Palak Vyas

Thyroid gland is situated almost in the centre of the throat region. It releases thyroid hormone which plays a major role in all metabolic and chemical processes in our body. It is important for the overall growth and development. There can be two conditions related to thyroid hormone:<ol><li>Hyperthyroidism: When the thyroid gland produces an excess of the thyroid hormone. Here, the gland is overactive.</li><li>Hypothyroidism: When the thyroid gland produces too little of the thyroid hormone. Here, the gland is under-active.</li></ol>You will need a paediatric endocrinologist to treat thyroid in children.&nbsp; Congenital Thyroid:Congenital defect is the defect that child has from its birth itself.1 in 4000 live babies can have congenital thyroid. If congenital Hypothyroidism (the situation where less amount of hormone is produced) is not detected on time and if treatment is not given on time, the child can suffer from poor growth and can get developmental defects. (S)he can develop severe mental retardation. Reasons for congenital thyroid:<ol><li>The thyroid gland is not able to develop fully and is unable to produce hormones.</li><li>The thyroid gland is totally absent.</li></ol>&nbsp; Hypothyroidism in children:Causes:<ul><li>Children who are born in a family that has a history of the same disease. If the parents, grandparents or siblings have it, the chances of the child developing this disease are more.</li><li>The amount of iodine is not enough in a child's diet.</li><li>Improper treatment of a mother’s thyroid during pregnancy.</li><li>Abnormal pituitary gland.</li></ul>&nbsp;Symptoms of hypothyroidism in newborns:<ul><li>Yellowing of the skin and whites of the eyes</li><li>Constipation</li><li>Poor feeding</li><li>Cold skin</li><li>Loud breathing</li><li>Hoarse crying</li><li>Enlarged tongue</li><li>Umbilical hernia</li></ul> Symptoms of hypothyroidism in toddlers:<ul><li>Shorter than average height</li><li>Shorter limbs</li><li>Slow mental development</li><li>Brittle hair</li><li>Tiredness</li><li>Constipation</li><li>Puffy facial features</li></ul> Diagnosis:Physical exam and specific diagnostic tests can be helpful in detecting thyroid in children. Specific diagnostic tests include blood tests. Treatment of hypothyroidism:Thyroid hormone therapy may resolve physical symptoms but permanent brain damage is most likely to have happened. Along with this, medication is also given by the doctor depending on the child’s age. Hyperthyroidism:<ol><li>Hyperthyroidism in newborns (Neonatal Hyperthyroidism): this is rarely seen in newborns.</li><li>Grave’s disease: this is an autoimmune condition where the body produces antibodies that stimulate the thyroid gland uncontrollably produce more than enough hormones.</li></ol>&nbsp;Symptoms of hyperthyroidism:<ul><li>Short attention span</li><li>Weight loss</li><li>Protruding eye</li><li>Goitre (enlarged thyroid gland)</li><li>Infrequent blinking</li><li>Muscle weakness</li></ul>&nbsp;Thyroid disease and endocrine conditions are interlinked as the thyroid is an endocrine gland.&nbsp;Diagnosis:Physical exam and specific diagnostic tests can be helpful in detecting thyroid in children. Specific diagnostic tests include blood tests. Treatment of hyperthyroidism:<ol><li>Anti-thyroid medication</li><li>Radioactive iodine ablation</li><li>Total thyroidectomy (surgical removal of the thyroid) or lobectomy (removal of half of the thyroid gland).</li></ol> Prevention: Thyroid cannot be usually prevented.

Here are Thyroid Symptoms, Causes, Treatment, and Diagnosis.

All about Thyroid

Ravina Sewani

If your child develops a swelling or a rash or any other allergic symptom due to medications, then it could possibly be an allergic reaction to the drug.A “true drug allergy” and “drug side effects” are both different. Side effects are usually mentioned on the packaging or on the label of the drug.A drug allergy is an immune response to a drug induced by its components which the body perceives as a threat and triggers an allergic reaction. Mild drug allergy symptoms are:<ul><li>Hives</li><li>Rash</li><li>Itchy skin</li></ul> Severe drug allergy warning signs can include:<ul><li>Swollen face</li><li>Throat tightness</li><li>Trouble breathing</li><li>Light-headed</li><li>Blisters</li><li>Reddened skin</li><li>Whole-body shock with life-threatening low blood pressure</li></ul> Side effects of drug are usually:<ul><li>Nausea</li><li>Lack of energy</li><li>Muscle aches</li><li>Hard to sleep</li><li>Coughing</li><li>Headache</li><li>Stuffy nose</li><li>Stomach cramps</li><li>Diarrhoea</li><li>Constipation</li><li>Ringing in the ears</li><li>Easy bruising</li></ul> <ul><li>Your child can develop a drug allergy even without a history of any other allergy.</li><li>It is also possible that your child may develop an allergy to a drug to which (s)he was not allergic before.</li><li>Your child’s paediatrician will diagnose your child's allergy to a drug through clinical diagnosis and allergy tests like SPT (for penicillin) or a Drug Challenge (similar to an Oral Food Challenge) under medical supervision.</li><li>For mild reactions to drug(s), your child may be given an antihistamine or a topical cream prescribed by your child’s paediatrician.</li><li>Severe reactions to a drug could be life-threatening. If you suspect a drug allergy in your child, discontinue it until further advice and seek immediate medical attention.</li><li>Make a note of the drugs your child may be allergic to and keep it handy each time you visit a doctor in the future.</li><li>If the drug your child is allergic to is essential for the child, then your child’s paediatrician may perform a rapid 'drug desensitisation' under medical supervision.</li><li>Vaccine-related drug allergy is rare and largely due to certain components in the vaccine. Alternatives will be recommended by your child’s paediatrician if your child is allergic to a component.</li></ul>

Drug allergies are not very common but it is important to stay aware.

Drug allergy

<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

Seafood allergy is an immune response induced by the proteins present in the seafood. This is because the body perceives seafood proteins as a threat and results in an allergic reaction.Seafood allergy, particularly fish allergies tend to stay on for life.Seafood is broadly categorised into fish (Tuna, Cod, Flounder, etc.), Crustaceans (crabs, lobster, crayfish, shrimp, prawn, etc.) and Molluscs (squid, snails, clams, oysters, scallops, etc.).If a child is diagnosed with a specific fish allergy, chances are (s)he may be allergic to more than one type of fish.If a child is allergic to fish, it does not mean that they will necessarily develop allergies towards crustaceans and molluscs as well.Confirm any type of allergy after proper diagnosis by a healthcare expert. 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:Seek help from a healthcare expert to get your child diagnosed of the seafood allergy. The doctor will examine your child’s symptoms, medical history, family history, and may suggest a few tests like skin prick tests, blood tests or Oral Food Challenge. Precautions:<ul><li>Avoid all kinds of seafood as the intensity of the reactions varies each time. Even trace amounts of allergens in seafood can cause life-threatening reactions.</li><li>Always read the ingredients on food labels.</li><li>Avoid visiting or eating at Seafood restaurants if your child has an allergy, as the vapours from cooking fish may trigger allergic reactions in highly sensitive children.</li><li>Avoid taking your child to the fish market due to the risk of cross-contact or cross-contamination.</li><li>Always have an adrenaline auto-injector (AAI) handy. Inform your child's school or caretakers about the seafood allergy and ensure they have an AAI.</li></ul> Foods to avoid:<ul><li>Pre-packed Scampi, which may contain white fish, imitation crab</li><li>Worcestershire/Barbecue sauces, Caesar salad dressings (may contain anchovies)</li><li>Even nougat or marshmallows may contain fish gelatin</li></ul> Possible sources of crustaceans or molluscs are:<ul><li>Fish Stock, sauces, soups, seafood flavourings, bouillabaisse, and cuttlefish ink</li><li>Fish cakes, pies, nutritional supplements</li><li>Fish food, pet food, fertilisers</li><li>Though Omega 3 fatty acids are recommended as a therapeutic option in children with allergy, fish-based Omega 3 products might still contain fish protein. Hence they need to be avoided as well.</li></ul> Seafood poisoning and seafood allergy:<ul><li>Seafood poisoning and seafood allergies are two totally different things even though their symptoms may seem similar.</li><li>Seafood poisoning is caused due to due to toxins and infections. The most common forms are given below:</li><li>Fish poisoning: Occurs after ingesting fish which is improperly frozen or poorly cooked, causing the bacteria to grow.</li><li>Herring worm infection: This is caused due to a parasite ingested while eating raw or pickled seafood.</li><li>Ciguatera Fish Poisoning (CFP): A toxin-induced seafood poisoning occurs in a child when (s)he ingests fish which contains algae toxin - ciguatoxins.</li><li>The treatments for seafood allergy and seafood toxins are also completely different. In seafood allergy, doctors usually prescribe antihistamine medications and adrenaline auto-injector (AAI) to children. Whereas in seafood poisoning, the medicine prescriptions are different. In any case, never give medications which haven’t been prescribed by your child’s paediatrician.</li></ul>

Seafood allergy is one of the common food allergies.

Seafood allergy

<ul><li>The allergic reactions in a child are triggered against an insect’s sting and not against an insect’s bite.</li><li>An immune response is triggered against the venom from the sting which the body perceives as a threat.</li><li>An allergic reaction against insect’s sting is also known to cause severe reaction – anaphylaxis.</li><li>The allergic reaction includes pain, redness, and swelling which might extend beyond the sting site.</li><li>As treatment, paediatricians usually prescribe antihistamine medicines for mild allergic reactions. Whereas for severe allergic reactions like anaphylaxis, your child’s paediatrician will prescribe an adrenaline auto-injector (AAI).</li></ul> Severe allergic reactions are usually caused by these stinging insects:<ul><li>Honey bees found in honeycombs.</li><li>Wasps living under leaves, shrubs, logs and woodpiles.</li><li>Fire ants living in large mounds on the ground.</li><li>Biting insects like mosquitoes, bed bugs, fleas, etc. cause localised allergic reactions.</li><li>A local reaction to an insect bite due to the chemicals from insect’s saliva is not the same as an allergic reaction to the venom from the sting.</li><li>When an insect has stung your child, remove the stinger as soon as possible to prevent more venom entering the body.</li><li>Quickly wash the sting site on the skin with soap and water immediately to disinfect the area. Apply ice on the sting site to reduce the swelling, if any.</li><li>If your child has a history of allergic reactions against insects, avoid going to places where insects are present with your child.</li><li>Once diagnosed, your child’s paediatrician will usually prescribe antihistamine medicines and an adrenaline auto-injector in case of severe reactions.</li><li>Your child’s paediatrician may recommend venom immunotherapy based on your child’s medical history of developing allergic reactions against insect sting.</li></ul> Symptoms:<ul><li>Itching</li><li>Rashes</li><li>Vomiting</li><li>Diarrhoea</li><li>Swelling of the lips or tongue or face</li><li>Throat constriction</li><li>Difficulty in breathing</li><li>Allergies may sometimes also cause a life-threatening reaction called anaphylaxis which constricts the airway passage and requires immediate medical attention.</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 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. It is important that these tests are 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>

Insect sting allergy can get very serious sometimes. It is better to stay cautious to keep your child safe.

Insect sting allergy

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.

All about Tongue tie

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 production is in abundance during the early days, which is good. But as soon as the baby settles in – in most cases – the flow regulates on its own. Sometimes though, the breastmilk volume may still be high and there may be a very forceful spurt of milk with a forceful let down. This may cause problems for you and your baby. Usually babies develop a breastfeeding pattern within the first month. If after a month, your baby is still restless during the feeding, or pulls off your breast, coughs, chokes, gulps quickly, has painful cries, holds on to your nipple with a bite like hold, oversupply might be the issue here. You, on the other hand, might experience engorgement, have bouts of mastitis, or you may feel a strong let-down, and leaking breasts. Due to oversupply, a condition called Milk Ejection Reflex occurs in which the milk is released from the milk ducts in a forceful and in an almost explosive manner. Oversupply could be either due to your body making more milk, or when you don’t empty your one breast fully before offering the other, or thyroid. You can handle this situation by trying a reclined position while you breastfeed, you can try using nursing pads, and express little milk before feeding. You can use breast pumps and store the milk. Just be careful that your child does not choke while breastfeeding. If none of the methods work, you should consult your lactation consultant.

It is possible to have an oversupply of milk.

Oversupply of breastmilk

A balanced diet for a young child means having variety of foods.&nbsp;From the age of two, a child should be moving towards a diet that is similar to the rest of the family.Follow below mentioned measures to increase weight of your underweight child in a healthy manner:<ul><li>Your child should have at least five portions of a variety of fruit and vegetables every day.</li><li>The meals should be based on potatoes, bread, rice, pasta or other starchy carbohydrates.</li><li>Some dairy or dairy alternatives (such as soy drinks and yogurts). Choose lower-fat and lower-sugar options.</li><li>Some beans and pulses, in case you prefer non-vegetarian food, fish, eggs, meat and other protein. Aim for two portions of fish every week – one of which should be oily, such as salmon or mackerel.</li><li>Plenty of fluids such as water, milk, fresh juice making up to – 6-8 cups/glasses a day. Energy-dense foods such as whole milk, yogurt, cheese and oily fish can also be given.</li><li>By the time your child is five, they should be eating a healthy low-fat diet. There are a few steps you can take to increase your child's calorie intake until they reach a healthy weight, while still providing a healthy diet.</li><li>Bulk up mashed potato by putting milk or cheese in it</li><li>Put grated cheese on beans on toast</li><li>Make milk puddings</li></ul> Try not to give more of:<ul><li>Sugary drinks and foods – It's not recommended to give your child high sugar drinks and foods. The longer and more often sugar touches your child's teeth, the more damage it causes. If your child does have sugary foods or drinks, it's best to give them at mealtimes to minimise damage to their teeth.</li><li>Saturated fats – These are unhealthy fats, such as those contained in burgers, sausages, pies, biscuits, cake and cheese. Try not to give these too often.</li><li>Whole grains – Wholegrain foods, such as wholemeal pasta, bread and brown rice, can be high in fibre and may fill up your child before they've taken in the calories and nutrients they need. After the age of two, you can gradually introduce more wholegrain foods.</li></ul> Note: It’s normal to worry that your child is not getting the food that he or she needs to grow. But kids are more than capable of knowing whether they are hungry or not. Unless your doctor tells you that your child isn’t getting the nutrients that he or she needs, you should not worry about the lack of food intake. As long as your child's weight is fine, (s)he is sleeping well and has normal bowel movements, there is no need to worry that whether your child is eating enough or not.

Underweight children require foods and diet that can provide them with enough nutrition and sufficient calories.

eye watering health concerns

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