Wednesday, September 29, 2004

Breast feeding cuts Asthma Risk

There is more good news for parents that have been exclusively breastfeeding, a recent published by AAAAI clearly shows that Babies who are exclusively breast-fed for their first four months of life have a reduced risk of asthma during their first four years. Researchers analyzed data about 4,089 infants and found that asthma rate was 6.4 percent among 4-year-old children who'd been exclusively breast-fed for the first four months or longer, compared with 9.1 percent of those who'd been exclusively breast-fed for less than four months.The important thing to note is that these kids had been given NOTHING but breast feed for the first 4 months. The study also found that continued partial breast-feeding after exclusive breast-feeding also helped protect children against asthma.
Given the trend of increasing asthma in Indian kids, this study shows a simple way to try and reduce this epidemic disease.
SOURCE: American Academy of Allergy, Asthma and Immunology, news release, Sept. 16, 2004

Tuesday, September 28, 2004

The FLU vaccine: What is it?

Does your child have ASTHMA (or whatever you prefer to call it: weak chest, chest allergy, bronchitis, allergic bronchitis etc.)?
Does he/she have recurrent colds, coughs etc. in the winters?
Does he/she have a hole in the heart?
Then the FLU vaccine is probably RIGHT for your kid.
What is the flu?
It is a cold like viral illness with more fever, bodyaches, and less running nose. If severe this can lead to pneumonia like illness.
One of the commonest reasons why young children (less than 2 years) get admitted in India is Pneumonia. It is interesting to find that many of these pneumonia are viral in origin (meaning do not respond to antibiotics), and it is estimated that almost 25-50 % of these may be due to the Influenza virus.
Who should get the Flu shot (vaccine)?
As per the US CDC recommendations 2004, ALL CHILDREN between 6 months to 2 years should be given the flu shot!
Adults over the age of 65 years (& probably even above 50 years as well), and those with chronic heart or chest problems like asthma should also get this vaccine.
What will the vaccine do?
In simple terms, it will reduce your child's chances of getting cold-like illnesses, and may reduce the chances of needing hospitalisation due to respiratory problems. Children with asthma and heart diseases are likely to benefit even more.
How much does the Flu vaccine cost?
In India till recently only a single brand of this vaccine was available (VAXIGRIP by Aventis), however this year GSK have come up with a competing brand (FLUARIX) and thus the prices have started falling, ask your pediatrician for details
What is the dosage for this vaccine?
The flu vaccine is UNIQUE in the fact that it has to be taken every year, and also because each year you get a different vaccine! Yes, every year WHO (World health Organisation) and other health bodies research the different types of viruses that cause Flu and then each year a 'fresh' batch of vaccine is prepared.
Two doses of the Flu vaccine are given in the first year (for children less than 9 years), and one every year thereafter. In children 6 months-3 years only half the dose (0.25 ml) is given Intramuscularly. The vaccine is NOT recommended below 6 months age.
For more on routine immunisations in India, visit Charak Clinics

Thursday, September 23, 2004

Kids say the Funniest Things!

I would not copy and paste an email unless it was really funny (and had something to do with kids)!
I find the following anecdotes hilarious, but they also point to a sense of innocence that seems to be rapidly disappearing in the modern world with its information overload!
Enjoy these and do share some of your own stories about your little 'adults'
10 reasons why we love children
1. A kindergarten pupil told his teacher he'd found a cat, but it was dead. "How do you know that the cat was dead?" she asked her pupil. "Because I pissed in its ear and it didn't move," answered the child innocently. "You did WHAT?" the teacher exclaimed in surprise. "You know," explained the boy, "I leaned over and went 'Pssst!' and it didn't move."
2. A small boy is sent to bed by his father. Five minutes later....."Da-ad...." "What?" "I'm thirsty. Can you bring drink of water?" "No, you had your chance before Lights out." Five minutes later: "Da-aaaad...." "WHAT?" "I'm THIRSTY. Can I have a drink of water??" "I told you NO! If you ask again, I'll have to spank you!!" Five minutes later......"Daaaa-aaaad....." "WHAT!" "When you come in to spank me, can you bring a drink of water?"
3. An exasperated mother, whose son was always getting into mischief, finally asked him "How do you expect to get into Heaven?" The boy thought it over and said, "Well, I'll run in and out and in and out and keep slamming the door until St. Peter says, 'For Heaven's sake, Dylan, come in or stay out!'"
4. One summer evening during a violent thunderstorm a mother was tucking her son into bed. She was about to turn off the light when he asked with a tremor in his voice, "Mommy, will you sleep with me tonight?" The mother smiled and gave him a reassuring hug. "I can't dear," she said. "I have to sleep in Daddy's room." A long silence was broken at last by his shaky little voice: "The big sissy."
5. It was that time, during the Sunday morning service, for the children's sermon. All the children were invited to come forward, one little girl was wearing a particularly pretty dress and, as she sat down, the pastor leaned over and said, "That is a very pretty dress. Is it your Easter Dress?" The little girl replied, directly into the pastor's clip-on microphone, "Yes and my Mom says it's a bitch to iron."
6. When I was six months pregnant with my third child, my three year old came into the room when I was just getting ready to get into the shower. She said, "Mommy, you are getting fat!" I replied, "Yes, honey, remember Mommy has a baby growing in her tummy." "I know," she replied, "but what's growing in your butt?"
7. A little boy was doing his math homework. He said to himself, "Two plus five, that son of a bitch is seven. Three plus six, that son of a bitch is nine...." His mother heard what he was saying and gasped, "What are you doing?" The little boy answered, "I'm doing my math homework, Mom." "And this is how your teacher taught you to do it?" the mother asked. "Yes," he answered. Infuriated, the mother asked the teacher the next day, "What are you teaching my son in math?" The teacher replied, "Right now, we are learning addition." The mother asked, "And are you teaching them to say two plus two, that son of a bitch is four?" After the teacher stopped laughing, she answered, "What I taught them was, two plus two, THE SUM OF WHICH, is four."
8. One day the first grade teacher was reading the story of Chicken Little to her class. She came to the part of the story where Chicken Little tried to warn the farmer. She read, ".. and so Chicken Little went up to the farmer and said, ' The sky is falling, the sky is falling! '" > >The teacher paused then asked the class, "And what do you think that farmer said?" One little girl raised her hand and said, "I think he said: 'Holy Shit! A talking chicken!'" The teacher was unable to teach for the next 10 minutes.
9. A certain little girl, when asked her name, would reply, "I'm Mr. Sugarbrown's daughter." Her mother told her this was wrong, she must say, "I'm Jane Sugarbrown." The Vicar spoke to her in Sunday School, and said, "Aren't you Mr. Sugarbrown's daughter?" She replied, "I thought I was, but mother says I'm not."
10. A little girl asked her mother, "Can I go outside and play with the boys?" Her mother replied, "No, you can't play with the boys, they're too rough." The little girl thought about it for a few moments and asked, "If I can find a smooth one, can I play with him?"
The problem with kids is not that they misinterpret what has been told to them, but often remember (and repeat) EXACTLY what has been said

Tuesday, September 14, 2004

Tonsillectomies! To do or not to do, that is the question

Tonsillectomies have long been the 'bread and butter' of the ENT surgeons. When they are indicated, they are a great help for the kids and parents, however it has been seen that a lot many tonsillectomies are NOT NECESSARY!
So how do we decide when a tonsillectomy is indicated?
A tonsillectomy is generally done for recurrent 'sore throat' or throat infections. However in most children it has been shown that there is no significant decrease in the number of Upper respiratory infections (URI) after undergoing tonsillectomies (Sept 11, 2004, BMJ).

Only those children who get a documented (seen by a doctor, preferably)
attack of URI of 6-7 times in 1 year, or 5 episodes per year for 2
consecutive years, or 3 episodes per year for 3 consecutive years should
probably be taken up for tonsillectomy.

Among other reasons for tonsillectomies would be extremely large tonsils interfering with sleep (Obstructive Sleep Apnoea) detected by snoring, irregular sleep, daytime sleepiness, and mouth breathing. Also if a child has very severe URI's with long lasting symptoms tonsillectomy may be undertaken sooner

Saturday, September 04, 2004

Breast Feeding, Breast Feeding and more Breast Feeding

You must be wondering as to the repetitions in the title?
It is to emphasize the importance of breast feeding for our precious babies!
There are a lot of misconcpetions and myths about this common topic, and each day a good part of the consulting time is spent in trying to convince mothers of newborns to EXCLUSIVELY BREASTFEED FOR 6 MONTHS!

Exclusively means NO WATER, NO JANAM GHUTTI, NO CERELAC/FAREX other baby foods, NOTHING BUT MOTHER'S MILK by mouth.
Sounds difficult, Impossible, theoretical?
Let me give you a small personal example. I have recently been blesssed with the cutest nephew possible. My bhabhi complained to me initally that he had dry skin. Use of non-drying soap, lactocalamine and even mild steroid creams had temporary benefit. He also was quite irritable and kept on rubbing his face and eyes repeatedly. They have a strong family history of asthma, and other allergies. However on asking I found that she was feeding the child Lactogen 1, because the child was born 'weak'. After some initial reluctance she accepted my suggestion to try and stop the formula COMPLETELY.
Voila! The dryness diappeared completely, and has not returned since. As a pleasant side-effect my Bhabhi is now much more impressed with the skills of the 'doctor at home' .
This is only a small part of what exclusive breastfeeding can do your for your baby!
Among the many benefits of breastfeeding, research has shown that the practice improves infants' immune responses, prevents chronic disease, contributes to better cognitive skills (higher IQ), stimulates bonding between mother and child and promotes healthiness in premature infants. Mothers who breastfeed also have a lower risk of breast cancer. Constipation, Diarrhoea, Ear infections, Pneumonia, Colic and chances of later allergy and asthma are reduced. Nowadays it is felt that breastfed infants are less likely to be obese, have lower cholesterol and thus less chances of heart problems. Add to this the fact that Breast milk is free of infections, at the right temperature and easily and plentifully available, and you have a winner.
No formula in the world can come close to breast milk!
As long as a mother is physically able, the American Academy of Pediatrics recommends that babies be breastfed for at least a year, while the World Health Organization recommends the practice for two years.
So what do you need to start breastfeeding?
A willingness to be a part of this beautiful experience;
An encouraging Obstetrician (pre-delivery) and Pediatrician (after delivery);
Especially in the Indian context a helpful and encouraging mother-in-law!
That is it, now you are ready to give your baby the best possible start in its life

Wednesday, September 01, 2004

Love in the Hands of Discipline

Just the other day I was asked to comment about self mutilation in normal teenagers. During the course of my research on the web I realised how little people understood the importance of self esteem and was aghast at the worthless advice given in this context on most websites! A positive self esteem will help your child take on challenges, achieve better, live happier, make friends and cope in acceptable ways with the stresses of living. Most websites I saw will have you believe that if you criticize your child you lower their self esteem and by praising them you increase it. But the truth is far from such 1 -2 -3.

Growing and maturing means constantly dealing with change. Not just changes in the surrounding but also within one's body. Keeping up can be a pain (mostly literally) for children as they cope first with crawling, then walking, running, and then taking resposibility for their own lives. A positive self esteem in such a scenario does not come automatically. It needs to be nurtured by parents who understand that they must share their pain as well as their glory with the kids they are bringing up.

Give Credit where it is due: Consistently applaud genuine EFFORTS made by your child. Help them understand how to convert efforts to results. A corollary is that you should let them feel proud of how they are shaping up, rather than keeping credit for parenting them well. Let them know it is up to them to be good or bad, happy or sad, appreciated or despised.
Do NOT Praise Excessively: Don't tell them they are the best at an activity when they are not. Kids are internally programmed to learn and will benefit much more from a realistic feedback than unbound praise. Remember the rest of the world will give them accurate feedback and you don't want to lose credibility.
Train them to Earn Their Rewards: When they ask you for a favour or even money to buy a candy, let them plan for it, work for it and "earn" it. It will give them a sense of self worth money can't buy.
Give Them Responsibilities: In keeping with their age, let them be responsible for clothing themselves, clearing the dinner table, making the beds, putting away their toys or whatever else. Let them feel useful in the household.
Let Them Fall and Rise Up: This is a tough one especially since we want to protect them from all hurt. Still don't rush to help them out of their predicaments. Help them figure out a way of getting out of their tangles.
Give Choices: In matters where you can risk it, let them make their own decisions and ask them to justify them to you. Display your trust in their judgement. Let them set their bedtime, playtime and TV time. Let them work out the effect of their choices and learn from mistakes. The best gift you can give them is to praise their judgement.
Discipline, Discipline, Discipline: Never be afraid to discipline your child. Be reasonable, be consistent and don't let your temper run away with you. Beyond that, set limits, make sure they are adhered to. Limits give kids a sense of security and also build self esteem.

Too much of love will not spoil your kid, but how you express it may well decide whether or not your child will turn out to be a fine and balanced grown up.
You will find more information of self esteem here