Intellectual disability (ID), previously known as mental retardation is characterised by below-average intelligence or mental ability and a lack of skills necessary for day-to-day living. Children with ID can learn new skills but at a slower pace than children without ID. There are varying degrees of intellectual disability, from mild to profound. Intellectual disability affects mental abilities in two areas:<ul><li>Intellectual functioning (such as learning, problem solving, judgement)</li><li>Adaptive functioning (activities of daily life such as communication and independent living)</li></ul> Symptoms:<ul><li>Achieving milestones like rolling over, sitting up, crawling, or walking later than children without ID</li><li>Talking late or having trouble with talking</li><li>Slowly mastering things like potty training, dressing, and feeding themselves</li><li>Difficulty remembering things</li><li>Inability to connect actions with consequences</li><li>Behaviour problems such as frequent tantrums</li><li>Trouble with problem-solving or logical thinking</li></ul> Causes:<ul><li>Genetic syndrome such as Down syndrome or Fragile X syndrome</li><li>Head trauma</li><li>Exposure to toxins such as lead or mercury</li><li>Premature birth</li><li>Severely malnourished child</li><li>Brain malformation</li><li>Maternal diseases</li><li>Environmental influences (alcohol, drugs or other toxins)</li><li>Problems during delivery</li></ul> Diagnosis:Intellectual disability is identified by problems in both intellectual and adaptive functioning. Intellectual functioning is usually assessed with an exam by a doctor. A full-scale IQ test might be suggested by your child’s doctor as part of a standard diagnosing procedure. However, the IQ score should not be the only basis of confirming intellectual disability of a child. Once the IQ tests hint towards intellectual disability, your child’s doctor might suggest further genetic tests to determine the cause of intellectual disability. During the diagnosis, three areas of adaptive functioning are considered:<ul><li>Conceptual – language, reading, writing, maths, reasoning, knowledge, memory</li><li>Social – empathy, social judgement, communication skills, ability to follow rules and the ability to make and keep friendships</li><li>Practical – independence in areas such as personal care</li><li>Adaptive functioning is assessed through interviews with family members, teachers and caregivers.</li><li>Intellectual disability can be mild, moderate or severe. Delays in language or motor skills may be seen by age two. However, mild levels of intellectual disability may not be identified until school age when a child may have difficulty with academics. In general, the milder the intellectual disability, the later it’s diagnosed.</li></ul> Treatment:<ul><li>Intellectual disability is a life-long condition and cannot be treated or prevented. However, early and ongoing intervention may improve functioning and enable the person to thrive throughout their lifetime.</li><li>After the diagnosis, the focus then shifts to looking at the child’s strengths and needs, and the supports he or she needs to function at home, in school/work and in the community.</li></ul> Tips for parents:<ul><li>Learn about your child’s disability.</li><li>Connect with other parents of children with disabilities.</li><li>Be patient and accept that your child will learn things slowly compared to other children.</li><li>Encourage independence and responsibility.</li><li>Look for opportunities in your community for social, recreational and sports activities.</li></ul> Prevention: Intellectual Disability cannot be prevented. FAQS about Intellectual Disability:What is intellectual disability?Intellectual Disability is also known as "Mental Retardation". It is a congenital disorder in which the child is born with low intelligence (low IQ – less than 70). Parents can observe a delay in milestone achievement of an intellectually disabled child in comparison to their sibling(s) or other children. Intellectual Disability includes deficit in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgement, academic learning, and learning from experience. Can IQ be increased with anything?Not at all. IQ can never be increased as it is a birth defect. Can a child with low IQ study in a normal school?Children with low IQ should be taught in a special school as different interventions and different approaches are needed to teach such children. If the parents are very hard-working, a child with mild intellectual disability can be sent to a normal school. From where I can do check the IQ of my child?You can consult a clinical psychologist for the IQ assessment of your child. Can a child with low IQ live a normal life?Only a child with mild intellectual disability may live a normal life if trained well. Otherwise, children with low IQ are always dependent on others for their basic needs of life.

Here are Intellectual Disability Symptoms, Causes, Diagnosis, Treatment, FAQs, and Prevention.

All about Intellectual Disability

Milk allergy, also known as Cow Milk’s Protein Allergy (CMPA), is an immune response triggered against the proteins present in the milk, which the body perceives as a threat and mounts a reaction.Even though milk allergy is one of the top food allergies, your little one is less likely to develop a severe reaction. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Always get your child diagnosed by a healthcare expert and never on your own. Never self-assume that your child has a peanut allergy. Commercial home test kits for self-diagnosis are not recommended as they may not be of the required standards.</li><li>Your child’s paediatrician may recommend that your child undertake tests like skin prick test, blood test or food/drug challenge. These tests must be performed under medical supervision as these tests might trigger an allergic reaction. Along with these tests, your child’s paediatrician will also examine your child's medical/family history, existing conditions like asthma and eczema.</li></ul> Cow Milk Protein Allergy can be present in two forms:Breast-fed children can develop CMPA before they turn 6 months and rarely after they are a year old. Most children either outgrow this allergy, and some learn to tolerate this. Children with eczema, asthma or hay fever have a higher likelihood of developing CMPA.&nbsp;Children develop CMPA due to one of these reasons&nbsp;– formula milk containing cow milk’s proteins, breastfeeding mother consuming cow milk, or a child consuming cow milk.&nbsp;Cow milk's allergy can be present in two forms:<ul><li>An 'immediate response' from minutes to hours and a 'delayed' type onset over hours to days. The “delayed” type is more common in children.</li><li>Fortunately, most children outgrow cow milk’s allergy in their early childhood.</li><li>Keep in mind that well-boiled or heated milk does not alter the structure of CMP or make it any less allergic.</li></ul> To alleviate CMPA, a breastfeeding mother should cut off products containing CMP from her diet until the child is weaned off from breastfeeding altogether. For formula milk, your child’s doctor may prescribe a hydrolysed formula that breaks the proteins. The majority of the children with CMPA can tolerate baked food due to different ingredients binding together. A doctor may advise you to introduce baked milk under medical supervision to improve your child's CMPA. If your child can tolerate it, a 'milk ladder' may then be recommended. A milk ladder is a structured approach to reintroduce milk protein products and is tailor-made for each child. Please make sure to inform your child's school, caregivers, or places frequently visited by your child's milk allergy and the possible alternatives in the diet. Milk allergy and lactose intolerance:<ul><li>Milk allergy is entirely different from milk intolerance.</li><li>Milk (lactose) intolerance triggers abdominal symptoms like diarrhoea, gas, or cramps due to the absence/deficiency of an enzyme called Lactase that helps digestion of milk sugar called 'Lactose'. Lactose intolerance can occur at any age but more commonly seen in babies and young children following infections, medications, or inflammatory bowel conditions.</li></ul> Alternative to cow’s milk:<ul><li>Consult your child’s paediatrician before selecting any alternative of milk for your child.</li><li>Milk from other mammals like sheep, goats, buffalo may also cause allergic reactions as they share similar proteins with cow's milk at varying levels.</li><li>Amino Acid-based Formulas (AAF) are recommended for children with a severe sensitivity to milk proteins.</li><li>It is not recommended to give other types of milk like rice milk, almond milk, soy milk to babies as it is not safe to use in children during the weaning period.</li><li>Formula based on soy proteins may be advised for infants over 6 months of age.</li></ul> Foods to avoid:<ul><li>If your child has CMPA, it is recommended to avoid milk proteins. As milk proteins may be found in the following food/food products, you must identify the variants.</li><li>Dairy products like yoghurt or curd, pudding, cheese, cottage cheese, sour cream, cream, custard, butter, ghee, whey, etc.</li><li>Particular food or drugs containing casein or its variants, lactose, lactulose, lactalbumin, lactoalbumin phosphate, lactoferrin, and cow's milk proteins.</li></ul> Other potential sources are:<ul><li>Chocolate, candies, nougat</li><li>Ice creams</li><li>Bakery products</li><li>Some medications/supplements</li><li>Artificial butter flavour</li></ul> Cow milk’s ladder:<ul><li>Milk Ladder is a guide to gradually introduce cow milk proteins in children who have a milk allergy. This is a reintroduction.</li><li>The first step of the ladder is to introduce baked products, progressing to less-treated milk products. It ends with a more allergenic form of cow's milk protein.</li><li>It is observed that few children can tolerate baked or well-heated milk.</li><li>The milk ladder may have eggs, soy or wheat. If your child is allergic to any other food, it is advisable to consult your child’s paediatrician for alternate options.</li></ul>

Milk allergy is one of the most common food allergies.

Milk Allergies in Babies

No human can stay hungry for long. Hunger is an integral part of survival. Every child has his/her own set of likes and dislikes when it comes to food. So the problem should not be that a child does not eat, rather the problem is that the child does not always eat what his/her parent wants them to eat. Every child likes something or the other. Identify that and feed them that. Introduce new foods along with their favourite foods.A few things which you can keep in mind:<ul><li>Avoid introducing junk foods with high taste levels at a young age: For example, if you introduce chocolate too soon, your child will be habituated to an intense sugary taste. Also, chocolates, biscuits, wafers have more calories. So if children eat 4-5 chocolates or biscuits, their calorie count is fulfilled and they will not require any more food for the whole day. These foods are highly rich in calories but do not provide other quality nutrition. Eating excess junk food will result in nutrient deficiency when they grow old.</li><li>Stop giving any junk food altogether: If you totally stop giving chocolates or biscuits, the child will gradually divert towards healthy nutritious food because no one can survive without food. You will have to work hard to develop a new habit of eating healthy and this can be time consuming and can demand a lot of patience.&nbsp;</li><li>Work as a team: When you know some things are not right for your child’s health, sit with the entire family and convince everyone to not give junk food every time a child demands. By being stricter, gradually your child will develop healthy eating habits.</li><li>Be a role model: If you want your child to follow your instructions, you too will have to say goodbye to your junk food habits. A child learns the most from his parents. Eat healthy and so will your children.</li><li>A frequent intake of sugar and sugary foods and drinks between meals causes tooth decay. Snacks and drinks taken between meals should be sugar-free.</li><li>Do not add more salt in the food either while cooking or at the table, as babies’ kidneys are not fully developed.</li><li>Every day, children need three meals plus snacks. Provide nutritious meals and snacks.</li><li>Young children are very active and have high energy (calorie) and nutrient needs in proportion to their small body size.</li></ul>

Children learn from your behaviour. Changing your eating habits will help them develop healthy eating habits as well.

Developing healthy food habits

<ul><li>When a grownup child of 4 or 5 years does not eat food on their own, it is a matter of concern. Actually, the training of a child eating on their own should begin in early years. When a child in of 6th or 7th month, (s)he tries to put everything in the mouth and that is the age when the child is eager to eat on his/her own.</li><li>At this time, the parent doesn’t allow thinking that the child is too young to eat on his/her own and will create mess like making their clothes dirty or floor and because the child will take longer time. So the child is being spoon fed and later when they get habituated to be fed by the parent, the parent starts complaining.</li><li>So the whole approach towards feeding needs to be changed. Child should be allowed to eat on his/her own even when (s)he creates mess or takes time.</li><li>Finger food which can be put on their fingers like fryums, cucumber or toast sticks, fruits are the kinds of food children like to eat on their own. Make food interesting for them and gradually they will develop the habit.</li><li>Of course developing a new habit is going to take time and you will need to be patient with your child.</li></ul>

When a child is ready to eat food on its own, (s)he will give you signals. Look for the signals and you will know how to help your baby.

Helping Children eat food on their own

Samiksha Choithani

There is nothing wrong in using breast pumps. Breast pumps are useful and come handy when you are travelling or for a working mother or when a child is having difficulty to latch on the breast. If you have decided to use a breast pump, follow these simple instructions:<ol><li>Clean all parts of the breast pump.</li><li>Wash your hands.</li><li>Find an isolated place where you can sit in peace and pump.</li><li>While you start pumping, think about your child, this will trigger hormones and will help to generate sufficient milk.</li><li>Make sure the shield of the pump is centred over the nipple.</li><li>Once you start pumping it may take a couple of minutes to start the flow.</li><li>Switch the breasts every 5 minutes; ensure each breast gets a total stimulation of 15 minutes.</li><li>After using the pump wash it with warm soapy water.</li><li>The milk extracted using a breast pump is safe for 4 to 6 hours at room temperature.</li></ol> In case after using breast pumps, you are experiencing problems such as - less milk supply or sore nipples, it is better to consult a doctor.

Using a breast pump is a personal choice.

Using Manual Breast Pumps or not?

Palak Vyas

Tearing is a normal function of the eye. But when tear ducts get blocked due to infection and inflammation, tears well up in the eye and fall excessively; this is called "eye watering". In newborns, the condition usually resolves itself within a few weeks. Common causes of watery eyes:<ul><li>Allergies</li><li>Blocked tear duct</li><li>Common cold</li><li>Dry eyes</li><li>Ingrown hair lashes</li><li>Pink eye (Conjunctivitis)</li><li>Stye (a red, painful lump near the edge of the child’s eyelid)</li><li>Tear duct infection</li><li>Eye injury</li><li>Chemical splash in the eye</li></ul> Symptoms associated with watery eyes:<ul><li>Eye pain</li><li>Eye infection</li><li>Runny nose</li><li>Vision impairment</li><li>Sneezing</li><li>Swelling in the eyes</li><li>Redness in the eyes</li></ul> Treating eye watering:<ul><li>Sometimes a sticky liquid may form around the baby's eye or eyes. You can use a piece of cotton wool that has been soaked in sterile water to clean the eyes. Make sure to boil the water to make it sterile and then cool enough before dabbing it on the child’s eyes with cotton wool.</li><li>Sometimes tears can be relieved by gently massaging the tear ducts. Apply light pressure with the finger and thumb to the outside of the nose.</li><li>If the situation persists for more than a day, consult a doctor.</li></ul>

The problem of constant tears usually resolves within a few weeks in a newborn. If eye watering is accompanied with other problems, you might want to consult a eye specialist for your child.

Treating eye watering

Ravina Sewani

The feeling of blocked or clogged ears is either due to water or sir getting stuck in the ears. Water in the ears:When water enters in an ear due to any reason, the ear feels clogged/blocked. If there's too much water in the ears, surrounding sounds also get muffled. It is important to remove the water from ears because otherwise it can cause infections. You can get the water out of your child's ear, these are a few steps to follow:<ul><li>First dry out your child's ear using a soft towel. Do not push the towel deep into the ear canal.</li><li>Ask your child to tilt their head on the side of the ear which has water stuck in it and let gravity to do the work. Slightly pull their earlobes; this will straighten the ear canal helping in draining the water.</li><li>If the clogging of the ear persists, you can get ear drops prescribed by your child's doctor.</li><li>Do not use cotton swabs as they will push the dirt deep into the ear. Warn your children to not stick their finger in their ear.</li></ul> Air in the ears:The ears tend to feel full and clogged when a person is sick, or when altitudes change. To relieve from this feeling, one needs to pop their ears. Here is how you can help your child:<ul><li>Yawn: Instruct your child to yawn as many times as possible as yawning helps in opening up the ear canal hence helping the ears to pop.</li><li>Swallow: Give water to your child or a candy to suck on as swallowing activates the muscles that open up the ear canal.</li><li>Valsalva maneuver: Take a deep breath and pinch your nose shut. Keep your mouth closed and gently exhale through the nose. If your child is too young, this technique to pop the ears is not advised as it carries a minute risk of rupturing the eardrum.</li><li>Toynbee maneuver: Pinch the nose shut and with your mouth closed, try swallowing. If your child has difficulty doing this, a mouthful of water will help in swallowing.</li><li>If nothing works, consult your child's doctor.</li></ul>

The feeling of blocked or clogged ears is either due to water or sir getting stuck in the ears.

Blocked ears

Lip tie is a condition where the underside of the upper lip tethers to the top of the gum with a skin tag. The piece of tissue behind your upper lip is called the frenulum. When these membranes are too thick or too stiff, they can keep the upper lip from moving freely. This condition is called a lip tie. Lip tie isn’t dangerous for babies, as long as they’re gaining weight according to their paediatrician’s guidelines. But lip tie, once diagnosed, is easy to correct. A baby with a tongue tie may not necessarily have a lip tie. Babies with lip tie may face challenges to breastfeed or bottle-feed, as it restricts the baby from stretching the lips to open the mouth wide. Causes: The causes of lip tie are still unknown. Lip tie symptoms:<ul><li>Difficulty in breastfeeding is one of the most common indications that your child may have a lip tie or tongue tie.</li><li>Struggling to latch on to the breast</li><li>Difficulty breathing during feeding</li><li>Making a clicking sound while nursing</li><li>Falling asleep often during nursing</li><li>Acting extremely fatigued by nursing</li><li>Slow weight gain or lack of weight gain</li><li>Colic</li></ul> If a child has a lip tie and you’re a breastfeeding mother, you may experience:<ul><li>Pain during or after breastfeeding</li><li>Breasts that feel engorged even right after nursing</li><li>Blocked milk ducts or mastitis</li><li>Fatigue from breastfeeding constantly even though your child never seems to be full</li></ul> Babies who have a severe lip or tongue-tie may go on to have difficulty eating from a spoon or eating finger foods, according to the American Speech-Language-Hearing Association. Lip ties don’t have as many complications later in life. Some paediatricians believe that an untreated lip tie can lead to a higher likelihood of tooth decay for toddlers. Diagnosis: A lip tie is diagnosed through a physical exam. Most paediatricians can diagnose a lip tie based on its appearance. Treatment:A lip tie can be treated on the basis of the class of lip tie. Whether it is a class 1, class 2, class 3 or class 4. It can also be fibrous, fleshy, thick or thin depending upon the texture of the skin fold. Manual treatment: For class 1 and class 2 lip ties, the baby doesn’t need any formal treatment. Parents have to gently slide the finger underneath the upper lip to stretch frenulum tissue. This type of manual practice can gradually release the tightness of the tissue and the child will have normal mobility of the upper lip. Frenectomy: This is a small surgical procedure where the frenulum is cut through an operation. A frenulum is a small fold of tissue that prevents an organ in the body from moving too far. Doctors usually use laser technology to cut the frenulum and so it is called laser frenectomy. General anaesthesia is not used; instead, a local topical numbing agent is applied to the frenulum. In this procedure, a child may or may not require stitches. The procedure hardly takes a few minutes to complete. Babies can experience mild pain post the procedure. Stay vigilant for any signs of swelling or bleeding from the lips and contact the doctor immediately. Prevention: Lip tie cannot be prevented.

Here are Lip Tie Symptoms, Causes, Diagnosis, Treatment, and Prevention.

All about Lip tie

A 'tongue-tie' (also known as ankyloglossia) limits the tongue's mobility due to an unusually short/thick frenulum (a piece of skin) that connects the tongue tip to the floor of the mouth. As the mouth parts develop in the fetus during the 1st trimester, a failure of the frenulum to separate completely from the base of mouth results in tongue tie. The severity ranges from being mild to a complete loss of mobility of the tongue. Causes: The causes of tongue tie are still unknown. Symptoms:<ul><li>Baby can’t latch well</li><li>Baby tends to chew more than suck</li><li>Baby doesn’t gain weight</li><li>Baby is fussy when trying to feed</li><li>Baby makes a clicking sound while feeding</li><li>Tongue can’t move far from side to side</li><li>Tongue can’t reach the upper gums or roof of the mouth</li><li>Tongue can’t stick out past the gums</li><li>Tongue has a V shape or heart shape at its tip when it’s sticking out</li><li>Older children may have difficulties pronouncing certain words with 't; 'th; 'd', 'dh', 's', 'Z', 'r', or 'II in it.</li><li>There is a higher possibility of dental problems (tooth decay, gingivitis, space between the bottom front teeth) in older children.</li><li>Gagging or choking on foods as your child starts to eat solids.</li><li>A hard time with basic things, like licking an ice cream cone.</li></ul> Diagnosis:A physical exam is all it takes to see what’s going on. The doctor will:<ul><li>Ask how feeding is going.</li><li>Check your child’s tongue, mouth, and teeth.</li><li>Use a tongue depressor, which is like a big popsicle stick, to look under your child’s tongue and check the range of motion.</li><li>The doctor may ask older kids to move their tongue around and make certain sounds, like of an r or l</li></ul> Treatment:The lingual frenulum generally loosens over time and it can be cured on its own most of the times. But if the problem persists, a lactation consultant can help with breastfeeding and a speech-language therapist can help with speech therapy. If there is any severe complication, then your doctor may suggest some surgical procedures like frenectomy or frenuloplasty. Frenectomy: This is a simple surgical procedure wherein the doctor uses sterile scissors to cut the frenulum free. It is a quick procedure. The baby hardly feels any pain during or after the surgery as there are few blood vessels in the lingual frenulum. The procedure can be done with or without sedation. Frenuloplasty: If the lingual frenulum is too thick, the doctor might need to do some additional repair and this is an extensive procedure known as Frenuloplasty. General anaesthesia is given by the doctor. The wound is usually closed with sutures. Complications are similar to frenectomy - Bleeding, infection, damage to tongue or salivary glands. In this procedure, the doctor will:<ul><li>Give your child drugs so they sleep through the whole thing</li><li>Use special tools to cut the frenulum</li><li>Put in a few stitches that dissolve on their own as the wound heals</li><li>After the surgery, the doctor might suggest a few tongue exercises to increase the movement of the tongue.</li></ul> Prevention: Tongue tie cannot be prevented.

Here are Tongue Tie Symptoms, Causes, Diagnosis, Treatment, and Prevention.

choking health concerns

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