Office management of Constipation in Children - 4 Simple & Important points for Child Specialists & parents

Q: Which is preferred first line medicine for constipation in children.. liquid paraffin vs sodium picosulfate vs lactulose vs macrogol 4000 vs PEG ??? also the dose of each drug ??? any contraindications to their use ?? most important question --  how long to use ??

other advise apart from plenty of water intake, fruits ,veggies, milk restriction ???

A:

90% of constipation in children is functional.before that we have to R/o organic cause .
Steps in management.
1.Consumption of dietry fibres and fluids.
2.Timed pattern of stooling:15 to 30 mts after feeding utilising the gastro colic reflux.
3.Then comes pharmacotherapy in the order of 
a).PEG 3350
b).Lactulose 1-3ml/kg/day in divided doses(maximum dose should not cross the adult doses (i.e 30 ml) ANother option is Sodium Picosulfate as a second line therapy. It is a stimulant with an excellent safety profile and better tolerated with good effect.
4.Duration: 2 to 4 wks and reassess

Source: Discussion on Docplexus.in

How to calm an overactive child - some simple yet sensible tips

How to Calm Hyperactive Children

I have an overactive child, and have found it quite difficult to control her sometimes. Here are some sensible tips that may be helpful for us parents of overactive children.

Five Methods:Creating a Calm EnvironmentPlanning ActivitiesCreating RoutinesChanging DietsUsing Natural Remedies

Hyperactive children may fidget, have difficulty concentrating, be unable to sit still or generally be overexcited. A child who is hyperactive does not always mean that they have Attention Deficit Hyperactivity Disorder (ADHD), but they may have certain tendencies that contribute to difficulty in maintaining focus. Medication for hyperactivity is often over-prescribed^[1]. Instead, diet changes, routines and calming activities can help to calm a hyperactive chil

Method 1 of 5: Creating a Calm Environment

1. 
   1
   Create a calming kids-only space. Dedicate a corner of a room, a nook, or other small space to making a space that the child can sit in by themselves. Put pillows, stuffed animals, books or other cozy items in this space. This is not a time-out space where they go when they are in trouble. Instead, this is a space where they feel safe and can get a chance to relax.^[2]
2. 
   2
   Play calm music. If you play music in your house, choose more soothing music like classical or meditative music, rather than upbeat pop or hard rock. Too much noise can be a trigger for some children to become hyperactive, and eliminating or changing the type of noise can be helpful in calming children.
3. 
   3
   Minimize screen time. Too much exposure to television, video games, computers and phones can trigger hyperactivity. These devices often have rapidly moving images, bright colors and loud sounds that are the opposite of calming. Limit screen time or eliminate it altogether.^[3]
4. 
   4
   Give a mini-massage. Hyperactive children in particular respond well to touch and affection. Give the child a little massage on their back, feet or hands to help them calm down.^[4] Physical touch and affection can stimulate endorphins, which can be very calming and healing.
5. 
   5
   Speak in a calm voice. Instead of shouting or talking loudly, reduce the volume of your voice by speaking to the child calmly. They may need to stop what they’re doing to hear you, which can help interrupt their hyperactivity.
6. 
7. Source http://www.wikihow.com/Calm-Hyperactive-Children

What is preferred form of taking medicine - Tablet, Softgel, Liquid, Powder or Capsules

There are many medicine doses forms available for products like Vit D. Here is an interesting article that talks about these treatment options.

I quote the following from this article -- http://www.allstarhealth.com/blog/products-and-ingredients/tablets-capsules-liquids-powders-chewables/

Tablets are the most shelf-stable choice and retain their potency over a longer time than liquids, powders and most capsules. Tablets don’t offer the flexibility of dosing that liquids and powders do.

Capsules advantages are their ability to break down quickly in the stomach. drawbacks are not air-tight, their shelf-life is shorter than tablets.

Softgels offer superior shelf-life profiles to capsules, liquids and powders

Chewables tend to be lower potency when compared to comparable products in tablet and capsule form. They also usually have some sugar and flavorings added

Powders must be mixed into a liquid, shake or a food. Powders do offer great flexibility with dosing Liquid supplements shelf life is shorter than with other formats. They often require refrigeration Even when the bottle is shaken before each use, dispersion of ingredients is imprecise and less consistent .