Child Care

Monsoon Care

Monsoon Care by Dr Shruti Ghatalia


Chapter 28 : Helping Child to Cope – Academics and Extra Curricular

Parent’s guide to child care by dr. shilpa aroskar


Chapter 29 : Teaching Children About Money

Parent’s guide to child care by dr. shilpa aroskar


Chapter 31 : How to be Good Parents?

Parent’s guide to child care by dr. shilpa aroskar

FEVER

Q.1 What is normal body temperature and how to measure?
Normal body temperature is 97.5-97.8°F (36.4-37.2°C) if taken in axilla, in the mouth 37.8°C and in the rectum 38.0°C. It is advisable to take axillary temperature (underarm) in infants and young children; if put in the mouth, there is a chance of biting and breaking the thermometer. Rectal temperature is to be taken by a rectal thermometer; however these should be used only by health care professionals.

a) Shake the thermometer before use

b) Dry the armpit and place the thermometer under the arm for 2 mins.

c) Remove the thermometer by holding one end and read the height of the mercury column corresponding to the temperature mark.

Q.2 Are digital thermometers or strips available to measure temperature accurate?
In my opinion, the mercury thermometer is most reliable.

Q.3 Why fever occurs?
Any infection in the body-caused by a virus, bacteria or a parasite causes fever. Fever is body’s response to an outside germ.

Q.4 Is fever dangerous?
Fever per se, is not dangerous. It is body’s response to fight against infection. However, in infants-and children especially till 6 years of age, there is a chance of convulsion (fits) with high fever (called febrile convulsion).

Q.5 What is the treatment of fever?
It is very important to treat the cause of fever and not treat or suppress only the fever. Many a times, parents give antipyretics (medicines) round the clock and suppress the fever. This is a wrong thing to do. Consult your doctor so that he can find the cause of fever and treat accordingly.

Q.6 What should be done at home during high fever?
a) Tepid sponging is the first thing that parents should do when fever exceeds 10l°F.
b) Technique: a. Use tap water for sponging. Do not use ice or cold water as it may suddenly reduce the temperature and cause shivering.
c) Strip all the clothes. Apply water on the whole body (either with hand or with towel soaked in water).
Do not keep towel only on the forehead but apply on the whole body. Allow the water to remain on the body as water from the body will be used for evaporation of water. Repeat the same procedure again and again, till the body temperature reduces to normal. Wipe the body and then put on the clothes.

Q.7 What is the safe and best medicine for fever? Is Nimesulide not good for children?
Paracetamol is a safe and good medicine for fever. It can be given in form of syrup or as rectal suppository. Nimesulide is a controversial drug at present. More trials are being conducted. Consult your doctor before using it.

COLD AND COUGH

Q1 What causes cold and cough?
Cold is of two types: One caused by viruses and other which is of allergic type and is usually hereditary. Cough, is a protective reflex of the body to any foreign agent – virus, bacteria or allergy of any kind. As cough is not harmful. However, it causes lot of discomfort and often disturbs the child’s sleep.

Q.2 Why is it-more common in children?
Children usually catch infection from family members in the house or other children at school or creche. Allergic type is most of the time inherited and is caused by dust, pollen, strong smells or particular type of food. Children who are exclusively breast-feed for first 4-6 months are less prone for recurrent cold and cough.

Q.3 What is the treatment?
Cold – Cold is a self-limiting disease. Steam inhalation and normal saline nose drops to prevent nose block is the best medicine for cold. Antihistaminic can be used to treat allergic cold. Very frequent and severe allergic cold respond well to steroid nasal sprays. Avoiding the allergen, which triggers the cold/cough is important.

Cough – It is ideal to treat the cause of cough than give suppressants. Sips of warm water during bouts of cough and salt water gargles are of some help.

a) Allergic cough – antihistaminic may help
b) Cough, if associated with high fever and bacterial, then antibiotic is needed (to be taken only with advice of your doctor)
c) Cough associated with wheezing requires bronchodilators. If associated with breathlessness then nebulisation is required and long-term inhaler therapy may be needed (as prescribed by your doctor).

Q.4 What should be the diet?
Avoid cold and refrigerated items. Hot soups, hot milk, ginger-honey, etc. are soothing for the throat.
Diet rich in vitamin-C – amla, citrus fruits help to prevent recurrent cold. Breast feeding exclusively for 4-6 months prevents recurrent cold and cough.

DIARRHEA AND VOMITING

Q.1 Why is diarrhea more common in children during teething?
Teething causes irritability and itching of gums in children. To relieve this, children put everything in the
mouth – thereby the germs enter the child’s intestine and causes diarrhea and vomiting. Children who are bottle fed or given supplemental food are more prone for diarrhea because of improper sterilization of utensils or unhygienic practices.

Q.2 How to assess dehydration at home?
a) Keep a watch on the intake of the child.
b) The number of times the child passes urine is a good indicator of the child’s hydration.
c) Note the child’s behavior. If the child is not alert, active, and is irritable is a sign of dehydration.

Q.3 How should we prevent dehydration?
a) If you are breast-feeding, you can give frequent breast feeds.
b) Administer ORS recommended by WHO. Once reconstituted use within twenty-four hours.
c) Increase fluid in the diet. Apple juice, pomegranate juice, rice kanji, aara-root kanji, buttermilk etc. are good homemade items.
d) I f the child is unable to retain ORS or fluids because of vomiting then the child may require IV (intravenous) fluids in the hospital.

Q.4 My newborn baby who is on breast-feed has frequent diarrhea with perianal redness.What should I do?
Breast feed babies seldom get infection. Your baby might be having a condition called ‘lactose
intolerance’ – the sugar in the breast milk causes frequent loose stools which are acidic in nature and
causes parianal redness. Changing over to soyamilk preparations available in the market helps in this
condition. However, it is a must to consult your doctor before trying this on your own.

Q.5 What precautions should be taken to prevent recurrent diarrhea and vomiting?
a) Proper hygiene and sanitation can help prevent recurrent infection.
b) Use boiled water as drinking water for your family.
c) Avoid eating outside food and water, especially roadside hawkers. If eating in a restaurant, choose one
with high standard of hygiene.
d) Wash hands after sanitation and before eating.
e) Wash fruits and vegetables before cooking.|
f) Oral zinc preparations are helpful in recurrent and chronic diarrhea.

Q.6 What are the do’s and don’ts for diet during diarrhea?
a) Avoid outside food.
b) Don’t force feed, this can induce vomiting.
c) Mothers who are breast-feeding can continue feeding frequently.
d) Fresh curds contain lactobacillus and are good in diarrhea,
e) Homemade rice kanji, apple juice, pomegranates, khichdi, buttermilk, aara-root, kanji are good.
No particular food restriction is necessary unless the diarrhea is because of lactose intolerance.

NEW BORN FAQS - SKIN CARE

Q.1 Which oil should be used for oil massage?
Mild, non-irritant oil free of fragrance is advisable for oil massage. Coconut , Olive or Almond oil are best
examples. However, if the baby has any rash on the skin, one should not do an oil massage until and
unless the doctor advises to do so.

Q.2 .What type of bathing soap should be used?
Mild baby soap can be used. In case the skin is dry, glycerin based soap is better.

Q.3 Are diapers safe for my child? Can it be used routinely throughout the day or only while traveling?
Diapers should be soft and absorbent. They should be changed frequently as soon as they are soiled with
urine or feces. If the child develops a rash due to diapers, it is better to use them only while traveling.

Q.4. Should I apply besan to my newborn baby or not?
Besan can cause acne like lesions. It could even cause an irritant dermatitis, if rubbed vigorously. Mild baby soaps are better cleansers. So avoid besan application.

NEW BORN FAQS - BREAST FEEDING

Q. 1. If I have a cesarean section, how early can I nurse my baby?
CSn is not a contraindication to breast feeding and can be started within 5 to 6hrs with side lying position with the help of a nurse or a female attendant. Mother’s motivation, patience and support of family members is important. Water, honey, glucose etc should be avoided.

Q. 2. Why does my baby gets hiccoughs?
It usually occurs after a feed because the full stomach presses the diaphragm. so it is nothing to worry but an indication of full stomach.

Q. 3. How can I store breast milk and use it to feed my baby?
EBM can be stored for 6hrs at room temperature and 24hrs in the fridge, it can be given to the baby with a sterilised vaati spoon or bondula.

NEW BORNFAQS - BREAST FEEDING

Mobile phones emit high frequency radiations which are harmful for children so it should not be given to infants and toddlers.

Never give glucose water when your child is vomiting, it is hyperosmolar and worsens the vomiting.

Eating too many sweets causes worms is a myth and frequent deworming in absence of symptoms should not be done.

Breakfast is the most important meal of the day and school going children should never go empty stomach in the morning but have cereal, milk, chappati etc.