Sunday, December 12, 2004

Television and your child

Television and your child
Have you ever wondered what influence Television has on the mental development of your child? I amend, not only mental but their physical outlook as well. Lets see what is the routine of a school going child nowadays. In the morning its off to school, in the afternoon have food (mostly while watching Television) and then either take a short nap or a tutor comes to get the homework done. In the evening again more of television or games on the computer. Dinners are also consumed mostly while watching TV and then off to bed. So lets see – out of 24 hours, besides the time spent at school and sleeping, the major chunk is spent by the child either watching TV or playing video games. Now lets go a few years back, say 20-30 years and compare the routine of children then. The sleeping and school hours are the same. Difference is in the time spent indoor/outdoors. Majority of the children were out in playgrounds, playing any sort of games ranging from cricket, hockey to pithu, stappu etc. It used to be task for the moms to get the children inside for meals and bed. Exposure to TV was very limited. Usually the child was packed off to bed by latest 10:00 PM, which is not the case nowadays. One wonders that with the advancing technology and all, whats the harm in your child being conversant with computers as early as possible. After all it’s a competitive world. You are absolutely right. A child needs to be an all rounder in this competitiveness. But, hello, all rounder means he should be good in outdoor activities also. There is usually a balance of mental and physical development, which should be maintained. What is happening is that, due to less exposure to outdoor games and spending more time inside, children are becoming very dull intellectually and weak physically. Lot of illnesses e.g. Asthma are on the rise due to decrease in physical activity of children. Child becomes more introvert due to limited friends. In fact I have seen that the petty tiffs during playing between friends helps children to become confidant and bold enough to face bigger situations later on. Now lets look at the other aspect of spending more time indoors in front of TV and computers. We all know that the TV has all kinds of programs ranging from cartoons to songs to violence to horror to sexual content. What effect do you think these kinds of programs have on the innocent mind of a child? In fact I was reading in a magazine that a 6-year-old child threatened to commit suicide by stabbing himself if he is not allowed to watch a certain program on TV. This idea came into his mind by watching TV, because I am sure he did not see any of this behavior occurring in his home. It was very difficult for the mother to tackle such an aggressive behavior of an otherwise happy go lucky child. Simple cartoon programs like Tom and Jerry also have some amount of violence in them. A lot of movies and music videos are showing explicit sexual exposure, which encourages children to indulge into such activities. I know it is impractical to totally cut off TV completely, but the watching hours can be made limited. And also encourage them to watch programs on Discovery and History channel etc. In fact you can make it more interesting by later on reading and discussing about the particular animal or history event seen on TV. This will make the child more inquisitive and knowledge some. Also you will be spending more quality time with him. I would compare a child to a simple lump of clay, which can be molded to any form you like. In this the parents have a major role to play. Encourage the child to play outdoor games and not substituting them by video games and watching Television.
Dr. Poonam Gupta

Thursday, December 09, 2004

How to choose the 'RIGHT' child specialist? (Part -2)

This is in continuation of the previous article wherein we had discussed the role of a pediatrician and the training needed to become a pediatrician (child specialist). Now coming to some more important questions
When Should You Look For A New Pediatrician?
Parents may seek a new pediatrician for several reasons.
The most common is that they are expecting a first child.
They may have moved to a new area,
They maybe unhappy with their prior child specialist.
Whatever your reason for looking for a pediatrician, it is important to choose one as soon as possible and not wait for your child to be ill. During pregnancy, it is wise to find a pediatrician by the beginning of the third trimester, or seventh month, of gestation.
Finding The Right Pediatrician: Where Do You Start?
Many people spend more time choosing a stock broker than they do picking a doctor for their children!
You should plan to meet with several pediatricians before choosing one, so be sure to give yourself enough time. Begin by compiling a list of candidates to interview.
You may get their names in a number of ways:
Ask friends, family, coworkers and neighbors you trust.
Contact your insurance plan for eligible pediatricians; many plans have Internet web sites.
Call local hospitals, many of which have referral services.
If you are expecting, ask your obstetrician.
You may also ask your primary care physician or another physician you trust.
Some Internet sites that may be useful in finding pediatricians in your community in India:
Pediatric on call
Indian Academy of Pediatrics - This website offers a list of registered pediatricians
Setting Up An Interview
In the west, most pediatricians offer free interviews, although some may charge for this preliminary visit. This is actually a good idea since in an emergency you would know where to rush your child to in case of any problems.
How do you decide whether the pediatrician is 'right' for you?
Screening begins with the initial telephone call: Before deciding to visit the pediatrician, you may gather some useful information from the office staff, including:
What are the doctor's office hours?
Does the pediatrician accept your insurance?
Are laboratory facilities on site? If not, where would your child be sent for these?
Don't forget to notice how easy or difficult it is to get through on the telephone.
Also, decide if you are more comfortable in a small office practice, or in a larger hospital based practising pediatrician.
Meeting The Pediatrician: Questions to Ask
It is useful to come to the interview with a list of questions. Be prepared not only to listen to the responses, but also, to pay attention to the way you feel about your interaction with the doctor.
Communication between the pediatrician, parents and child are
Some things to think about are:
How well does the doctor listen?
Do your questions get cut off, or do you feel rushed?
Does the doctor treat you as a partner in the care of your child?
Do you feel a sense of trust in the doctor?
Does the pediatrician ask you important information about your home or family?
The safety of your home environment, presence of other children or pets, and family health problems can all affect the health of your present or expected child.
Look around you:
Does the office seem clean and organized?
Is the staff courteous?
Is there a separate waiting area for sick and well children?
Check credentials:
Remember that you want a doctor who is knowledgeable to handle both common and unusual health problems.
What is the pediatrician s educational background?
How long has she been in practice?
Is he certified by IAP (check the listing at Indian Academy of Pediatrics website)?
How does she keep up-to-date with medical knowledge?
Does she have any special medical interests?
Determine the doctor's availability:
Children get many acute illnesses, and it is important to know how available your pediatrician is to see your child, on the same day if necessary.
How do you reach him for routine questions or urgent problems?
Does he have specific telephone call-in times?
Can you reach him by e-mail?
Does he have a web site?
What if your child becomes ill? If your child is ill, will she usually be seen in the office?
When would she be referred to the emergency room?
If your child needs to be hospitalized, what hospital would the doctor use, and who would be responsible for your child's care?
Who covers the pediatrician when he is away?
What type of staff is in the office?
Are there nurses, nurse practitioners, resident physicians or medical students on staff in the office?
Will any of these staff care for your child?
Are you likely to see different providers at each visit?
How much time will the pediatrician spend with you and your child at a typical visit?
Care of newborns:
When is the first newborn exam in the hospital?
Will your pediatrician be doing it?
When is the first newborn office visit recommended?
Is there office staff supportive and knowledgeable about breast-feeding?
How often are subsequent visits?
What is the physician's recommended vaccine schedule?
After the first visit, recommended checkups in the first 2 years are at 1.5, 2.5, 3.5, 6, 9, 12, 15, 18 and 24 months.
Explore the doctor's attitudes about things that are important to you:
If you use complementary or alternative health methods, or traditional health practices, ask about the pediatrician s knowledge and acceptance of these.
If you have important cultural, religious or moral beliefs related to your child s health care, express these to the pediatrician and observe the response.
When does he prescribe antibiotics?
I personaly that this is a very important point and you need to tell your doctor if you are comfortable in getting a prescription without antibiotic, many doctors will give antibiotics because they believe that the parents want it!
Going To The Interview As A Family
It is useful to go to the visit with your spouse or partner, so that you may both get a sense of the interaction. Also, if you are interviewing the pediatrician after childbirth, you may want to bring your child along to the visit. It could be helpful to see how the doctor and your child relate to each other. However, if you are considering leaving another physician to whom your child has become attached, you may want to be careful about how and where your child meets a new doctor. Remember that your choice of pediatricians is not permanent. If at any time you are not satisfied with your child's care, discuss your concerns with the pediatrician. If the problem continues, it may be time to find a new doctor.
This article is largely copied from the original article here by Dr. Daniel Neuspiel; however it has been suitably modified for an Indian perspective.
For more information on Child care log on to Charak Clinics

Monday, December 06, 2004


Choosing a pediatrician is an important event that should actually begin even before the child is born. As a general pediatrician, I frequently speak with both current and expecting parents about choosing a pediatrician. Many parents are not aware of the importance of selecting the right doctor for their children, or of how to go about doing it. Let us first begin by asking the basic question:
Why Choose A Pediatrician To Care For Your Child?
The role of a pediatrician involves all of the following:

Screening and evaluating babies and children for appropriate growth and development, and assessing abnormalities and disabilities, if any.
Vaccination of babies and children, and advice about specific disease
Advice on feeding, diet, food supplements, and other nutrition concerns.
Assessing illnesses and treating them, including admission to hospitalisation for serious diseases. Coordination of care for children receiving treatment from different specialists, and responsibility for the child's overall health.
Health education for the family.
Pediatricians have the most comprehensive medical training
to respond to these needs.

Source: Mehta child care

How Are Pediatricians Trained?
A Pediatrician is a 'qualified' Child Specialist. In India this means that after doing his basic MBBS (5 years) a pediatrician has to undergo an additional training (for 2-3 years, on-the-job training) in dealing exclusively with children. This residency training prepares pediatricians to help meet the needs of healthy children in such areas as normal growth, development, nutrition and behavior. After completing the training an exam needs to be passed to become a Pediatrician. A normal physician has less pediatric training than pediatricians, and may not be able to provide the same quality of care to a child as a pediatrician. Some pediatricians have additional subspecialty training beyond residency.
In the next part we will discuss the 'ideal qualities' to look for in a pediatrician!