Palak Vyas

Type 1 diabetes in children is a condition where the child’s body is unable to produce an important hormone called insulin. Without this hormone, the sugar in the blood cannot travel to the cells causing high blood sugar levels. This condition is also known as juvenile diabetes or insulin-dependent diabetes. Insulin deficiency in the body has to be replaced by insulin injections. It is hard on both the parents and the kids when the child is diagnosed with type 1 diabetes. This is because after the diagnosis, the child has to be given regular insulin injections and his/her sugar intake has to be limited as well. Parents and the child have to be extra cautious all the time.&nbsp;Symptoms:<ul><li>Increased thirst</li><li>Frequent urination, bed-wetting even if the child has been potty trained.</li><li>Too much hunger</li><li>Drastic weight loss</li><li>Fatigue</li><li>Irritability and changed behaviour</li><li>Fruity smelling breath</li><li>Girls may also develop a yeast infection.</li></ul>&nbsp;Causes:<ul><li>The first and foremost reason could be a family history of this disease. The child having parents or siblings having the same condition is at a high risk of developing it.</li><li>Genetics play a major role here.</li><li>It is said that exposure to various viruses can trigger the autoimmune destruction of the islets cells (cells that produce insulin).</li></ul>&nbsp; Diagnosis: Blood glucose level is measured before and after food and by observing for symptoms of diabetes. Complications associated with type 1 diabetes in children:<ul><li>This condition affects the major body organs of the child.</li><li>It narrows down a child's blood vessels, causes high blood pressure, heart disease and can cause stroke issues in later stages of life.</li><li>Basically it affects blood vessels which in turn damage the kidneys, eyes, and nerves.</li><li>Type 1 diabetes reduces bone mineral density causing a risk of developing osteoporosis in later stages of life.</li><li>DKA- Diabetic ketoacidosis is a leading cause of mortality in children with type 1 diabetes. When insulin levels are very low, the body cannot use sugar to produce energy. So it starts breaking down fat for energy. This leads to ketones production, which is toxic at high levels. When the levels are high, it results in DKA, where the body becomes acidic.</li></ul> Treatment: The only treatment for type 1 diabetes is the use of insulin tablets or injections. Prevention:<ul><li>This condition cannot be prevented. Research is still going on in this direction. All you can do is control the damage.</li><li>Maintain blood sugar levels.</li><li>Ensure your child has healthy food.</li><li>Regular exercise routine</li><li>Regular examination and monitoring by the doctor.</li></ul>

Here are Diabetes Symptoms, Causes, Treatment, Prevention, Diagnosis, and Complications.

All about Type 1 Diabetes

Samiksha Choithani

Usually the reactions stay for a few days after the vaccination. If your child has taken a vaccination in the past few days you can expect these reactions:<ul><li>Low-grade fever</li><li>Redness and Pain around the leg or arm where the vaccination was given</li><li>Slight swelling</li><li>Trouble in sleeping</li></ul> Here are some tips to ease the pain:<ul><li>Feeding works wonders when babies are in pain, breastfeeding more often after vaccination can help the baby keep hydrated and take the mind off from the pain.</li><li>Apply ice pack in the injected area, you can also soak a soft cotton cloth in cold water and place it on the injected area.</li><li>Swaddle the baby immediately after vaccination.</li><li>Swing them in arms.</li><li>Do not massage in the injected area for a few days.</li></ul> If the reactions persist for more than 2-3 days, it is better to consult your child's paediatrician.

Almost all vaccinations have mild reactions post vaccination; this means the vaccine is working.

Common reactions after vaccination

Ravina Sewani

Squint eye or strabismus is misalignment of the two eyes where the eyes do not look in the same direction. This means that a child with squint eye(s) may not focus on an object (s)he is looking at. When a child is looking straight ahead, one of the eye may turn either inwards, outwards, upwards or downwards. Some babies are born with a squint (strabismus), and some babies and children develop a squint later. Acquired squints are sometimes caused by the eye trying to overcome a vision problem, such as short-sightedness, but in many cases the cause is unknown. Rarely, a squint may be caused by a condition in the eye itself. In most squints one eye turns inwards or outwards. Less often, it may turn up or down. The misalignment in some cases is constant while in other can appear only at some particular times. Squint eye is also associated with weak eyesight. Types of squint:<ul><li>An eye that turns inwards is called an esotropia.</li><li>An eye that turns outwards is called an exotropia.</li><li>An eye that turns upwards is called a hypertropia.</li><li>An eye that turns downwards is called a hypotropia.</li></ul> Causes:<ul><li>Trauma</li><li>Lesions in the brain</li><li>Staring screens for long hours</li><li>Imbalance in the eye muscle</li><li>Aberration in the nerve supply</li><li>Decreased vision in one eye</li></ul> Symptoms:<ul><li>A family member, teacher, or a health care provider notices that the eyes of a child are not straight.</li><li>Kids usually don’t complain for vision problems although some kids may complain of double vision (seeing two objects when there's only one in view) or have trouble seeing things in general.</li><li>Younger kids who cannot fully talk may squint a lot and turn or tilt their heads in an attempt to see more clearly.</li></ul> Diagnosis:Squint can be diagnosed when a child is taken to an ophthalmologist for routine check-up. Tests to find a squint can involve covering and uncovering each eye in turn. This often shows which eye has the squint and how it moves. The pupils of the eye can be checked with a torch, to check that they become smaller (constrict) with light and widen (dilate) when the light is removed. Very occasionally a scan of the eye or the brain may also be needed. Treatment:<ul><li>The correction of squint eye can be done by an eye specialist only. The first is that your child will be prescribed glasses to wear. After the prescription of the glasses, the doctor usually assesses the squint again.</li><li>The doctor will either advise patching of the eye or the use of dilating drops depending on the type of squint. The eye specialist might also suggest some eye exercises to strengthen the eye muscles.</li><li>In a more complicated case of squint eye, the doctor might also suggest a surgery to be done.</li></ul>

Many a times, squint eye resolves on its own but if it does not, it needs correction and treatment.

Squint eye in children

If your baby has green, foamy or frothy, explosive stools and pain, it might be a case of lactose overload. Lactose overload can happen when your baby gulps a very large quantity of breastmilk either due to a long gap between the feedings or due to an oversupply of milk. Healthy babies are able to break down the lactose in normal volumes of milk. The presence of fat in the milk ensures the slow movement of milk through the gut. But if your baby consumes a lot of milk that is relatively low in fat, it can rush through the digestive system without being digested. This can cause the problem of gas causing pain and frothy stools. If you suspect lactose overload, try to check your baby's latch. Try different positions to feed your baby if you have a problem of oversupply of milk. Try frequent feeds as your baby to avoid build up of watery low fat milk. If the problem persists, you know what to do, head straight to your doctor.

Lactose overload happens when the milk is not digested properly.

Lactose Overload

Eating excess junk food like pizza and pasta can cause constipation as they are made of refined flour. The child, who is already suffering from constipation avoids going to the toilet because it is painful. Because of this, the stool stays in the stomach and gets harder and it gets more painful when the child goes to the toilet next time. This cycle continues. Make sure the child eats enough fibrous foods like fruits and vegetables so the stool gets softer and passes out easily. . For 0-1 year:Constipation among infants is not a serious problem. The child is constipated when (s)he misses passing the stool for less than thrice a week or when they pass thick/hard stool. Babies who are exclusively breastfed may not pass bowel movements every day. So, do not worry much. If your child is happy, does not cry much and does not have a gas problem, be rest assured about constipation. If you feel that your child's belly is very firm than usual, it could be a sign of constipation. In that case, you can try the following:<ul><li>Adjust your diet so that the baby gets healthier breast milk.</li><li>If your baby is below 6 months, gently massage the his/her stomach and gently move his/her legs in the bicycle movement.</li><li>If your baby is older than 6 months, you can try giving him/her semi-solid foods and fruit juices to improve bowel movements.</li></ul> Also, do not worry about the variance in the colour of the potty. The colour of the potty changes during the first year due to diet and the introduction of new foods to babies. The colours of potty may vary from black, mustard yellow, green, orange. If the colour is white or grey or chalky, it indicates the baby is suffering from liver problems and in this case, you should consult a paediatrician. For 2-6 years:If you are a parent of a toddler, keep a check on potty routine. At times children skip potty as they are more interested in playing or watching their favourite cartoon and hence avoid going for potty. Even change in routine makes them uncomfortable about going to potty. If constipation persists, you can try the following:<ul><li>Give them a glass of warm water once or twice a day if they regularly skip potty.</li><li>Give them carrot and green leafy vegetable soup.</li></ul>Also, give your child proper potty training. Set a fixed time of the day when they are supposed to go for potty. This will help maintain a regular bowel cycle. If constipation persists for more than a week, it is better to consult your child's paediatrician.

The problem of constipation in children worries a lot of parents. There are a few ways in which you can address this problem.

Constipation among infants and toddlers

<ul><li class="ql-align-justify">Breastfeed your baby as much as (s)he wants. In the early days and weeks, your baby will wake and feed frequently, day and night.</li><li class="ql-align-justify">When your baby is a newborn, their stomachs are tiny. Babies can physically take only small amounts of milk. They can digest breast milk easily and it soon gets absorbed it into their system. That's why babies might demand constant feeding.</li><li class="ql-align-justify">After the first few days, most young babies feed at least 8 to 10 times in 24 hours. This means your baby could be asking for a feed every 90 minutes to two hours.</li><li class="ql-align-justify">It's worth keeping an eye on the number of feeds the child has, and offering them your breast, even if the baby not asking. By breastfeeding often, you're building up your milk supply. The more your baby feeds, the more milk you will produce. This is called responsive feeding. And your baby will love snuggling into you, whether or not they are hungry.</li><li class="ql-align-justify">Do check that your baby is latched on well. Otherwise, (s)he may be nipple-feeding, rather than breastfeeding. This can make your nipples sore, and your baby may be unsettled, because they can't get a good amount of milk. Get advice from your elders or paediatrician if you're worried that your baby isn't feeding well.</li><li class="ql-align-justify">Your baby needs to open wide and take a good mouthful of your breast. Once they have latched on, the chin should be touching your breast, the nose should be clear and baby's lower lip should be evened.</li><li class="ql-align-justify">Your baby may want to feed more often, or for longer, at night. This is normal, because your body produces more prolactin, the hormone that makes milk, at night. By feeding often at night, your baby stimulates your body to make more milk.</li><li class="ql-align-justify">Over the next few months, your baby's feeding pattern may become more predictable. This can take a while to establish, though, so try not to be disheartened.</li><li class="ql-align-justify">Always keep the weight of the baby in check, to track their physical development. The track of baby’s weight will also help you to understand whether your baby is feeding enough or not.</li><li class="ql-align-justify">It is recommended to JUST breastfeed your baby until the age of twelve months and it can be continued till the age of four depending on mother's and child's comfort.</li></ul>Signs that your child is adequately breastfeeding:<ol><li class="ql-align-justify">Frequent urination up to 6-7 times a day.</li><li class="ql-align-justify">Adequate weight gain.</li><li class="ql-align-justify">A sleepy baby post breastfeeding.</li><li class="ql-align-justify">Let down reflex (Milk comes out from the other breast while baby feeds from one breast).</li></ol>

Worried about whether you are feeding the child enough? Look for the signs that your child gives.

Breastfeeding Schedule

Begin brushing your baby’s teeth from the time they start appearing. Even in the absence of teeth you can wipe their gums with soft clean cotton cloth carefully. Brush their teeth with clean small soft bristled toothbrush using small circular movements. Change their brush every 3 months. Cause of bad breath could vary:<ul><li>Sometimes, infections can cause bad breath. If your toddler has an infection at the back of his throat, such as tonsillitis, this can make his breath smell foul. Other symptoms of tonsillitis include a sore throat and coughing. Your toddler’s bad breath will disappear when the infection clears up.</li><li>It’s also possible that the smelly breath is because your little one has a blockage in his nose. That could be because he has a cold or sinus infection.</li><li>If your toddler sucks or chews on a blanket, or sucks thumb, it could lead to developing bad breath.</li><li>If your toddler has persistent bad breath, take him for a check-up at the dentist.</li></ul>

It is important to maintain proper oral hygiene since day 1. Bad breath is an indication of poor oral hygiene.

Taking care of Bad breath

<ul><li>Generally there is a notion that a gluten free diet is healthy but it is not true for everyone. Gluten free diet is for those who have either 1) celiac disease (immune reaction against eating wheat) or 2) non celiac gluten sensitivity. Gluten present in wheat, barley, rye and other products can be troublesome for celiac patients and it can make gluten sensitive people sick.</li><li>So if the kid has any of the above conditions you can go gluten free otherwise it isn’t wise to keep your child’s diet gluten free.</li><li>Gluten free diet generally includes food like vegetables, high quality protein, healthy fats (nuts, seeds, avocado), fruits and grains that do not have gluten.</li></ul> Reasons why you should not have gluten free diet for your child:<ul><li>Whole Grains that contain gluten have lots of crucial nutrients including B vitamins, antioxidants, iron, selenium, magnesium etc. Excluding whole grains will lead to nutrition deficiency in children.</li><li>Whole grains have fibre too which is good for digestion.</li><li>Gluten free diet can be too low in calories for growing children. It is hard to get healthy calories from other sources.</li><li>Gluten free diet can be high in arsenic. Those who do not eat wheat prefer rice as a staple food. Now rice and rice products are rich in arsenic which is not good for the baby’s body.</li></ul>

It is very important to maintain a balanced diet for the proper growth and development of the baby. Going gluten free or not is an individual's choice. It is better to look into the pros and cons before taking the decision.

Gluten free diet for children or not

<ul><li>Earaches in children are common. An earache may affect one or both ears, but the majority of the time it’s in one ear. Earaches can be constant or come and go, and the pain may be dull, sharp, or burning.</li><li>Kids below 5 years are at a higher risk for ear infections. Young children with ear infections get fussy and irritable. They may also tug or rub their ears.</li></ul> Symptoms:<ul><li>Ear pain (when chewing, sucking, or lying down)</li><li>Redness of the ear</li><li>Swelling of the ear</li><li>Pulling or rubbing the ears</li><li>Leakage from the ear</li><li>Trouble hearing</li><li>Ear fullness&nbsp;</li><li>Ear popping</li><li>Fussiness</li><li>Vomiting</li><li>Headache</li><li>Fever</li><li>Loss of balance</li><li>Difficulty sleeping</li></ul> Causes:<ul><li>Ear infections - outer, middle, or inner ear</li><li>Change in pressure, such as when flying on a plane</li><li>Earwax buildup</li><li>A foreign object in the ear</li><li>Sinus infection</li><li>Shampoo or water trapped in the ear</li><li>Use of cotton swabs in the ear</li><li>Referred pain - when the pain is felt somewhere other than the infection or injured site. For example, pain that originates in the jaw or teeth may be felt in the ear.</li></ul> Diagnosis:Your child's doctor will use an otoscope to look at the ears, throat and nasal passage. (S)he will might also listen to your child breathe with a stethoscope. Sometimes, doctors might use a Pneumatic otoscope to diagnose an ear infection. The doctor might perform other tests if there is any doubt about a diagnosis.<ol><li>Tympanometry: This test measures the movement of the eardrum.</li><li>Acoustic reflectometry: This test measures how much sound is reflected back from the eardrum.</li><li>Tympanocentesis: An instrument to drain the fluid from the middle ear. This fluid is then tested for viruses and bacteria.</li></ol> Visiting the doctor:<ul><li>If your child has a persistent fever of 104º F (40º C) or higher, seek medical attention.</li><li>For an infant, seek medical help immediately for a fever higher than 101º F (38º C).</li><li>You should also seek immediate medical attention if your child has severe pain which stops suddenly. This could be a sign of the eardrum rupturing.</li></ul> Treating earaches at home:<ul><li>Place a warm compress carefully over your child's ear for approximately 20 minutes.</li><li>Apply a cold washcloth to the ear.</li><li>Avoid getting the ear wet.</li><li>Sit upright to help relieve ear pressure.</li><li>Feed an infant to help them relieve their pressure.</li></ul> Medical treatment:<ul><li>If your child doesn't have too much discomfort or a high fever, the doctor will likely wait 24 to 48 hours (1 to 2 days) to see if the ear infection gets better on its own.</li><li>Your child's doctor will prescribe oral antibiotics or ear drops if the earache does not resolve on its own. In some cases, (s)he can prescribe both.</li></ul> Prevention:<ul><li>Make sure your child gets the pneumococcal conjugate vaccine (PCV) and the flu vaccine, which may reduce their odds of getting middle ear infections.</li><li>Do not clean ears with cotton swabs or sharp objects.</li><li>Dry the ears after swimming or bathing.</li><li>Avoid secondhand smoke.</li><li>Make sure your child has a habit of washing his/her hands.</li><li>Don't give a bottle when your baby is lying down.</li><li>Ask the doctor if earplugs and special ear drops are a good idea if your child swims a lot.</li></ul>

Here are Earache Symptoms, Causes, Treatment, Prevention, Diagnosis, and Home remedies.

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