SCREENTIME AND CHILDREN

In the present day lifestyle with almost all families becoming nuclear and both the parent's working, TV and computers have become a powerful and influential tools in a child's life.They combine audio with visual stimulation making them very attractive and spellbinding for most of our kids. As parents, we would like to give our child what they like. As we don't find anything objectionable in the cartoons DVD and some game sites we allow our children to spend time in front of the screens early in life. This also keeps them occupied for a few hours giving the parents or many times the care givers time to do their other chores. But it is not without problems. 

TV and Computer cause problems through two ways:

1. They engage the child during which the child could have done some other more important activity.
2. They directly cause effect by causing behavioral changes in the child.

Let us take each of these and see.

They engage the child during which the child could have done some other more important activity

• TV and computers occupy the child during the time when the child could actually have other human interaction. This is very important especially in a child less than two year. Brain growth and development is maximum in the first 24 months. Child's brain is most receptive to ideas during this time window. As the child has more social interactions it grows more intellectually and socially, especially in areas like language and communications. When screens occupy this valuable time, this development is lost.
• In older children it prevents the child from having physical activity. It has been found in many studies that children with obesity spend significantly more time in front of TV or computers.

They directly cause effect by causing behavioral changes in the child.

It is very important to know that the content of what the child watches in TV and DVD is known to influence their behavior. There are many examples where it is known that screen exposure causes the child to have violent, accident prone and high risk behaviors. It also decreases or causes irregular sleep time causing lack of attention span in school and results in poor academic performance.

Thus it is very important that we follow at least a few general guidelines.

• Avoid screen time for children below 2 years.
• Above two years restrict the screen time to 2 hours per day.
• Avoid TV in the bedroom of the child.
• Keep a tab on the content of the TV or DVD program your child watches including the ads.
• While parental influence is the single best influence and interaction for a child, it is also true that parents need a break. Try to find other methods of engaging the child so that you could do your daily chores or take your daily break from baby sitting through the day. This may include a few hours with grand parents, engaging the child in story telling sessions, workshops, art classes etc conducted by professional organizations.
  
  We all aspire for our children to do well in life and try to do all that we can to make it happen. But in the urge to give our kids the best , at times we also overdo things. While we cannot expect our kids to have the same kind of lifestyle that we had as kids, the onus is upon us to strike a balance.
  
  
  Authored by:Dr.Subramanian M.D
  

First Weeks At Home With A New Born

After the initial excitement  about the arrival of a baby, dawns the reality of caring for a newborn. A little awareness and preparation ensures that you become a great parent.

Medical Checkup on the Third or Fourth Day of Life

Early discharge from the newborn nursery has become commonplace for full-term babies with no other complications.In general this is a safe practice if the baby's hospital stay has been uncomplicated. These newborns need to be re-checked 2 to 5 days days after discharge to see how well they are feeding, urinating, producing stools, maintaining weight, and breathing. They will also be checked for jaundice and overall health.

The Two Week Medical Check-up

This checkup is probably the most important medical visit for your baby during the first

year of life. By two weeks of age your baby will usually have developed symptoms of any physical condition that was not detectable during the hospital stay. Your child's healthcare provider will be able to judge how well your baby is growing from his or her height, weight,and head circumference.This is also the time your family is under the most stress of adapting to a new baby.  

Try to develop a habit of jotting down questions about your child's health or behavior at home.  Bring this list with you to office visits to discuss with the healthcare provider. Most physicians welcome the opportunity to address your agenda. If at all possible, both the mother and father should go to these visits. Most physicians prefer to get to know both parents during a checkup rather than during the crisis of an acute illness.If you think your newborn starts to look or act sick between the routine visits, be sure to call your child's healthcare provider for help.

Feeding Your Baby: Achieving Weight Gain

  

Your main assignments during the early months of life are loving and feeding your baby. All babies lose a few ounces during the first few days after birth. However, they should rarely lose more than 7% of the birth weight. Most breast-fed babies regain birth weight by 10 days of age. Then infants gain approximately an 20grams per day during the early months. If milk is provided liberally, the normal newborn's hunger drive ensures appropriate weight gain.

A breast-feeding mother often wonders if her baby is getting enough calories, since she can't see how many ounces the baby takes. Your baby is doing fine if he or she demands to nurse every 1 1/2 to 2 1/2 hours, appears satisfied after feedings, takes both breasts at each nursing, wets 6 or more diapers each day, and passes 3 or more soft stools per day. Whenever you are worried about your baby's weight gain, bring your baby to your healthcare provider's office for a weight check. Feeding problems detected early are much easier to remedy than those of long standing. A special weight check 1 week after birth is a good idea for infants of a first-time breast-feeding mother or a mother concerned about her milk supply.

Dealing with Crying

Crying babies need to be held. They need someone with a soothing voice and a soothing touch. You can't spoil your baby during the early months of life. Overly sensitive babies may need an even gentler touch.

FOR YOU MOM 

The Postpartum Blues 

  You are not alone. More than 50% of women experience postpartum blues on the third or fourth day after delivery. You may be experiencing  tearfulness, tiredness, sadness, and difficulty in thinking clearly. The main cause of this temporary reaction is probably the sudden decrease of maternal hormones. Since the symptoms commonly begin on the day you come home from the hospital, the full impact of being totally responsible for a dependent newborn may also be a contributing factor.  In any event, these symptoms usually clear in 1 to 3 weeks as the hormone levels return to normal and you will develop a routine and a sense of control over your life.

There are several ways to cope with the postpartum blues:

1. First, acknowledge your feelings. Discuss them with your husband or a close friend as well as your sense of being trapped and that these new responsibilities seem insurmountable.
2. Second, get adequate rest. You will probably feel overworked, even overwhelmed.  Inadequate sleep will leave you fatigued. Caring for a baby can be a lonely and stressful responsibility. You may wonder if you will ever catch up on your rest or work. Every baby awakens one or more times a night. The way to avoid sleep deprivation is to know the total amount of sleep you need per day and to get that sleep in bits and pieces. Your baby doesn't need you hovering while he or she sleeps. If sick, your baby will show symptoms. If you don't take care of yourself, you won't be able to take care of your baby.
3. Third, get help with all your work.
4. Fourth, renew contact with other people; don't become isolated. Get out of the house at least once a week.
5. If you don't feel better by the time your baby is 1 month old, see your healthcare provider about the possibility of counseling for depression.

Dad's To Do List

You need to take time off from work to be your wife during labor and delivery, as well as on the day she and his child come home from the hospital.

 Not only does your wife need your support  to help her with household chores,  the baby also needs to develop a close relationship with you. You may participate in feeding, changing diapers, bathing, putting to bed, reading stories, dressing, disciplining, homework, playing games, and calling the doctor when the child is sick.

You need to be your wife's support system. The longer you go  without learning parenting skills, the harder it becomes to master them . Remember parenting is jointly done by both the parents.

Visitors

Only close friends and relatives should visit you during your first month at home. They should not visit if they are sick.

Friends without children may not understand your needs. During visits the visitor should also pay special attention to older siblings.

Taking Your Baby Outdoors

You can take your baby outdoors at any age. You already took your baby outside when you left the hospital, and you will be going outside again when you take him or her for the two-day or two-week checkup.

Dress the baby with as many layers of clothing as an adult would wear for the outdoor temperature. A common mistake is overdressing a baby in summer. In winter, a baby needs a hat because he or she often doesn't have much hair to protect against heat loss.

Cold air or winds do not cause ear infections or pneumonia.

The skin of babies is more sensitive to the sun than the skin of older children. Keep sun exposure to small amounts (10 to 15 minutes at a time). Protect your baby's skin from sunburn with longer clothing and a bonnet.

Camping and crowds should probably be avoided during your baby's first month of life.Also, during your baby's first year of life try to avoid close contact with people who have infectious illnesses.


Authored by :Dr.Subramanian M.D

The Best Feeding For Your Baby

Do you know that you can work on improving your child’s IQ, the moment he/she is born? You have a naturally endowed power within you as a mother to do so. Want to know how? Read On.

Breast feeding is the answer. Studies have shown that babies fed human milk may have a higher I.Q than babies fed artificial formulas.

Evidence-based medical research has clearly established that mother’s milk is the ‘perfect first food’ for the newborn, physiologically, developmentally and psychologically. Mother’s milk is nature’s gift of a head start for the baby. As soon as the baby is born, the mother’s milk that is secreted is called the colostrum and this is the ideal food for the baby’s developing stomach. It is concentrated in carbohydrates and proteins and low in fat and is easily digested. It also has a laxative effect and among the many benefits it bestows on the baby, this laxative effect helps to get rid of the excess ‘bilirubin’ that accumulates with childbirth as this can cause jaundice if in excess. Human milk is a species-specific first food that also helps the newborn develop a strong immune system to fight the many infections he/she will face. Importantly, breastfeeding has been touted as a strong preventive factor in chronic diseases such as diabetes mellitus, cardiovascular disease, obesity and even in some cancers.

 Breastfeeding is natural and be assured that women from time to time have breastfed their babies and the natural instinct is within you to do so. All that the new mothers need are help, counseling, guidance and support to ensure successful breastfeeding.

Preparing or learning how to breastfeed before the baby is born is a bit like learning how to drive a car without actually sitting in one. The practical aspect would be learnt only with the baby. Nevertheless, the theoretical knowledge helps you prepare mentally for the stress involved and also helps you make right choice.

Learn as much as you can about breastfeeding even before your baby's born. Talk to other nursing moms, read books to familiarize yourself, take the advice of a  qualified lactation consultant, and consider taking a breastfeeding class (offered by many centers) some time in your last trimester. The more you know about how to get started and the benefits of nursing, the more likely you are to succeed. 

Your pregnant body is preparing itself for breastfeeding during your pregnancy. That's one reason your breasts get so much bigger during pregnancy — your milk ducts and milk-producing cells are developing, and more blood goes to your breasts than before. But breast size has nothing to do with your ability to nurse successfully. For example, it's not true that smaller-breasted women make less breast milk.

The hormonal changes pregnancy brings to your breasts are sufficient preparation for most women. Don't rub or scrub your nipples — this will only hurt you and make breastfeeding difficult. Latching your baby correctly from the beginning is the most effective way to prevent soreness.It's not uncommon for a woman to have flat or inverted nipples and not realize it. Neither of these circumstances will prevent you from breastfeeding, but they may present some additional challenges in the beginning. If you have any question about your nipple shape, you should specifically ask your doctor.

Do understand that exclusive breastfeeding is the best feeding for your baby during the first six months. It helps you bond with the baby and it enhances the experience of motherhood. If you are a working mom, there are ways to manage breastfeeding. Talk to a lactation consultant who will guide you to do the best for your work life and your baby's feeding.


Authored By: Dr.S.Subramanian M.D

Antibiotics-Not the ultimate answer for all illness

What is an antibiotic?

An antibiotic is a medicine that destroys bacteria. There are a variety of antibiotics such as penicillin and ampicillin.

Antibiotics WILL NOT WORK for cold or flu. Why?

Generally germs called viruses cause colds and flu. Antibiotics do not fight viruses. Antibiotics fight germs called bacteria.

What is a viral infection?

Many common infections of the respiratory tract (nose, throat, sinuses, ears, and chest) are caused by viruses. Flu-like illnesses are also caused by viruses. Diarrhoea and/or vomiting are often due to a viral infection of the gut. Under normal circumstances your child's immune (defense) system is good at fighting off many types of viral infections. An antibiotic is not needed if a virus is causing an infection.
This is because:

• Antibiotics do not kill viruses. Antibiotics only kill bacteria.
• Overuse of antibiotics unnecessarily has led to some bacteria becoming resistant to them. This means that some antibiotics might not be effective when they are really needed.
• Antibiotics may cause side-effects such as diarrhoea, rashes, feeling sick, etc

What is the treatment for viral infections then?

Your child may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms. Treatments that are commonly advised for viral infections include the following.

• Paracetamol or ibuprofen to reduce a high temperature (fever), and to ease aches, pains, and headaches.
• Make sure your child drinks enough fluids to prevent dehydration. Dehydration may develop if your child has a high temperature, and it can make a headache and tiredness much worse.
• Do not wrap the child, but try to cool down when there is a high temperature. This is particularly important in children. If a child has a high temperature, then take off the clothes (in a warm, but not hot, room) and consider giving some paracetamol or ibuprofen.
• Other advice may be given for specific symptoms. For example, decongestants for a blocked nose, etc. Ask your doctor or nurse for advice.

What about bacterial infections?

The immune system can clear most bacterial infections. However, your child may need antibiotics for certain more serious infections caused by bacteria. When your child is ill, check with your doctor.

What if symptoms change?

Occasionally, a viral infection or a minor bacterial infection develops into a more serious infection. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops.

What if mucus from the nose changes color from clear to yellow or green? Does this mean that my child needs an antibiotic?

Yellow or green mucus does not mean that your child has a sinus infection. It is normal for the mucus to get thick and change color during a viral cold.

Does this mean I should never give my child antibiotics? What If the pediatrician gives an antibiotic prescription?

If your child's doctor prescribes antibiotics for your child, it is most probably an illness caused by bacteria. Give all of the medication (full course-correct dose and duration) as directed.


My child is sick with symptoms consistent with a previous episode of illness, can I repeat the previous prescription given by the doctor? 

Never repeat prescriptions.  The medication prescribed by the doctor stand good only for that particular situation. Never give antibiotics without consulting your doctor.

My child has recovered within few doses of the antibiotics prescribed, should I complete the full dose and trouble the child unnecessarily?

You must complete the full prescribed dose of antibiotics. It is important you do so. If you do not do so, although your child has recovered there may be some dormant  bacteria and  the antibiotic is needed to wipe out all of the bacteria.  Also if the bacteria is not completely eradicated, the surviving bacteria become more resistant and can be spread to other people.

In conclusion

• Antibiotics are strong medicines, but they don’t cure everything.
• When not used correctly, antibiotics can actually be harmful to your child’s health.
• Antibiotics can cure most bacterial infections – they cannot cure viral illnesses.
• Antibiotics kill bacteria – not viruses.
• When your child is sick, antibiotics are not always the answer.
  
  
  Authored by : Dr.Subramanian. M.D

Understanding Temper Tantrums in Children

Oh! No! Not again!!! How often have we sighed at a kid in an emotional state of agitation!!. At times, these temper tantrums can be infectious  and can unleash our tempers as well. Understand that temper tantrums are a normal part of growing up and all children have them. They happen for different reasons at different ages.  There is nothing as difficult as dealing a kicking, screaming child. There are no magic cures, but here are some successful techniques that can help.

AGE GROUPS


INFANTS
Infants may cry a lot, but they don’t really have tantrums. They cry because they are wet, hungry, cold, or lonely. Crying is their only way of letting adults know that they need something.
TODDLERS
Toddlers throw tantrums for many reasons—some big, some small.Toddlers have tantrums because they get frustrated very easily. Most toddlers still do not talk much. They have trouble asking for things and expressing their feelings. Toddlers also have very few problem-solving skills. Tantrums are most likely to happen when toddlers are hungry, exhausted, or overexcited.
PRESCHOOLERS
Preschoolers are less likely to throw tantrums. They have developed more coping  skills and are able to communicate better. Still, when dinner is late or when things get frustrating, your preschooler may begin to behave more like a 2-year-old! Some children learn at this age that tantrums can be used to get something they want. If parents give in to demands, tantrums may begin to occur with greater frequency. 


How to handle a tantrum?

• Try to remain calm. Screaming at your child tends to make the tantrum worse instead of better. 
• Set a positive example for your child by remaining in control of yourself and your emotions.
• Pause before you act. Take at least 30 seconds to decide how you will handle the tantrum. 
• Four possible ways to deal with a tantrum include: 
• Distract—Try to get your child’s attention focused on something else. If your child screams when you take away something unsafe (like mommy’s purse) offer something else to play with. This technique works well with toddlers.
• Remove—Take your child to a quiet, private place to calm down. At home this may the child’s room or a special “cooling down” place. Out in public it may mean sitting outside for a few minutes or in the car. Avoid trying to talk or reason with a screaming child. It doesn’t work! Stay nearby until your child calms down. Then you can talk and return to whatever you were doing.
• Ignore—Older children will sometimes throw tantrums to get attention. Try ignoring the tantrum and go about your business as usual. If staying in the same room with a screaming child makes you uncomfortable, leave the room. If necessary, turn on the radio and lock yourself in the bathroom for a few minutes.
• Hold—Physically restrain children if they are “out of control” (may harm themselves and others). You also might say something like: “I can see you are angry right now and I am going to hold you until you calm down. I won’t let you hurt me or anyone else.” Often this approach can be comforting to a child.

• Wait until your child calms down before talking about the situation. It’s difficult to reason with a screaming child. Insist on a cooling down period and follow-up with a discussion about behavior. Use this opportunity to teach your child acceptable ways to handle anger and difficult situations.  With practice, preschoolers and schoolagers can learn:
• How to ask for help,
• When to go somewhere to cool down,
• How to try a more successful way of doing something, and 
• How to express their feelings and emotions in words (rather than hitting, kicking, or screaming).
• Comfort and reassure your child. Tantrums scare most kids. They often are not able to understand the reason for their anger and generally feel shaken when it is all over. They need to know that you do not approve of their behavior, but that you still love them. 

Prevention

 If tantrums seem to be happening often, you might consider the following suggestions.

• Study your child’s tantrums. When and where do they occur? Who is generally involved? What happens before, after, and during a tantrum? Often, looking for patterns can give you clues about conditions or situations that bring out the tantrum in your child.
• Set realistic limits and help children stick to a regular routine. Predictable mealtimes and bedtimes are particularly important. 
• Offer real choices. Don’t say, “Would you like to take your nap?” unless you are prepared to honor your child’s choice not to nap. Instead try, “It’s nap time now.”
• Choose your battles carefully. Say “No” to things that are really important. Avoid fighting over little things.
• Give your child a few minutes warning before you end an activity. Saying “We are going to leave the park and go home in a few minutes,” or “I wonder what we can cook for supper when we get home,” helps your child get ready for change.
• Help children not to “get in over their heads.” Children need challenging activities, but not so challenging that they experience overwhelming frustration and failure.

Authored by : Dr.Subramanian M.D

Welcome

Welcome to Children's Health- India. There are many instances where parents would like to know more about the health, illness and wellness of their child. A visit to a pediatrician or health professional, very often, seems to end fast and parents feel that there are more questions to be answered only after the visit. Being pediatricians who are also parents, my wife Dr.Meenakshi and I understand these needs of parents and have ventured to offer our online help through this blog. We plan to discuss in detail, issues and concerns that you as a parent  might want to know and learn about. Please read the posts and give us your comments. 


Dr.Subramanian.