Tuesday, December 19, 2017

Talking Back - Guest Post by Psychologist & Author, Garima Gupta

Talking Back

Your child is behaving rudely, speaking to you and others in a disrespectful way, either in tone or choice of words, or both.
Usual Reasons- when this is unusual or new behavior for your child
·         He or she is sick or coming down with something. If you notice sniffles, irritation in throat, nasal voice, lethargy, lowered interest in usual games, warm forehead, rashes or problems with urinating or bowel movement, then we may suspect the child is coming down with a viral or other problem. This is likely creating temporary irritability. Best option is to talk to them about your suspicion, help them understand, and ask them to keep an eye on further symptoms. Start them on some warm water and tulsi leaves and prevent exposure to extreme temperatures. After addressing their health issue, ask them to mind their tone or language with you. This should be easier for your child when they understand where it is coming from.
·         Growth spurt making them hungrier and more cranky than usual. Since a child is born to teenage, there are periods lasting a few days to a couple of weeks when a child experiences growth spurts. During this time, the child is hungrier and sleepier than usual. During a spurt, there are changes in the body that make the child cranky or fussy. Be empathetic and patient. Add some wholesome snack to their diet, if old enough. So, if they have lunch at 3pm, milk at 6pm and dinner at 9pm, during a growth spurt give them snack at 5:30pm and milk at 7 before dinner. This can be fruit chaat, oatmeal, healthy sandwich (with salad leaves, cucumbers, cheese and seeds), dosa, poha or upma etc. Encourage them to nap in day or bring up bedtime by half an hour. With their blood sugar balanced better, their mood and language should reset to a more stable level. Growth spurt passes after few days to weeks.
·         Change in diet
o   Eating too much sugar –If your child starts taking too much sugar through candies, ice-creams or in other ways, they will experience mood swings, with some children being much more vulnerable than others to crankiness or jumpiness due to excessive sugar. If they are popping candies a lot, ask if they are feeling hungrier than usual these days and/or have growing pains like aching legs. If you suspect a growth spurt, take actions as above to add healthy snack and reduce the sugar intake. Sometimes children overeat sugary foods when feeling upset. Ask about their feelings, friends, studies etc. Remove candies from view and keep fresh fruits and non-sugar snacks like makhane (lotus-seeds), roasted almonds or savouries in plain sight. Reducing sugar intake will automatically stabilize mood. Then, a gentle reminder to be polite will be enough.
o   Getting too little raw or uncooked veggies and fruits (salads) –Growing children need highly nutritious food. Make sure you give them fresh, raw foods like cucumber, carrot, broccoli, onion, tomato, sprouts, salad leaves etc. in enjoyable ways. Get creative. Put chopped uncooked veggies into pita bread, with a dollop of cream cheese to make a Mexican-style dish or put it on multigrain bread, sprinkle seeds like flax, sesame, chia and add some dressing for continental-style sandwich. Boiled potatoes and fried pieces of bread can be added to salads to enhance the “fun factor”. Also get them to get some early morning or late evening sun. This adds the missing nutrients and re-balances their mood.
o   Too little carbs like rice or chapatti that stabilize mood –One bane of modern urban life is that everyone wants to go on a diet. Taking too little carbs like chapatti and rice reduces the tryptophan available to our brain to make the happy chemical serotonin. Serotonin is a mood regulator and is considered a “happiness hormone”. Carbs in diet make tryptophan available to brain to make serotonin. Add a chapatti, parantha, or some rice and watch your child go from frown to smile. Happy kids speak nicely.
·         Experiencing bullying in school or online –Children may start talking back if they feel threatened at school or home. Ask them about bullying and ask their preferred way of dealing with it. Write or talk to their teacher and help them feel safe again. Teach them a few tricks to deal with bullying behavior, like standing up for oneself, threatening to inform the authorities, involving the bully’s parents etc. Then draw your boundary by saying what kind of language or tone you will not tolerate. This also tacitly teaches the kids to demand better treatment from others without feeling bad about it.
·         Breakup or quarrel with friend –It is frustrating for a child to lose their “best friend”. A quarrel or breakup can make them angry, confused, hurt or distrustful. Even 3 year olds are very serious about friendships and need help sorting through their feelings when a friend starts ignoring them or breaks up. Give a patient ear. Teach them a few life lessons you wish to pass on. Then ask them to be polite to you and others.
·         Exam or performance pressure –As school systems become more child-centric, you would think exam pressure is nearly gone. But it is not so. Kids have performance pressures, whether in sports, co-curriculars, academics or various group activities and competitions they participate in. Tell them they can talk to you about their pressures but need to keep their tone soft. As they find outlet for their troubles they will become happier and return to politeness.
·         Disturbed sleep –Sleep is critical for a healthy body. If sleep disturbance is responsible for cranky mood of child use these tricks for healthy and peaceful sleep.
o   Stop or reduce daytime napping
o   No scary or violent shows before bedtime
o   Use soothing music
o   Start a short sleep routine, e.g., wash face and feet, change clothes, pack schoolbag for next day, sip water, turn out light and get into bed. You may include a short chant or prayer if it resonates with your family culture.
o   Check room for mosquitoes, excess noise, and excess dust. Do the needful for it.
o   If there are medical reasons for sleep disturbance, like blocked nose, body-ache, infection or other problem, treat the disease.
Once sleep is restored usual personality of child will be back.
Usual Reasons- When this is the typical style of behavior
Try to bring all family members on the same page when trying to change a child’s behavior. So that the child gets similar cues and is not confused about what is expected from him or her.
·         Imitation. If your little monkey has seen someone like a close family member or regular visitor using rough language, he or she may choose to copy this person. Esp. if the rude person is also feared, respected or enjoys special status. Help your child see the power of politeness, how courtesy opens doors and easily gets us what we want. Show them successful and happy people in real life who are always polite. Give them better role models to imitate. Be one.
·         Don’t get attention when polite. We often forget to pay attention to the kid when he or she is doing everything right. Sometimes speaking loudly or rudely is the fastest or surest way to get your attention. Then rude language becomes the child’s habit. Retrain yourself so that you ignore the child’s demands when he or she speaks rudely. You appreciate them for speaking nicely, either to you or their friends or other family members. When child starts getting attention for nice tone they will gradually change their habit. It always works.
·         No negative consequence. “Give it” is quicker to say than, “Please may I have it”. If there is no negative consequence of taking the rude shortcut, impolite language becomes a habit. Expect courtesies like please. For children under 5 do show the correct behavior by using polite words to them and other family members.
·         Too much screen, too little physically strenuous activity. Kids are bundles of energy and need to burn it off. Give your child lots of opportunity for rough and tumble play, outdoor activities and age-appropriate sports and games. Limit screen time (read chapter on screen-time for how-to). When their natural aggressive energies are release through play they can be taught to use polite language much more effectively. Demand politeness, show them how and give attention when you get the kind of language you appreciate.

Reproduced with permission - Garima Gupta, Life Coach & Author

Wednesday, September 20, 2017

Just 5 foods and 2 tips to get iron rich diet in India?.


Just 5 foods and 2 tips to get iron rich diet in India?. Just 5 foods and 2 tips to get iron rich diet in India?.

Just 5 foods and 2 tips to get iron rich diet in India. पीरियड रेशन टॉक्स अबाउट हाउ टू गेट आयरन रिच फूड्स इन चिल्ड्रन ऑफ इंडिया https://youtu.be/liVYb2Zants Charak Child Care

Friday, September 15, 2017

MR vaccination campaign India school, should you do it for your child? MR vaccination campaign India school, should you do it for your child?

MR vaccination campaign India school, should you do it for your child? A child specialist talks about Government of India MR vaccination campaign started in 2017, to eradicate measles and rubella https://youtu.be/TXc0qgHtrQI Charak Child Care

MR vaccination campaign India school, should you do it for your child?


Friday, July 21, 2017

Everything You Need to Know About the Yellow Fever Vaccine, July 2017

A guide to the vaccines travelers may need to have. 

The Yellow Fever Virus

Yellow fever, a viral hemorrhagic disease caused by the yellow fever virus, affects roughly 200,000 people a year. Though the disease got its start in Africa, outbreaks have occurred as far away as the Yucatan Peninsula and even Philadelphia, where 5,000 people were wiped out during a single epidemic in the 18th century.
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Typically, yellow fever causes, chills, nausea, vomiting, muscle pain, and — of course — a fever. It's certainly not a pleasant way to spend any part of your trip. While most people recover after 3 or 4 days, some experience a second wave of afflictions, which can bring jaundice (hence the name), abdominal pain and vomiting, and bleeding from the mouth, nose, and eyes. In cases where yellow fever has developed past this point, the risk of death is about 50 percent.
Back in the day, yellow fever was no joke. A single outbreak had the power to annihilate huge groups of people in small areas, though the cause of the illness eluded doctors. It wasn’t until the 1900s that they determined yellow fever was transmitted by mosquitoes.

The Yellow Fever Vaccine

Per the Centers for Disease Control and Prevention, there is no cure for yellow fever. Instead, patients are treated based on their symptoms (described above), and on their recent travel history.
While a vaccine is recommended for any travel to Africa or South America, other important prevention methods include mosquito nets, wearing clothes that cover the entire body, and using a strong insect repellent with DEET.
The yellow fever vaccine was developed by Max Theiler in the United States, and he won the Nobel Prize for this life-saving contribution. Unlike other vaccines, the yellow fever vaccine is a one-time deal: a single dose provides lifetime immunity. (Travelers who frequently visit at-risk areas should get a booster shot ever 10 years.)
The vaccine can be given to infants as young as 9 months, and is recommended for anyone traveling to certain areas in Africa and South America.
As with most vaccines, an amount of time is needed for the vaccine to work its way through your body, and it’s recommended that you schedule the vaccine appointment 10 days prior to traveling.
The yellow fever vaccine is only offered at designated vaccination centers, and can cost between $150 and $350, depending on availability. Certain countries, including Ghana, Liberia, and Sierra Leone, even require a proof of vaccination from all travelers when they arrive — and that certificate is obtained from your doctor after being given the shot.

Vaccination rules for Haj pilgrims announced - 2017, Saudi Arabia

RIYADH: Saudi Arabia has issued the vaccination and health requirements for pilgrims applying for Haj visas, according to a Ministry of Health official.
The requirements for this year focus on the likes of the Zika virus, dengue, Middle East respiratory syndrome coronavirus (MERS), yellow fever, cholera, meningitis, polio and vaccination against seasonal influenza.
Vaccination against meningitis is mandatory for all local and foreign pilgrims. The flu vaccine is not mandatory but it is desirable to take it considering the climate and susceptibility of pilgrims.
The official advised high-risk patients — those with ailments such as diabetes, hypertension and renal problems — to take the flu vaccine, which will help them perform their Haj and Umrah rituals without problems.
In accordance with the International Health Regulations from 2005, travelers arriving from countries at risk of yellow fever transmission must present a valid yellow fever vaccination certificate. The life-long certificate is valid from 10 days after the vaccination date.
Aircraft, ships and other means of transportation coming from countries affected by yellow fever are requested to submit a certificate indicating that they applied disinsection in accordance with methods recommended by the World Health Organization (WHO).
Regardless of age and vaccination status, proof of receipt of a dose of oral polio vaccine, or inactivated polio vaccine, within the previous 12 months and at least four weeks prior to departure, is required to apply for an entry visa to Saudi Arabia for travelers arriving from countries including Afghanistan, Nigeria and Pakistan.
The polio vaccine is also required of pilgrims from states no longer affected by the infectious disease, but which remain vulnerable to reinfection. These include Cameroon, Central African Republic, Chad, Guinea, Laos, Madagascar, Myanmar, Niger, Ukraine, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Iraq, Kenya, Liberia, Sierra Leone, Somalia, South Sudan, Syria and Yemen.
Dominique Legros, a WHO cholera expert, said in Geneva last week that the Kingdom has taken adequate preventive measures to combat communicable diseases during the annual pilgrimage.
The Ministry of Foreign Affairs has sent out circulars to all its missions abroad regarding the rules.

Tuesday, July 11, 2017

Vaccine FAQs India - Hep B dose at birth missed

Query : 
Hepatitis B missed at birth. niw she will be 6 wks what to do?

START now, and complete 3 doses by 6 months age,

India vaccination FAQs parents: BCG Pus formed, what to do?

Query : 
pus after bcg. is it normal? how long it will last?

Pus after BCG is normal,
It will last for a few days and may happen more than once, generally there is a small scar left by the time the baby is 3 months old,
Talk to your pediatrician if you have more concerns,


Friday, June 23, 2017

Best foods for your brain

Research shows that the best foods for your brain are the same ones that protect your heart and blood vessels, including the following: 
Green, leafy vegetables. Leafy greens such as kale, spinach, collards, and broccoli are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta carotene. Research suggests these plant-based foods may help slow cognitive decline. 
Fatty fish. Fatty fish are abundant sources of omega-3 fatty acids, healthy unsaturated fats that have been linked to lower blood levels of beta-amyloid—the protein that forms damaging clumps in the brains of people with Alzheimer's disease. Try to eat fish at least twice a week, but choose varieties that are low in mercury, such as salmon, cod, canned light tuna, and pollack. If you're not a fan of fish, ask your doctor about taking an omega-3 supplement, or choose terrestrial omega-3 sources such as flaxseeds, avocados, and walnuts. 
Berries. Flavonoids, the natural plant pigments that give berries their brilliant hues, also help improve memory, research shows. In a 2012 study published in Annals of Neurology, researchers at Harvard's Brigham and Women's Hospital found that women who consumed two or more servings of strawberries and blueberries each week delayed memory decline by up to two-and-a-half years. 
Tea and coffee. The caffeine in your morning cup of coffee or tea might offer more than just a short-term concentration boost. In a 2014 study published in The Journal of Nutrition, participants with higher caffeine consumption scored better on tests of mental function. Caffeine might also help solidify new memories, according to other research. Investigators at Johns Hopkins University asked participants to study a series of images and then take either a placebo or a 200-milligram caffeine tablet. More members of the caffeine group were able to correctly identify the images on the following day. 
Walnuts. Nuts are excellent sources of protein and healthy fats, and one type of nut in particular might also improve memory. A 2015 study from UCLA linked higher walnut consumption to improved cognitive test scores. Walnuts are high in a type of omega-3 fatty acid called alpha-linolenic acid (ALA), which helps lower blood pressure and protects arteries. That's good for both the heart and brain. 
SOURCE--Harvard Medical School Newsletter tiled Health Beat, dated 22 June 2017.

Comment: And that is why I drink coffee :)
There is also an interesting anecdote related by Dr Deepak Chopra's (the new age guru) brother, Dr Sanjiv Chorpa, who is a liver specialist. He believes that having 4 cups of coffee daily prevents you from ever needing a liver transplant !

Friday, June 09, 2017

4 Tips to Help Kids Stay Safe on Smartphones

Have you noticed how even one year olds know their way around a smartphone, while we’re struggling to stay updated on everything tech! If you’ve ever thought that kids seem to spend half of the day on their smartphones, you’re not wrong – the average child might spend more than seven hours a day on their phone, and for at least some of them, that’s more time than they spendsleeping.
Well, there’s nothing wrong with technology or gadgets; there are many useful things they can do. But it’s when things go beyond a healthy limit that problems arise. Technology is a huge part of life now, yet many parents still haven’t implemented basic rules to help their children stay safe online. There are all kinds of horrors on the internet, and naive kids are particularly vulnerable. Don’t worry, here’s help! Here are some simple tips to help kids stay safe on smartphones.

4 Tips to Help Kids Stay Safe on Smartphones

Kids these days are glued to their phones which makes them vulnerable to many dangers. Check out these 4 Tips to Help Kids Stay Safe on Smartphones.

1. Place Limits On When And Where The Phone Can Be Used

Tips to Help Kids Stay Safe on Smartphones
Kids don’t need to be texting at the dinner table, when they’re in the middle of homework, or late at night – yet many of them are still allowed to do so. One of the major problems with teens today is that their minds are always online – when they’re not using their smartphone, they’re thinking about using it, and there’s no clear separation between online and offline time.
In a similar vein, there are places phones should never be allowed – such as in their bedrooms. Establishing phone-free zones is critical for teaching children that there are times and places where phones should not be allowed, no matter how badly they want to pick them up and start texting, using apps, or otherwise connecting to the digital realm.
Until a child can resist the temptation to use their smartphone, they shouldn’t have unrestricted access to it.

2. Use Content Filters and Limit Phone-based Purchases

Tips to Help Kids Stay Safe on Smartphones
Most cell carriers offer these services for free (or at an extremely low monthly price) – and they should be installed on every child’s phone. In addition to basic content control, providers may also offer services like not allowing the phone to be used to access the internet past a certain time each day… though it’s often easier to just have your child give you the phone at a certain time each night.
On top of that, make sure your child gets your permission to download and install apps – when they have to ask about each one, they’re less likely to start downloading things just because it sounded fun, and more likely to exercise good judgment and discretion.

3. Install Ad-Blockers

Tips to Help Kids Stay Safe on Smartphones
Online ads are… interesting. However, as much as some companies would love for you to do nothing other than click on ads all day, the truth is that they’re distracting and tend to eat up a lot of data. How much? Well, according to a recent study by the New York Times, just putting an ad-blocker on made many sites load three or four times faster.
In general, kids can’t control the content of ads, so installing ad blockers can help them avoid seeing content that doesn’t matter to them. (And they’ll probably thank you for making the internet smoother for them, too.)

4. Instruct Them On Proper Behavior

Tips to Help Kids Stay Safe on Smartphones
In recent years, cyber bullying has become a major problem for teens. There are a lot of things you can do to help keep them safe, but the most important thing for your child to understand is that they can (and should) come talk to you any time there’s a problem.
Most kids are unwilling to talk about their problems because they fear losing access to their smartphone – as such, you should make it clear that you will not take their phone away if you know they’re getting bullied. Instead, explain that you just want to teach them how to resolve the problem and move on with their life. As long as a child trusts you enough to come talk to you when there’s a problem, you’ll be able to protect them from just about every issue that can occur online.
Kids are getting smartphones at a younger and younger age, so it’s important to start monitoring them early – and with these regulations in place, you can help ensure that your child is as safe as they can possibly be while using their smartphone.

Friday, May 26, 2017

Why it may be a good thing that the Dengue vaccine is NOT available in India right now?

I am a Pediatrician, and a large percentage of my work involves preventive pediatrics and counseling. I am also a big fan of vaccines, so why am I saying that NOT having Dengue vaccines in India is a good thing? Read on….
I understand that Dengue is a very serious problem, and as a pediatrician I have personally diagnosed and treated many kids with Dengue in Chandigarh and surrounding areas.
The problem, in my opinion, is the way new vaccines are generally launched in India. Previously the drug controlling authority (DCGI) used to ask for small trials on 150 to 200 people and we used to test if the vaccine was leading to good antibody response after 3 months in these people. Once this was confirmed, the vaccine was allowed to be used without any further research in our kids.
On the other hand, most developed countries would ask any vaccine company to do large studies in their own country/ continent before allowing use of a newer vaccine.
For the first time, it appears that the Govt of India is asking the Vaccine Company (Sanofi Pasetur) to do large scale trials in our country for the Dengue vaccine before launching it. The scientific data thus generated will help us to recommend the vaccine far more effectively.
However, if the permission is given by the GOI to launch the vaccine with small amount of data (as before), then we will end up with limited data. This means we will have to rely on studies from foreign countries to decide how effective this vaccine will be in our situation. For a new vaccine like Dengue, I believe this is NOT the right way to go.
Sure, large studies will take at least 2-3 years, but the results will help us get a better idea on how and when to use the vaccine for kids & adults in the future. This is why I am recommending waiting and watching and getting high quality data from India for the Dengue vaccine, before launching it.
What do you feel as a parent or a doctor?

Tuesday, January 31, 2017

MR vaccine by Govt of India, IAP recommendations, Jan 2017

Date: January 27, 2017
Dear All,This is to inform you that a mass campaign (Supplementary Immunization Activity (SIA) to provide a single dose of Measles-Rubella (MR) vaccine is going to start from February 2017 in five states/UTs namely, Goa, Karnataka, Tamil Nadu, Lakshadweep and Puducherry.
It is our utmost duty to support this activity by encouraging parents of eligible children to participate in these campaigns. We need to offer our clinics/ hospitals/ nursing homes, or other facility to function as “Adverse Event Following Immunization (AEFI) management site/centre” in case any serious AEFI is encountered during the campaign. Furthermore, we need to fully support and cooperate with the local health authorities to counteract any misinformation against these campaigns.
What is MR campaign?
  • MR campaign is a special campaign to vaccinate all children of 9 months to <15 age="" br="" nbsp="" of="" years="">group with one dose of MR vaccine.

  • The MR campaign dose is given to all targeted children, both immunized and unimmunized,
    irrespective of prior measles/rubella infection.

  • The goal of a MR campaign is to accelerate population immunity by reaching 100% target
    children with MR vaccine that will reduce cases and deaths from measles and disabilities from
    Congenital Rubella Syndrome (CRS).
Rationale for MR campaign
  • Country Population Immunity is insufficient to stop ongoing MR transmission as evident form
    MR surveillance data

  • MR outbreaks wide spread across the entire country

  • Population immunity has waned after the last MCV (Measles containing vaccine) campaign

  • Rubella vaccine introduction requires high level of population immunity to prevent the paradoxical effect as a risk mitigation strategy

  • NTAGI has recommended wide age range MR vaccination campaign targeting 9 months-<15 all="" before="" immunization="" in="" india="" introducing="" li="" of="" routine="" rubella-containing="" states="" the="" vaccine="" years="">
  • MR vaccine will be available for administration under the routine immunization (RI) programme after the completion of MR Campaign.
Who should be vaccinated?
  • All children who have completed 9 months of age and are below 15 years of age regardless of previous vaccination status with measles/rubella vaccine and regardless of measles/rubella infection in the past

  • Every child who is eligible for either 1st dose or 2nd dose of measles vaccine in his/her RI schedule will be provided with combined MR vaccine .

  • Malnourished children should be vaccinated on a priority basis, as they are more likely to have complications like diarrhea and pneumonia

  • Children with minor illnesses such as mild respiratory infection, diarrhea, and low grade fever

  • Even those children who have documentation of receiving one dose of Measles/MMR at 9 months and/or MMR at 15 and/or again at 4-6 years MUST also be offered this vaccine!!
Where will the children be vaccinated?
  • From fixed posts only. No house-to-house vaccination

  • During the first week in schools

  • Non-school-going and left out children will be vaccinated in the following two weeks in fixed outreach sessions and mobile posts in villages and urban areas

  • If, at any place, 4 or >4 children have been found missed during Rapid Convenience Monitoring, the MR campaign activity should be repeated in the area during fourth week of the MR campaign to cover these missed children.
Why MR and not MMR (measles, mumps & rubella) vaccination?
  • Though IAP has strongly recommended inclusion of MMR instead of MR in UIP, the Government of India (GoI) still do not consider mumps as a serious public health problem in the country. Therefore only MR vaccine is being introduced.
Dr. Anupam Sachdeva
PresidentIAP 2017
Dr. Bakul Jayant Parekh
Hon. Secretary General