular drugs. This helps to overcome the risk of drug-resistant strains of the bacilli emerging.

The standard drug combination for the treatment of tuberculosis consists of four drugs, usually including Rifampicin, Isoniazid, Pyrazinamide and Ethambutol. Other drugs may be substituted if the initial treatment fails or if drug sensitivity tests indicate that the bacilli are resistant to these drugs.

The standard duration of treatment for a newly diagnosed tuberculosis infection is a six month regimen as follows: Isoniazid, Rifampicin, Pyrazinamide and Ethambutol daily for two months, followed by Isoniazid and Rifampicin for four months. The duration of treatment can be extended from nine months to upto two years in older children at particular risk, such as those whose immune system has been suppressed. Ethambutol can sometimes be omitted if resistance is unlikely. Corticosteroids may be added to the treatment, if the immune system is not supressed, to reduce the amount of tissue damage; and Pyridoxine is also often prescribed to protect the nerves from damage by Isoniazid.

Both the number of drugs required and the long duration of treatment may make treatment difficult, particularly for those who are homeless. To help with this problem supervised administration of treatment is available when required, both in the community dispensary and in the hospital.
Tuberculosis infection in patients with HIV infection or AIDS is treated with the standard anti-tubercular drug regimen; but lifelong preventative treatment with Isoniazid may be necessary.

How They Work

Anti-tubercular drugs act in the same way as antibiotics, either by killing bacilli or preventing them from multiplying.

How They Affect You

Although the drugs start to combat the disease within days, the benefits of drug treatment are usually not noticeable for a few weeks. As the infection is eradicated, the body repairs the damage caused by the disease. Symptoms such as fever and coughing gradually subside and the appetite and general health improve.

Risks And Special Precautions

Anti-tubercular drugs may cause adverse effects (nausea, vomiting, and abdominal pain) and they occasionally lead to serious allergic reactions. When this happens, another drug is substituted.
Rifampicin and Isoniazid may adversely affect the nerves as well. Ethambutol can cause changes in colour vision. Dosage is carefully monitored, especially in children, the elderly and those with reduced kidney function.

Tuberculosis Prevention

A vaccine prepared from an artificially weakened strain of cattle tuberculosis bacteria can provide immunity from tuberculosis by provoking the development of natural resistance to the disease (see Vaccines and immunisation). The BCG (Bacille Calmette-Guerin) vaccine is a form of tuberculosis bacillus that provokes the body's immune response but does not cause the illness because it does not invade tissues. The vaccine is usually given to children between the ages of 10 and 14 years who are shown to have no natural immunity when given a skin test. BCG vaccination may be given to new born babies if, for example, someone in the family has tuberculosis.
The vaccine is usually injected into the upper arm. A small pustule usually, appears 6-12 weeks later, by which time the person can be considered immune.

Common Drugs

Capreomycin, Cycloserine, Ethambutol and Isoniazid, Pyrazinamide, Rifampicin, Refabutin, Streptomycin.

Anti-Bacterial Drugs

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Anti-Bacterial Drugs

This broad classification of drugs comprises agents similar to the antibiotics in function but dissimilar in origin. The original antibiotics were derived from living organisms such as moulds and fungi. Anti-bacterials were developed from chemicals. The Sulphonamides were the first drugs to be given for the treatment of bacterial infections and were the mainstay of the treatment of infection before Penicillin (the first antibiotic) became generally available. Increasing bacterial resistance and the development of more effective and less toxic antibiotics have reduced the use of Sulphonamides.

How They work

Most anti-bacterials function by preventing the growth and multiplication of bacteria. Folic acid, a chemical necessary for their growth, is produced within bacterial cells by an enzyme that acts on a chemical called para aminobenzoic acid. Sulphonamides interfere with the release of the enzyme. This prevents folic acid from being formed. The bacterium is therefore unable to function properly and dies.

How They Affect You

Anti-bacterials usually take several days to eliminate bacteria. During this time your doctor may recommend additional medication to alleviate pain and fever. Possible side effects of Sulphonamides include loss of appetite, nausea, a rash and drowsines.

Risks and Special Precautions

Like antibiotics, most anti-bacterials can cause allergic reactions in susceptible people. Possible symptoms that should always be brought to your doctor's attention include rashes and fever. If such symptoms occur, a change to another drug is likely to be necessary. Treatment with Sulphonamides carries a number of serious but rare risks. Some drugs in this group can cause crystals to form in the kidneys, a risk that can be reduced by drinking adequate amounts of fluid during prolonged treatment. Because Sulphonamides may also occasionally damage the liver, they are not usually prescribed for people with impaired liver function. There is also a slight risk of damage to bone marrow, lowering the production of white blood cells and increasing the chances of infection. Doctors therefore try to avoid prescribing Sulphonamides for prolonged periods. Liver function and blood composition are often monitored during unavoidable long term treatment.

COMMON DRUG

Common Drugs

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Common Drugs

Quinolones, Cinoxacin, Ciprofloxacin, Grepafloxacin, Levofloxacin, Nalidixic acid, Norfloxacin, Ofloxacin. Sulphonamides, Co-trimoxazole, Sulfadiazine, Sulfadimidine.

Drug treatment for Hansen's disease (Leprosy)

Hansen's disease, more commonly known as leprosy, is a bacterial infection caused by Mycobacterium leprae. It is rare in the United Kingdom, but relatively common in parts of Africa, Asia, and Latin America.
The disease progresses slowly, first affecting the peripheral nerves and causing loss of sensation in the hands and feet. This leads to frequent unnoticed injuries and consequent scarring, Later, the nerves of the face may also be affected.

Treatment uses three drugs together to prevent the development of resistance. Usually, Dapsone, Rifampicin and Clofazimme will be given for at least 2 years. If one of these cannot be used, then a second line drug (Ofloxacin Mmocycline or Clarithromycin) might be substituted' Complications during treatment may require use of Prednisolone, Aspirin, Chloroquine, or even Thalidomide

Uses of Antibiotics

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Uses of Antibiotics

The table at the end of this chapter shows common drugs in each class of antibiotics that are used to treat infections in different parts of the body; it is not intended for use as a guide to prescribing. For comparison, some anti-bacterial drugs are included under 'Other drugs'. Generally when a type of antibiotic is needed that cannot be given by mouth, the drug may be given by injection. Antibiotics are also included in tropical preparations for localized skin, eye, and ear infections, infective, skin preparations.

How They Work

Depending on the type of drug and the dosage, antibiotics are either bactericidal, killing organisms directly, or bacteriostatic, halting the multiplication of bacteria and enabling the body's natural defenses to overcome the remaining infections.
Penicillin and Cephalosporin’s are bactericidal, destroying bacteria by preventing them from making normal cell walls; most other antibiotics act inside the bacteria by interfering with the chemical activities essential to their life cycle.

CLASSESS OF ANTIBIOTICS

Classes of Antibiotics

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Penicillin’s: The first antibiotic drugs to be developed, penicillin’s are still widely used to treat many common infections. Some are not effective when they are taken by mouth and therefore have to be given by injection in the

hospital. Unfortunately, certain strains of bacteria are resistant to penicillin treatment, and other drugs may have to be substituted. Penicillin’s often cause allergic reactions.
Cephalosporins: These broad spectrum antibiotics, similar to the Penicillin’s, are often used when Penicillin treatment has proved ineffective. Some can be given by mouth, but others are only given by injection. About 10 per cent of people who are allergic to Penicillin’s are also allergic to Cephalosporin’s. Some Cephalosporin’s can occasionally damage the kidneys, particularly if used with amino glycosides. Another serious, although rare, adverse effect of a few Cephalosporins’ is that they occasionally interfere with normal blood clotting, leading to abnormally heavy bleeding, especially in the elderly.

Macrolides: Erythromycin is the most common drug in this group. It is a broad spectrum antibiotic that is often prescribed as an alternative to Penicillin’s or Cephalosporin’s. Erythromycin is also effective against certain diseases, such as Legionnaries' disease (a rare type of pneumonia), that cannot be treated with other antibiotics. The main risk with Erythromycin is that it can occasionally impair liver function.

Tetracyclines: These have a broader spectrum of activity than other classes of antibiotics. However, increasing bacterial resistance has limited their use, but they are still widely prescribed. As well as being used for the treatment of infections, Tetracyclines are also used in the long term treatment of acne, although this application is probably not related to their anti-bacterial action. A major drawback to the use of Tetracycline antibiotics in pregnant women and young children is that they are deposited in developing bones and teeth.

With the exception of Doxycycline, drugs from this group are poorly absorbed through the intestines and when given by mouth they have to be administered in high doses in order to reach effective levels in the blood. Such high doses increase the likelihood of diarrhea as a side effect. The

absorption of Tetracyclines can be further reduced by interaction with Calcium and other minerals. Drugs from this group should not therefore be taken with iron tablets or milk products. Tetracyclines deteriorate and may become poisonous with time, so leftover tablets or capsules should always be discarded.

Aminoglycosides: These potent drugs are effective against a wide range of bacteria. They are not as widely used as some other antibiotics since they have to be given by injection and have potentially serious side effects. Their use is therefore limited to hospital treatment of serious infections. They are often given with other antibiotics. Possible adverse effects include a severe skin rash and damage to the kidneys and nerves in the ear.
Lincosamides: The Lincosamide — Clindamycin — is not commonly used as it is more likely to cause serious disruption of bacterial activity in the bowel than other antibiotics. It is mainly reserved for the treatment of bone, joint, abdominal and pelvic infections that do not respond well to the safer antibiotics. Clindamycin is also used topically for acne and vaginal infections.

Quinolones: These drugs, often called anti-bacterials, are derived from chemicals rather than living organisms. Quinolones have a wide spectrum of activity. They are used in the treatment of urinary infections and are widely effective in acute diarrhoeal diseases, including that caused by salmonella, as well as in the treatment of enteric fever.
The absorption of Quinolones is reduced by antacids containing Magnesium and Aluminium. They are well tolerated but should be avoided by epileptics, as they may in rare cases cause convulsions, and by children, as studies have shown that they may cause arthritis.

How They Affect You

Antibiotics stop most common types of infection within days. Because they do not relieve symptoms directly, your doctor may advise additional medication, such as Analgesics, to relieve pain and fever until the antibiotics take effect.
It is important to complete the course of medication as prescribed by your doctor, even if all your symptoms have disappeared. Failure to do this can lead to a resurgence of the infection in an antibiotic-resistant form.

Most antibiotics used in the home do not cause adverse effects if taken in the recommended dosage. In people who do experience them, nausea and diarrhea are common. Some people may be sensitive to certain types of antibiotics, which can result in a variety of serious adverse effects.

ANTIBIOTICS RESISTANCE

Antibiotics Resistance

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The increasing use of antibiotics in the treatment of infection has led to resistance in certain types of bacteria to the effects of particular antibiotics. This resistance to the drug usually occurs when bacteria develop mechanisms of growth and reproduction that are not disrupted by the effects of the antibiotics. In other cases, bacteria produce enzymes that neutralize the antibiotics.

Antibiotic resistance may develop in a person during prolonged treatment when a drug has failed to eliminate the infection quickly. The resistant strain of bacteria is able to multiply, thereby prolonging the illness. It may also infect other people and result in the spread of resistant infection. One particularly important example is Methicillin resistant Staphylococus aureus, which resists most antibiotics but can be treated with other drugs such as Teicoplanin and Vancomycin.

Doctors try to prevent the development of resistance to antibiotics by selecting the drug most likely to eliminate the bacteria present in each individual case as quickly and as thoroughly as possible. Failure to complete a course of antibiotics that has been prescribed by your doctor increases the likelihood that the infection will recur in a resistant form.

Risks and Special Precautions

Most antibiotics used for short periods outside a hospital setting are safe for most people. The most common risk, especially with Cephalosporins and Penicillins, is a severe allergic reaction to the drug that can cause a rash and sometimes swelling of the face and throat. If this happens, you should stop the drug and seek immediate medical advice. If you have had a previous allergic reaction to an antibiotic, all other drugs in that class and related classes should be avoided. It is, therefore, important to inform your doctor if you have previously suffered an adverse reaction to treatment with an antibiotic (with the exception of minor bowel disturbances).

Another risk of antibiotic treatment, especially if it is prolonged, is that the balance among micro-organisms normally inhibiting the body may be disturbed. In particular, antibiotics may destroy the bacteria that normally limit the growth of Candida, a yeast that is often present in small amounts in the body. This can lead to overgrowth of Candida (thrush) in the mouth, vagina or bowel and an anti-fungal drug may be needed.
A rarer, but more serious result of disruption of normal bacterial activity in the body is a disorder known as Pseudo-membranous colitis, in which bacteria that are resistant to the antibiotic multiply in the bowel, causing violent, bloody diarrhoea. This potentially fatal disorder can occur with any antibiotic, but is most common with the Lincosamides.

Common Drugs

Aminoglycosides: Amikacin, Gentamicin, Neomycin, Netilmicin, Streptomycin, Tobramycin.
Cephalosporins: Cefadroxil, Cefaclor, Cefalexin, Cefamandole, Cefazolin, Cefixime, Cefodizime, Cefoxitin, Cefodoxime, Cefradine, Ceftazidime.
Lincosamides: Clindamycin.

Anthelminthic Drugs

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Anthelminthic Drugs

Anthelminthics are drugs that are used to eliminate the many types of worm (helminthes) that can enter the body and live there as parasites, producing a general weakness in some cases and serious harm in others. The body may be host to many different worms. Most species spend part of their life cycle in another animal, and the infestation is often passed on to humans in food contaminated with the eggs or larvae. In some cases, such as hookworm, larvae enter the body through the skin. Larvae or adults may attach themselves to the intestinal wall and feed on the bowel contents; others feed off the intestinal blood supply, causing anemia. Worms can also infest the bloodstream or lodge in the muscles or internal organs.
Many people have worms at some time during their life, especially during childhood. Most infestations can be effectively eliminated with anthelminthic drugs.

Why They are Used

Most worms cause only mild symptoms and usually do not pose a serious threat to general health. Anthelminthic drugs are usually necessary, however, because the body's natural defenses against infection are not effective against most worm infestations. Certain types of infestation must always be treated since they can cause serious complications. In some cases, such as threadworm infestation, doctors may recommend

Anathematic treatment for the whole family to prevent reinfection. If worms have invaded tissues and formed cysts, they may have to be removed surgically. Laxatives are given with some anthelminthics to hasten expulsion of worms from the bowel. Other drugs may be prescribed to ease symptoms or to compensate for any blood loss or nutritional deficiency.

Types of Infestation

Threadworm (Enterobiasis): The most common worm infection, especially among young children. It lives in the intestine but travels to the anus at night to lay eggs, causing itching; scratching leaves eggs on the fingers, usually under the fingernails. Sucking the fingers or eating food with unwashed hands often transfers these eggs to the mouth. Keeping the nails short and good hygiene, including washing the hands after using the toilet and before each meal, and an early morning bath to remove the eggs, are important in eradication of the infection.

DRUGS

Drugs

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Drugs : Mebendazole, Piperazine.

All members of the household should be treated simultaneously.
Common roundworm (Ascariasis) : The most common worm infection worldwide. It is transmitted to humans in contaminated raw food or in soil. The worms are large, and they infect the intestine, which can be blocked by dense clusters of them.

Drugs : Levamisole, Mebendazole, Piperazine

Tropical Threadworm (Strongyloidiasis) : Occurs in the tropics and southern Europe. The larvae from contaminated soil penetrate the skin, pass into the lungs, and are swallowed into the gut.

Drugs : Albendazole, Thiabendazole, Ivermectin

Whipworm (Trichuriasis) : Mainly occurs in tropical areas as a result of eating contaminated raw vegetables. The worms infest the intestines.

Drug : Mebendazole.

Hookworm (Uncinariasis): Mainly found in tropical areas. The worm larvae penetrate the skin and pass via the lymphatic system and bloodstream to the lungs. They then travel up the airways, are swallowed and attach themselves to the intestinal wall, where they feed off the intestinal blood supply.

Drug : Mebendazole.

Pork roundworm (Trichinosis): Transmitted in infected undercooked pork. Initially, the worms lodge in the intestines, but larvae may invade muscle to form cysts that are often resistant to drug treatment and may require surgery.

Drugs : Mebendazole, Thiabendazole.

Toxocariasis (Visceral larva migrans): Usually occurs as a result of eating soil or eating with fingers contaminated with dog or cat faeces. The eggs hatch in the intestine and may travel to the lungs, liver, kidney, brain, and eyes. Treatment is not always effective.

Drugs : Mebendazole, Thiabendazole, Diethylcarbamazine.

Creeping eruption (Cutaneous larva migrans): Mainly occurs in tropical areas and coastal areas of the southeastern US as a result of skin contact with larvae from cat and dog faeces. Infestation is usually confined to the skin.

Drugs : Thiabendazole, Ivermectin, Albendazole

Filariasis (including Onchocerciasis and Loiasis): Occurs in tropical areas only. It may affect the lymphatic system, blood, eyes, and skin. Infection by this group of worms is spread by bites of insects that are carriers of worm larvae or eggs.

Drugs : Diethylcarbamazine, Ivermectin

Flukes Sheep liver fluke (Fascioliasis): Is indigenous to the UK. Infestation usually results from eating watercress grown in contaminated water. It mainly affects the liver and biliary tract. Other flukes only found abroad may infect the lungs, intestines, or blood.

Drug : Praziquantel

Tapeworms : Including beef, pork, fish, and dwarf tapeworms. Depending on the type, it may be carried by cattle, pigs, or fish and transmitted to humans in undercooked meat. Most types affect the intestine. Larvae of the pork tapeworm may form cysts in muscle and other tissues.

Drugs : Niclosamide, Praziquantel

Hydatid disease (Echinococciasis): The eggs are transmitted in dog faeces, and the larvae may form cysts over many years, commonly in the liver. Surgery is the usual treatment for cysts.

Drug : Albendazole.

Bilharzia (Schistosomiasis): Occurs in polluted water in tropical areas. The larvae may be swallowed or penetrate the skin. Once inside the body, they migrate to the liver; adult worms live in the bladder.

Drug : Praziquantel.

HOW DO THEY WORKS

How They Work

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How They Work

Anthelminthic drugs act in several ways. Many of them kill or paralyse the worms, which pass out of the body in the faeces. Others, which act systemically, are used to treat infection in the tissues.

Many anthelminthics are specific for particular worms, and the doctor must identify the worm before selecting the most appropriate treatment. Most of the common intestinal infestations are easily treated, often with only one or two doses of the drug. However, tissue infections may require more prolonged treatment.

How they affect you

Once the drug has eliminated the worms, symptoms caused by infestation rapidly disappear. Taken as a single dose or a short course, anthelminthics do not usually produce side effects. However, treatment can disturb the digestive system, causing abdominal pain, nausea, and vomiting.

Common Drugs

Albendazole, Diethylcarbamazine, Ivermectin, Levamisole, Mebendazole, Niclosamide, Piperazine, Praziquantel, Thiabendazole.

Infection and Infestation

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The human body provides a suitable environment for the growth of many types of micro-organisms, including bacteria, viruses, fungi, yeasts, and protozoa. It may also become the host for animal parasites such as insects, worms, and flukes.
Micro-organisms (microbes) exist all around us and can be transmitted from person to person in many ways: direct contact, inhalation of infected air, and consumption of contaminated food or water. Not all micro-organisms cause disease; many types of bacteria exist on the skin surface or in the bowel without causing ill effects, while others cannot live either in or on the body.
Normally the immune system protects the body from infection. Invading microbes are killed before they can multiply in sufficient numbers to cause serious disease.

Types of Infecting Organism

Some bacteria are aerobic — that is, they require oxygen — and therefore are more likely to infect surface areas such as the skin or respiratory tract. Others are anaerobic and multiply in oxygen-free surroundings such as the bowel or deep puncture wounds. Bacteria can cause symptoms of disease in two principal ways : first, by releasing toxins that harm body cells; second, by provoking an inflammatory response in the infected tissues.

Viruses are smaller than bacteria and consist simply of a core of genetic material surrounded by a protein coat. A virus can multiply only in a living cell by using the host tissue's replicating material.
Protozoa are single celled parasites and are slightly bigger than bacteria. Many protozoa live in the human intestine and are harmless. However, some types cause malaria, sleeping sickness and dysentery.

Infestations

Invasion by parasites that live on the body (such as lice) or in the body (such as tape worms) are known as infestation. Since the body lacks strong natural defenses against infestation, antiparasitic treatment is necessary. Infestation is often associated with tropical climates and poor standards of hygiene.

What Can Go Wrong

Infectious diseases occur when the body is invaded by microbes. This may be caused by the body having little or no natural immunity to the invading organism, or the number of invading microbes being too great for the body's immune system to overcome. Serious infections can occur when the immune system does not function properly, as in the malnourished or the elderly, or when a disease that weakens or destroys the immune system, as occurs in AIDS (acquired immune deficiency syndrome).

Infections (such as childhood infectious diseases or those with flu-like symptoms) can cause generalized illness, or they may affect a specific part of the body (as in wound infections). Some parts are more susceptible to infection than others—respiratory tract infections are relatively common, whereas bone and muscle infections are rare.

Some symptoms are the result of damage to body tissues by the infection, or by toxins released by the microbes. In other cases, they result from the body's defense mechanisms.
Most bacterial and viral infections cause fever; and bacterial infections may also cause pus formation and inflammation in the affected area.

WHY DRUGS ARE YOUSED

Why Drugs Are Used

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Why Drugs Are Used

Treatment of an infection is necessary only when the type or severity of symptoms shows that the immune system has not overcome the infection.

Bacterial infection can be treated with antibiotic or antibacterial drugs. Some of these drugs kill the infecting bacteria; others simply prevent them from multiplying.
Unnecessary use of antibiotics may result in the development of resistant bacteria.
Some antibiotics can be used to treat a broad range of infections, while others are effective against particular types of bacteria or in a certain part of the body. Antibiotics are most commonly given by mouth, or by injection in severe infections, but they may be applied topically for a local action.

Anti-viral drugs are used for severe viral infections that threaten body organs or survival. Anti-viral may be used in topical preparations, given by mouth, or administered in hospital by injection.

Other drugs used to fight infection include anti-protozoal drugs for protozoal infections such as malaria; anti-fungal drugs for infection by fungi and yeasts, including Candida (thrush); and anthelmintics to eradicate worm and fluke infestations. Infestation by skin parasites is usually treated with the topical application of insecticides.

Major Drug Groups

• Antibiotics and anti-bacterial drugs (including drugs for meningitis, drug treatment for Hansen's disease (Leprosy), and anti-tubercular drugs)
• Anti-viral drugs
• Vaccines and immunizations
• Anti-protozoal drugs (including anti-malarial drugs)
• Anti-fungal drugs
• Anthelminthic drugs

PREMATURITY

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CAUSE AND PREVENTION OF PREMATURITY

The incidents of prematurity are increasing day by day, throughout the world. Although for the most part the cause is unknown, there are a few obvious reasons for prematurity

INFANT VOMITING

Cervical incompetence

This probably is the only condition which is avoidable. But, until it has occurred once, there is no way of predicting and so preventing it. In this, the cervix is too weak to stay closed for the duration, generally giving way in the latter weeks of the second trimester. The incidence is higher in women who have had abortions.

Multiple pregnancies

Women who are carrying two or more babies are predisposed to premature birth, commonly occurring between 30 and 34 weeks.

Foetal abnormality

NAPPY RUSH

If an abnormality is detected by screening methods, such as ultrasound or amniocentesis. It may alert your doctor to the possibility of pre-term labour occurring.

Induction and caesarean section

Certain conditions, including pre-eclampsia and antepartum haemmorhage. Sometimes call for induction or caesarean, to save the lives of mother and/ or baby. Likewise, pre-existing maternal conditions, such as diabetes, epilepsy and kidney diseases, or serious illness may indicate intervention in the pregnancy.

INFANT COMPLICATIONS

Hydramnions

This rare condition, in which there is an excess of amniotic fluid, is most likely to occur where the uterus is carrying identical twins, although occasionally it is associated with diabetes,

Uterine abnormalities

Usually large fibroids muscle tumours in the uterine wall are the rare cause of pre-term labour. A congential abnormality in the size or shape of the uterus may prevent it from carrying a foetus for the full term.

Maternal age

Mother under the age of 20 years may have a predisposition to premature labour

Hereditary factors

If your mother delivered her baby prematurely, there is a slight chance that you will have inherited this trait.

INFANT TRUSH

Prevention of pre-term birth

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Where the reason is unknown, generally nothing can be done to prevent the start of premature labour. However, sometimes it can be halted if the baby is considered too young to survive.

If cervical incompetence caused a pre-term birth previously, a second may be avoided by the insertion of a cervical stitch at about 14 weeks gestation, to be removed a couple of weeks before expected delivery date or when labour starts, whichever happens first.

Drugs can be given to lower blood pressure, obviating the need for induction. However, once labour has started, intervention is usually not undertaken.

If premature labour begins for no apparent reason, a woman will be admitted to hospital where drugs may be administered to stop contraction temporarily. During this respite, the mother will be treated with a drug which will cross the placenta and work on developing the baby’s lungs.

When a woman has had a previous pre-term labour, she may be advised to abstain from intercourse for the final two months. This is because prostaglandins in semen are believed to trigger contractions.

Some doctors suggest that patients expecting multiple birth take to their beds as a safeguard from about 30 to 34 weeks of for the rest of their pregnancy.

BABY MASSAGE AND BATHING

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Massage is a marvelous way to enhance the natural bonding between the mother and the new born baby as touch is a natural way to establish contact between both. All babies instantly respond to cuddling and caressing. You must have noticed how a baby tightly curls its hands and feet when touched. In the case of babies, no essential oil is used, but only light vegetable oil, like sweet almond, sunflower and baby oil or olive oil, are used.

Advantages and significant points about massage

Unless Okayed by an aroma-therapist, no essential oil should be added to massage oil.

Do not expose the baby’s tender skin to strong or biting cold, cold winds and snow fall.

Warm your hands before the massage. It is still better if oil is also slightly warmed.

Gently stroke baby’s tender body and do not exert any pressure.

Do not massage when the baby is weeping or is ill or even when he resists any type of touch.

Room should be warm, quiet and without any draughts.

Massage relieves babies of colic, alleviates wind, improves digestion, cures coughs and colds etc.

Keep movements gently and smooth flowing.

Massage builds up general resistance of body.

Do not apply any oil on the baby’s eyes and face.

Do not massage immediately before, during or after a feed.

Make sure that massage helps your baby to feel lighter and better and that no discomfort or agitation is caused to her, if the baby weeps or cries during the massage, it means the massage area is either painful or too sensitive. In such a situation stop massaging. You may restart when the baby feels comfortable.

Procedure

Take a large sized towel and spread half portion on your legs or lap and other half under the baby’s back out. ensure there are no wrinkles or folds. Lay the baby on its back, or lay her in the position that makes her feel comfortable. Apply some oil, about 5 ml, to your palms and then apply gently and softly over the frontal portion of the body. Ensure that your hands are warm, the room is also warm and quiet and also there are no draughts. You can massage baby’s body either before the bath or after the bath. But the ideal time is said to be one hour before the bath.

Frontal massage of the baby

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· Gently and slowly apply a little oil on the front of the body, from shoulder to feet, but avoid the face. Now lightly stroke down the chest and abdomen using the tips of your fingers. By your light and delightful strokes, you can calm your baby’s body at any time. Remember, the touch of hands on the body will cheer up the baby and will show her happiness through gentle laughter of innocent smiles. Let the legs be kept in a straight line but if she curls them up, let her do so. It is a sign that she is enjoying the movements.
Keep the pressure very light. Move both your hands smoothly in circular strokes over the abdomen, working up the baby’s right side across and down the left side. Keep your movements continuous by lifting your left hand when your arms across. Now repeat such circular movement many a time

Baby massage Left side

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Left side

· If your baby lets you, gently stretch out both the arms to the sides, spreading hands and fingers. Then gently squeeze out along the arms and, with light and circular thumb movements massage the palms and wrist before you finish your movements, do not forget to stretch out each finger with a light pull.

Now move on to legs and feet, but work out only on and leg at a time. Supporting baby’s leg with both your hands, gently squeeze and release the fleshy part of his thigh. Thereafter, support the leg with one hand and stroke the leg, from knee to the thigh and back down again.

Babay massage Right side

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Right side

· Now move your supporting hand behind the ankle. Then gently smooth palm of your hand over top of baby’s foot—that is from toe to ankle and back again. As you reach the toes, stretch each toe very gently, without exerting any force/pressure. The same step should be repeated 4-5 times on the baby’s other leg also.

Baby’s back side massage

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· Now turn the baby over onto the front. Then start to stroke her entire back side so that applied oil is evenly distributed to the whole of the back side. After applying the oil evenly over her back side, work up your strokes around baby’s side also and then up the legs, back and over the arms. If you massage her back side, as suggested. It will have a very calming impact on the baby’s spinal nerves, because soothing effect always cheers the baby up

· To stimulate the blood circulation, gently knead and squeeze the buttocks. For this you should make a loose fist and rotate over the baby’s buttocks in circular movements.

Now gently stroke up one side of the back to the shoulders and down again. Repeat the suggested movements on the other side of the back also.

Now bring both your hand’s around the sides of your baby and , then using your thumbs, massage gently up the back to the base of the neck. You should also massage baby’s shoulders with the help of thumbs.

Finally, before you finish up, repeat the feather strokes that were used at the beginning of the massage, by working all over the back, from neck to buttocks.

Bathing the baby

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Bath time gives your baby the opportunity to enjoy herself by kicking and splashing in the water. It should be happy time for mother and baby and if you are well prepared, it will be a relaxing time.

Most babies are bathed every day but if you are rushing or you are still not very confident with your newborn baby, topping and tailing can done instead of daily bathing.

To do this, wash the baby’s bottom from front to back with cotton wool. Swab her eyes. Make sure you use different cotton wool swabs for each eye otherwise infections can spread from one to the other. Topping and tailing is also part of the bathing routine.

Some mother prefer to soap up their babies before placing them in the bath. When you place her in the bath cradle your arm and support her head on your forearm, use your free hand to splash water and play with her.

Tickle some water over her head and wash her head gently with soap or baby shampoo. Use gentle circular motion to wash her scalp and dry head by stroking it with towel.

Wash your babies arms underarms feat and allow her to enjoy her bathing for some times. Rinse the soap off and gently lift her out of the bath and pat her dry with towel.

Dry all creases before redressing your baby.

When you bathe or change the nappy of the new born baby, always clean the umbilical cord with a cotton bud. The more often you clean the cord with methylated spirits, the sooner it will fall off.

The kitchen sink, a hand basin or the laundry tub can be substitute for a baby bath.

Choosing the right time for bathing your baby influences how much she will enjoy the water. Hungry babies usually object to bath because, obviously, they would prefer a bath may regurgitate some of their food during their bath, so, feed her half an hour before bathing her.

BABY’S CRY AND SLEEP

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Sleep problem are the most common and disturbing in a baby’s first year of life. The overtired baby or infant can be almost impossible to manage in the daytime and the frequent waker at night can put a strain on family relationships.

There are two types of sleep: Active and Passive. Active sleep is associated with body movements, muscle jerking eye movements and dreaming. Contrastingly, passive sleep is deep and restful, without body movement or dreams.

These two types of sleep occur together in cycle which last about 50 minutes at birth 75 minutes by 4 years of age. This is the reason so many babies wake or becomes very restless an hour after being put to bed.

The new born sleeps about 17 to 20 hours a day. The sleep periods usually don’t last more than five hours and wakeful period not more than two or three hours. By three months, 70 percent of babies sleep about eight hours a night. Hunger and feeding are closely related to sleep in the early weeks and many babies wake screaming with hunger. Once the baby is 6 or 8 weeks old, hunger is less of a driving force and your baby will begin to wake before an occasional feed and not automatically expect food. MORE

Baby cry and sleep 4

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By 4 months, hunger rarely dictates the day sleep patterns. By this time nearly all babies will wait for food; hunger will not produce screaming. But temper may add the noise factor.

If a baby is over stimulated, overtired and unrelaxed she will fight being put down to sleep and will wake frequently. In the early months, a baby will not sleep unless she is fed sufficiently and then allowed to pass happily into sleep. Any pressure from the parents reflects on the baby; she will object, become sleepless and cry.

By 6 to 8 weeks some babies required a play period after feeds before they will sleep. This required the parents to recognize the baby’s desire for sleep, which may not be an easy thing to do. When the baby is 3 or 4 months old, the afternoon sleep period will begin to shorten, for most babies of about 3 months, the number of day sleeps is generally related to the number of feeds. The change from two to one day sleep depends on the individual child and usually occurs soon after the first birthday.

The total cessation of day sleeps also occurs at individual ages and can occur anywhere between 18 months and 5 years of age. For the poor sleeper, especially at 3 to 4 months old it may be important to establish a ritual about going to sleep. It is essential this ritual is established in the early weeks and during the first year.

A special cuddling position, a lullaby, being put down to sleep in a particular position, music playing near the baby’s head and knocking, patting or stroking may be part of ritual. Sucking and rocking during the first year almost always improves sleep and so too does music or pulsating sound. MORE

Baby cry and sleep 3

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Prematurely born babies have unsettled sleep patterns compared to normal term babies and can take longer for them to adopt sleep patterns which are satisfactory to parents. You can indicate to your child when she should go to sleep but it is impossible to make him sleep unless he wants so.

Tiredness and fatigue can build up to a situation of continued over-tiredness. All parents at some time experience the overtired baby who cannot be cuddled, who screams, who wont be soothed and wont feed. Tiredness can also be important in producing a colicky baby who cries continuously.

The 9 month year old baby sleeps only one hour a day may be too over tired to stop her perpetual motion, which can become controllable.

Constant crying and sleeplessness could also be caused by a physical disorder. Discomfort or pain can be caused by a wet nappy, an open pin or wind. Wind occurs because the baby swallows air as she feeds. Burping can help bring the wind up. This can be done by holding the baby with her head on your shoulder and gently rubbing the back.

Babies also cry when they don’t conserve heat well and may be cold. The over-anxious mother who goes into the baby’s room constantly to see if she is all right is disturbing her sleep. The baby is almost always aware of the mother’s presence and may wake up and be unable to go back to sleep.

Night waking can begin again after 6 months with teething or no obvious reason. Parents can often pat the child back to mobility, will wake at night with talking and singing but this only becomes a problem if the parents join the baby and she expects them to come when she calls. Disturbed sleep patterns can also be induced by the new surroundings of holidays or by the anxiety of a maternal separation.

If your baby wakes frequently, let her cry it out so she learns night time is for sleeping. This does not apply to babies who are not mobile and it does not work for those parents who can’t stand to hear their infants screaming.

BABY GROWTH PATTERN

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FIRST MONTH:

Can be breast-fed or bottle-fed, sleeps most of the time and weeps when hungry, has to pass urine/stools, keep first closed.

SECOND MONTH:

Smiles when looked up; can lie on stomach and raise neck also.

THIRD MONTH:

Smiles more and it looks very attractive

FOURTH MONTH:

Turns head to the directions from where sound is coming; smiles when looked at or when called create noises.

FIFTH MONTH:

Tries to catch toys or colorful objects and is attracted by dark colours. Especially red, green, yellow and blue.

SIXTH MONTH:

starts cutting lower teeth(two), raises head from the pillow, laughs and smiles, is able to sit (but only when support is provided), can itself turns to another side and holds feeding bottle.

SEVENTH MONTH:

Tries to put all things into the mouth, watching and hears with great interest when others talk, can sit for a few minutes without support. If held and supported by arms/hands, tries to get up and dance/jump, can take water or milk with a cup.

EIGHTH MONTH:

starts speaking ‘Ma-Ma’ ‘Pa-Pa’, ‘Da-Da’etc. cuts two (frontal) upper teeth.

NINTH TO TWELVE MONTH:

Can sit without any support, starts toddling, can stand with some support, laughs heartily and feels happy with child-like response, when fondled or called. Some kids try to walk also, can point to some object with a point finger but some of them fall while trying to walk. At the age of one, some children learn to walk by them or with support. Some children start standing and walking even without any support.

12-15 MONTH:

Can get up and start to walk, learns to play with toys, starts speaking words like ‘Dada’Mama’Papa’ etc , starts to understand, learns to hold spoon and tries to eat also.

18 MONTHS:

An 18-month year old child can walk, go up and down the stairs, can throw and collect a ball, sit in the chair without any support. Starts to imitate her mother and other elders, does not resist in changing cloths, can herself remove her socks, attains control over urine and stools but may pass urine at night (Enuresis which is quite common in winter)

24 MONTH:

A two year old child can run, can herself get into chair, can call her mother and express her demands , watch her toys and other playing with interest and attention, intently listens to voices, can ascend stairs without anybody’s support.

The above progressive stages are merely indicators to general stage of a child development. Some children cut their teeth quite early or late, some learns to walk while others do not respond. Patterns also vary from child to child.

Diet for the Child

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Following suggestions are given simply as a guide to infantile diet but requirement of each infant/child are different, hence there is no need to firmly stick to the given pattern.

1st Month: Only Milk can be given to the baby.

2nd Month: Milk, a teaspoon of sweet lime/orange juice, or curd.

3rd Month: Rice and curd, milk, soup of pulses, crushed banana, juice of pomegranate or apple. But do not mix up juices of two fruit, milk.

4th and 5th Month: Wheat dishes cooked in dhal, green cooked vegetables can be given.

6th Month: Thin gruel of khichri, kheer of sooji or saboodana. Milk 2-3 times.

7th and 8th Month: Chapatti mashed in dal, soup of vegetables, curd, paneer , milk

NOTE

During summer give lemon juice, honey or sugar mixed water, to which some salt also may be added. You may also give lassi, curd.

Height of infant

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Height is generally dependent on standard of food, opportunity for mental and physical growth, physical activity or games. It is believed that height does not grow after 18-20 years. Generally, height must commensurate with weight and age. Hormonal secretions play a major role in containing or increasing of height. Following data will simply give a general view on height (From birth to 2nd year).

Do not get anxious if your child does not measure up to the indications given above. Some children grow rapidly, while the others may grow gradually or in phases.

Weight of a Child

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Weight of a child decreases after birth but again starts increasing after 10-20 days, when weight again measures up to original weight(what was actual at the time of birth). A child gains about 28 grams (about one ounce) per day during the first three months. As a general rule, a child’s weight almost doubles between 5-6 months, but at the end of one year his weight is thrice the weight which was actually at his birth time. Weight gain is faster and quicker in male children than the female children. Weight of each child should be measured after every fortnight during the first 3 months and thereafter once in each month. Growth pattern and weight gain/loss depends on many mental, physical factors which vary from one child to another. Following table will give an average of weight.

5% weight, when compared to the above table, should be taken as normal but any deviation, on higher or lower side should also not cause any anxiety. If a child is quite active, and is also mentally sound and alert and has no physical problem, there should be no cause for undue anxiety, as growth pattern differs in each child. Some healthy-looking children have been seen to be less mentally alert and vice versa. But a close watch needs to be kept on sudden weight loss or gain. If there are abnormal growths, consult your doctor and follow his advice.

DENTAL DEVELOPMENT IN BABY

2007-03-24T01:30:00.002-07:00

A common source of parental concern is regarding the teething of their child. They are worried as to when the child will cut her first tooth. As it is true with all types of development, there is no fixed or ideal time when the first tooth should erupt. In some children, it may erupt as 5 month, while in others, it may not erupt up to the age of 1 year. there is nothing wrong wit your child if her tooth doesn’t come out by 1 year. Most of the parents think that their child is deficient in calcium and/or vitamin-D, which may be true, but only in a few cases, in majority of cases, it is just a normal variant and hence no intervention is required.

Parents also attribute a lot of things to teething. Every complaint at the time of teething is attributed to it. Thus if the child has fever, irritability, diarrhea etc, the parents usually blame it on teething. Problems like fever, vomiting etc. cannot be attributed to teething. It is sure that during the teething phase, there is irritation on the gums of the child and to reduce it, she puts foreign objects in her mouth and chew on them. These foreign objects may be an indirect source of infection in the child and cause diarrhea.

There are two types of teeth: deciduous or milk teeth and the permanent teeth. There are 20 milk teeth and 32 permanent teeth. The milk teeth start erupting from the age of 5 months onwards and first tooth to come is usually the lower central incisor.

A simple way of remember the eruption of milk teeth is that by 6 months there are 0 teeth; by 12 months, 6 teeth; by 18 months, 12 teeth, and by 24 months, 16 teeth. The last 4 teeth make their appearance by 2 and one by 2 – 3 years.

COMPLICLATIONS DURING TEETHING

2007-03-24T01:30:00.001-07:00

It is repeated that headache, fever and colic cause abnormal discomfort in the child, hence control these symptoms first. But if diarrhea also persists and frequency of stools passed is too great, give Electral power (ORS) dissolved in (boiled and then cooled down) water so that sodium-glucose-water levels stay within normal limits. As for Allopathic drugs to control diarrhea, consult a physician for proper medicine, dosage and frequency--- above all the side-effects--- which are many. If Electral power is not handy, mix 2 teaspoons of sugar, a pinch of salt in 1 liter of boiled and cooled water and feed to the infant as frequently as needed.

Ayurvedic physicians recommend massage of honey and borax (Suhaga) powder---500 mg of suhaga to 2 tsp of honey. This compound, if given too quickly or in large quantity, will spill over to stomach and cause loose motion. But when the child is having constipation, this compound is said to remove constipation.

In summer, the child should be given plenty of oral fluids and protected from heat, hot winds and exposure. In winter, keep the feet, abdomen and chest fully covered with woolen garments and do not let her be exposed to cold winds. All these measures are meant to be observed in a routine manner but, when the child is cutting teeth, her danger of exposure to changing thermic conditions should be fully guarded.

SOME COMMON COMPLICATIONS OF INFANTS

2007-03-24T01:29:00.001-07:00

A mother should be fully conversant with some of the disorders, detailed hereunder and take preventive or corrective steps so that the disorders do not assume serious proportions.

INFANT HICCOUGH/HICCUP

Some children, through not all of them, develop hiccoughs after taking milk and it is natural and does not constitute a disease. But if hiccough last for longer span and continue unabated, it does exhaust the little one, especially when breathing gets interrupted; and in this condition a doctor must be consulted for medical advice. Generally such hiccups subside automatically after a few minutes when no treatment is called for. According to some experts, hiccough is a healthy sigh for a baby, and the same disappears if some lukewarm water is given to the infant.

INFANT WEEPING

2007-03-24T01:28:00.002-07:00

It is no disease but merely a pointer to some discomfort felt by the baby like

Pain in the stomach

Locking up of wind in the abdomen and gurgling sound

Constipation

Redness and swelling of anus due to acidity

When bladder is empty but had not been voided

Fever or pain in the body

Nappy rash

Cold bed or exposure to cold or when his cloths get saturated with stool or urine

Pain in the ear

In some cases the child may weep even without any visible and/ or apparent cause, but it is height of imprudence to attribute every weep of child as a demand for feeding. If a child draws up her legs and does not bear her abdomen to be touched with hand, even when mild pressure is applied abdomen which might bloat. Some children are relieved after the passage of wind. But colic pain generally disappears by the 3rd month.

The baby will cry if urine or stool is not passed. This situation can be easily countered by passage of urine/stool. If the stools are hard, she will have pain while passing stools and there may be some redness also in and around the anus. Give some quantity of water (boiled and then cooled)

If there is a pain in the ear the child will try to touch her ear. Pain in ear can also be due to some injury or blockage of nose or wax accumulation. Do not touch the ear. Rather have the child examined by a specialist.

Baby’s nappies should be changed as soon they become spoiled by sweat, stool or urine. When it is winter, the child will cry more due to cold and wet nappy. Even otherwise, if a child lies in wet clothes, he will develop itching, rashes and pain.

INFANT NASAL BLOCKADE AND COUGH

2007-03-24T01:28:00.001-07:00

Blockade of either or both the nasal passage cause breathing problems, especially when the child has breathe through her mouth. If there is cough also, it will make even mouth-breathing difficult. If cough is stingy and tenacious, she won’t be able to cough up the sputum and, thus, feel choked. When all these problems combine the child feels gagged, suffocated and tired. To cure these complications, insert a drop of saline water in each nostril or use Nasivion paediatric nasal drop. Give 2.5 ml of Tyxylax syrup after an interval of 4-6 hours. Vicks vaporub or steam inhalation will facilitate passage of mucus by liquefying the phlegm. If the child vomits while coughing, exhausts and faint, the body turns blue, it points to whooping cough/bronchitis/broncho-pneumonia which all must be treated by a child specialist.

VOMITING OF MILK BY INFANT

2007-03-24T01:27:00.002-07:00

Almost all the infants vomit 2-3 spoon quantity of ingested milk and there is nothing unusual in it. Vomiting may be caused by feeding with milk in excess of the required quantity, putting pressure on his stomach, moving him to and fro or letting him lie on his stomach or keeping his head low. If such undesirable situation is not allowed to occur, no vomiting may occur. If the child has pain irritation in his throat and coughs frequently, even then he may vomit. If the child could belch, no such vomiting can occur. Uncurdled milk is simply a regurgitation and flows from side(s) of the mouth. But if there is yellow or greenish vomit, consult a doctor. But repeated and frequent vomiting is a serious complication which must be investigated by a specialist. In a few children, the pyloric orifice is at fault which may be the cause of vomiting. Surgery should be resorted to as an ultimate option.

INFANT’S NAPPY RUSH

2007-03-24T01:27:00.001-07:00

The term applies to red skin which occurs due to the nappy being too tight or saturated with urine. Add some boric acid, (say 500 mg to half tumbler of water) to water and wash the skin and then dry up with a soft towel or cloth. You may apply some baby cream or Vaseline. In summer, the child often sweats a lot--- in that condition also do as is advised above. Never tie a wet nappy to the child, as it may cause itching, irritation and other skin diseases.

INFANT’S SUMMER RASHES/ERUPTIONS

2007-03-24T01:26:00.002-07:00

During summer, small pimples appear on face, neck, shoulders, skin folds which can be treated by keeping the child under moderate to cool temperature, with minimum clothes on body. Apply Johnson’s baby powder over the whole body, but make sure the powder does not fall into eyes, ears and nostrils. Do not use powder in excess as it may cause dryness to the skin, nor apply any other oil or ointment or cream. Simple hygiene and keeping the infant’s skin dry will keep away many skin problems

INFANT’S TRUSH

2007-03-24T01:26:00.001-07:00

It is a fungus diseases which appears in the mouth of infants. There could be white spots inside the cheeks, on the tongue, gums or soft palate due to which the child has pain feels restless and gives up milk. It is caused by dirty and unwashed nipple and feedings bottle. Consult a paediatrician for treatment.

It is a fungus diseases which appears in the mouth of infants. There could be white spots inside the cheeks, on the tongue, gums or soft palate due to which the child has pain feels restless and gives up milk. It is caused by dirty and unwashed nipple and feedings bottle. Consult a paediatrician for treatment.

INFANT’S CRADLE CAP

2007-03-24T01:25:00.000-07:00

Sometimes white, grayish or light brownish crust appears on the head which is known as cradle cap. Massage the head with baby oil or olive oil so as to soften the crust which will get removed when the child’s head is shampooed. If no relief is noticed, consult your doctor.

Sometimes white, grayish or light brownish crust appears on the head which is known as cradle cap. Massage the head with baby oil or olive oil so as to soften the crust which will get removed when the child’s head is shampooed. If no relief is noticed, consult your doctor.

INFANT’S WATERING FROM EYES

2007-03-24T01:24:00.000-07:00

A thin tube permeates from eyes to nose which, at the time of birth--- remains either blocked or undeveloped due to which water flows from one or both the eyes. This tube is known as ‘lachrymal’ or ‘tear duct’. Though there is no harm to vision it disturbs the child and her parents. Generally this duct opens of its own within 6-9 months. At time, infection may also be the cause when some mucus may appear, thus agglutinating the eyelids. Wash the eyes with lukewarm water and put a drop of soframycin eye drops (diluted) in each eye. It is better to consult a doctor to ensure if there is some other complication or not.

SWELLING OF NIPPLES

2007-03-24T01:23:00.000-07:00

Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.

Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.

Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.

SOME COMPLICATED INFANT DISORDERS

2007-03-24T01:22:00.002-07:00

Here we have discussed those disorders which should be noticed by parents and should be treated properly by a physician.

WHEEZING

Wheezing is a sound created during respiration and is pointer to some infection or/and obstruction in the nasal passage, chest and lungs. There is a feeling of choking and dyspnoea (breathlessness), tightness of chest—especially on lying down, more so in the morning and at night, use nebulisers or nasal drops to clean the respiratory tract. In some cases antibiotics like Ampicillin, Amoxycilline etc may be required but dosage must be guided and determined by a doctor and never of your own.

In any case, another attack should be warded off. Spasms may be caused while dusting, cleaning carpets, furniture’s, walls and floor, by odours arising from the kitchen, by gas leakage, smoke/smoking. Complaints is more commonly found in children, and if they are allergic to some triggers, they have to be taken care of properly

MARASMUS

2007-03-24T01:22:00.001-07:00

This is a severe wasting disease of infant when the body weight falls below ¾th of that of expected age. The skin shrivels, the infant gives an aged look and looks much older, is apathetic and paled and body temperature remains much below normal.

Causes

Wrong feeding and malnutrition

Protein deficiency

Repeated vomiting and diarrhea

Metabolic disorders

Severe disease of heart, kidneys, lungs, or urinary passage

Some chronic parasitic or bacterial disease

Lack of breast feed, arising due to maternal rejection of an infant or the child may herself refuse to take breast milk

Actual treatment can be started only the underlying cause has been discerned or located, but, in all cases irrespective of the cause, start giving fluids and nourishment, apart from good nursing and care. If the disease continues and lingers on for a longer period, without being detected and treated, it may prove fatal.

RICKETS

2007-03-24T01:21:00.001-07:00

In this condition, a child’s bones do not harden and are ill/malformed due to deficiency of Vitamin-D that helps Calcium salts to get deposited in the bones so that the bones could become rigid. Lack of Calcium absorption results in softer bones which bend and gets deshaped. Renal rickets surfaces due to impaired rental function---the bones are malformed due to excretion of bone-forming minerals in the urine. If this condition occurs in adults, it is called Osteomyelitis. Best and cheapest source of Vitamin-D is sunshine which, if not available, may be compensated through related Vitamin. Consult a doctor about actual treatment, dosage, frequency and duration of medication. Mothers who are deprived of sunlight are also victims of these diseases (called Osteomyelitis)

POLIO OR INFANTILE PARALYSIS (Poliomyelitis)

2007-03-24T01:20:00.000-07:00

This situation due to an infection virus (diseases) that affects the central nervous system. The virus is excreted in the fasces of an infected person, thus the disease is very common where there is extremely poor sanitation. But breakout of disease in epidemic form often occurs even where there are hygienic conditions, where people have not been immunized against the disease during infancy. Symptoms commence 7-12 days after infection but, in majority of cases paralysis may not occur. There should be no degree of confusion as to the type of paralysis which explained as follows:

Abortive Poliomyelitis

Only intestines and throat are infected and general symptoms are influenza or stomach upset.

Non-paralytic Poliomyelitis

In this type, symptoms are accompanied by stiffness of muscles—in particular, muscles of neck and back.

Paralytic Poliomyelitis

It is not very common.

Bulbar Palsy

Here breathing is affected due to involvement of muscles of respiratory system.
Symptoms of milder form of disease are followed by weakness and ultimately paralysis of the muscles. Best form of treatment is by giving Polio drops to the infant in earlier months. Once the infection sets in, the symptoms cannot be treated or reversed expect by resorting to supportive methods.

PNEUMONIA/BRONCHO-PNEUMOIA/PNEUMONITIS

2007-03-24T01:19:00.000-07:00

This disease is caused by bacteria due to which there is inflammation of the lung. Air sacs fill up with pus so that air is excluded and the kung becomes solid. The symptoms depend upon the amount of lung involved and the virulence of bacteria but most common symptom include pain in chest and cough, apart from that there are shadows in X-ray (of chest). Broncho-pneumonia is the commonest form which is quite a serious type. In lobar pneumonia, whole lobes of either or both the lungs are affected due to strains of streptococcus pneumonia but hypostatic pneumonia develops in dependent parts of the lung in those who are otherwise ill, chilled or immobilized.

Whatever be the type of infection, no case should be handled by a layman due to its serious complication. These bacteria that cause pneumonia or any type of it are sensitive to antibiotics and timely treatment can ensure quicker recovery.

DIPHTHEIA

2007-03-24T01:17:00.000-07:00

It is an acute, highly contagious infection, caused by the bacteria coryne bacterium diphtheria, generally affecting the throat but occasionally other mucus membranes and the skin. The disease is spread by direct contact with a patient or a carrier or by contaminated food. After an incubation period sore throat, weakness, and mild fever develop. Later a soft grey membrane forms across the throat, constricting the air passage and causing difficulty in breathing and swallowing. A tracheostomy may be necessary. Bacteria multiply in that infected area and release a toxin into the blood stream, which damage heart and nerves. Death from heart failure or general collapse can follow within four days but disease, complete recovery required prolonged bed rest. An effective immunization programmer has now made diphtheria rare.

MEASLES (Rubella, morbilli)

2007-03-24T01:16:00.000-07:00

It is said that measles appear at the infancy stage but, in some cases, it may surface in elderly people also. It is a highly infectious disease that tends to appear in epidemics every 2-3 years and mainly affect children.

Progress of the disease is as follows

After 7-14 days of incubation period, symptoms like cold, followed by a high fever develop, along with appearance of small red spots on the inner side of the mouth.

On the 3rd to 5th day, a slightly elevated pink rash develops---first of all behind the ears, then on the face and other parts, and it lasts for 3-5 days.

The patient continues to remain infectious throughout this period.

In majority of cases symptoms disappear and subside but the patient becomes susceptible to infection of the middle ear and pneumonia.

Complete recovery is generally seen within 2-4 weeks.

The child must be immunized by vaccination. Unless and until the patient does not have pneumonia, there is hardly any danger to life, but more complicated cause need medical care and proper treatment, through in general progression of the disease; hardly any medicine is called for. But, other children and attendants should be careful about spread of infection. The children must be kept away from the ailing patient.

MUMPS (Infectious Parotids)

2007-03-24T01:15:00.000-07:00

It is a common virus infection that affect children mainly between 5-15 years of age, through some adults have also been seen to be suffering from this infection but. It is quite a rare occurrence. Onset and progress of disease is as follows.

· Symptom appears 2-3 weeks after the exposure.

· Fever, headache, vomiting may be the fore running symptoms which might precede a typical swelling of the parotid salivary glands.

· Gland on one side of the face, swells up days before the other but, at times, only one side gets affected.

· Almost all the symptoms disappear within 3-5 days but the patient remains infectious until swelling has fully disappeared.

· The infection may even spread to other salivary glands and from there to brain, testicles and pancreas.

· In adult males,, mumps may even cause sterility and render them impotent.

In fact, mumps may not appear if the infant was immunized at the infancy stage. If, in spite of immunization, mumps appear, their period of invasion and intensity is much less, and no medicine is called for, expect control of high fever efforts should be made to see that the infection does not spread to other vestal organ. Paediatric drops of paracetamol, given 6 hourly, will control fever and pain but no medicine is called for, except control of high fever.

MENINGITIS

2007-03-24T01:13:00.000-07:00

Meningitis is the inflammation of the meninges due to infection by bacteria or viruses which are responsible for TB, syphilis and/or pneumonia.

Symptoms

Intense headache and fever

Loss of appetite

Intolerance to sound and light

Rigidity of muscles---especially of the neck

Convulsion

If meningitis is caused by bacteria, it can be treated with sulphonamides or antibiotics, whereas viral meningitis does not respond to treatment/drugs. In the latter condition, complete rest-in-bed, quiet and darkness is only treatment. This condition may be complicated by cerebrospinal fever, for which read the following information. Both the conditions are quite serious and must be treated in a hospital only and not at any other places nor by a non-medico or a layman.

CEREBROSPINAL FEVER

2007-03-24T01:12:00.000-07:00

It is also called Spotted fever and is a type of meningitis, caused by the bacterium Neisseria meningitides. The bacteria are transmitted by sneezing and coughing. The disease occurs mostly in overcrowded areas and children are mainly the victims than the adults.

After an incubation period of 3-5 days, symptoms develop and appear suddenly when there is fever, severe headache; stiffness in the neck’s muscle and rash of small red spots appears on the trunk. Quite often the ailment enters a chronic stage when blindness, deafness and mental deterioration of serious nature may develop. Treatment, if given in time, is possible with sulphonamide or penicillin drugs but otherwise death may occur. This disease should also be treated in a hospital under the care and supervision of qualified doctors and staff but never by a layman.

WHOOPING COUGH (Pertussis)

2007-03-24T01:11:00.002-07:00

Whooping cough is a well known disease that occurs, in most cases, during childhood. If a child has already been given DTP vaccine (which is given in a combined form), such an immunization will reduce the incidence and severity of attack and if the attack comes, its duration and severity/intensity would be far less. It is believed that an attack also usually confers immunity.

Symptomatic Causes and progress of disease

It is contagious disease caused by the infection of mucus membranes by the bacterium Hemophilus pertussis

It primarily affects children, though older children or even adults could also be the victims.

After an incubation period of 1-2 weeks, mild fever, cough, catarrh and loss of appetite develop and persist for 1-2 weeks.

Cough becomes paroxysmal when short bouts of cough follow in an almost quick succession, and followed by involuntary drawing in of the breath which produce the whooping sound.

After each paroxysm there is vomiting, bleeding from mouth and nose. This state lasts for about 2 weeks and the child remains infectious throughout.

The foregoing stage lasts for 2-3 weeks after which symptoms starts declining but cough may persist for another few weeks.

During an attack, the child may even turn blue which indicates lack of oxygen and poor circulation.

Though whooping cough is seldom serious and generally poses no danger to life, but the child remains exposed and susceptible to T.B. and pneumonia which complication can create further health problems. As soon as above-mentioned initial symptoms are noticed, consult a doctor for prompt and requisite treatment but never administer any drug or home remedy of your own.

MALARIA

2007-03-24T01:11:00.001-07:00

It is claimed that malaria, like small pox, has also been eradicated but there are still confirmed and declared Malaria zones or belts in our country where recurrence of malaria still exists.

Malaria infection is caused by presence of the parasite known as protozoa of the genus plasmodium transmitted into the red blood cells. Malaria disease is transmitted by the female mosquito called anopheles. Malaria is mainly confined to subtropical and tropical zone/areas.

Parasites in the blood of an infected person are taken into the stomach of the mosquito as it feeds. Here they multiply and then invade the salivary glands.

In order to ensure whether one is suffering from malaria or not, required blood test is called for. But if the patient is already loaded with quinine, the clinical investigation may reveal a negative result. Dosage, safeguards and duration and frequency of medicine should be under expert guidance of a doctor only.