Samiksha Choithani

Newborns and infants cannot inform when they are hungry. Some of these signs are subtle hints that will tell you when the child is hungry:<ul><li>The baby is putting fingers in mouth</li><li>Sucking lips or tongue</li><li>Making little crying sounds</li><li>Getting restless</li><li>Avoids other family members and only wants to be with mother</li></ul> Some babies are too sleepy and do not show any signs of hunger, but wake them up and feed the baby at least 8 to 12 times in 24 hours. Babies often get hungrier than usual (every hour) during the growth spurt. Growth spurt is the time when the baby is physically growing; it lasts for 2-3 days. Growth spurts occur periodically, within 7-10 days of birth, 2-3 weeks, 3 months, 4 months, 6 months and 9 months.

Irritability is probably the most common signs among babies that indicates a child is hungry.

Signs that indicate babies are hungry

Palak Vyas

There are different types of thermometer available in the market:<ol><li>Glass thermometer with mercury</li><li>Glass thermometer without mercury</li><li>Digital thermometer</li></ol> Glass thermometer can be of two types depending upon its usage - rectal thermometer and an oral thermometer. There are several ways to take your child’s temperature: Rectal Method (by the rectum or buttocks):<ul><li>Use a thermometer with a stubby tip.</li><li>Put a diaper or other cloth across your lap. Put your child over that diaper or cloth on his/her stomach or back; whichever way is comfortable for the child.</li><li>Put a little amount of petroleum jelly on the tip of the thermometer.</li><li>Insert the tip gently without giving any pressure, into the rectum. Do not try to force it at all.</li><li>The silver tip of the thermometer is half an inch. If your child is less than 3 months old, insert only half an inch, that is just the silver tip of the thermometer.</li><li>If your child is above 3 months, insert as deep as 1 inch, not more than that.</li><li>Hold the thermometer in place. A digital thermometer makes a beep sound in 30 seconds. Glass thermometers take longer, approximately 3 minutes. Take the thermometer out and read the temperature.</li><li>Measuring the temperature via the rectal method is a bit tricky hence it Is advisable to be done only by healthcare experts, not at home.</li></ul> Oral Method (by mouth):<ul><li>Use an oral thermometer, the one with a thin long tip.</li><li>Do not give anything hot or cold to the child for 20 minutes before measuring the temperature.</li><li>Place the tip of the thermometer in your child’s mouth, under the tongue and close to the mouth.</li><li>You will have to hold a thermometer for him/her. A beep sound comes in 30 seconds with a digital thermometer. For glass thermometers, hold in place for 3 minutes. Take the thermometer out and read the temperature.</li><li>If your child is very young, this method is not advisable as they might bite on to the thermometer and hurting themselves.</li></ul> Axillary Method (under the armpit):<ul><li>Here, you can use an oral thermometer.</li><li>See that your child’s underarm is dry, or else wipe it dry first.</li><li>The tip of the thermometer is directly placed in the armpit.</li><li>Press the child’s upper arm against his chest to keep the arm still and the thermometer in place.</li><li>Digital thermometers may take longer than 30 seconds before beeping when using this method. Using glass thermometer can be tedious because it takes 7-10 minutes which is too long for a child to be still.</li><li>This is the safest method to use at home.</li></ul> Temporal artery Method (forehead):<ul><li>Temporal artery thermometer is an infrared device that scans the temporal artery and shows temperature.</li><li>Put it straight across the forehead, to the temporal area and not down the side of the face.</li><li>Remove, read and record the temperature.</li><li>The device used here is expensive compared to a digital thermometer.</li></ul> Tympanic Method (in the ear):<ul><li>If your child has been outdoors on a cold day or is overheated because of playing, he needs to be inside for 15 minutes before taking the temperature this way.</li><li>Slowly pull your child’s ear backwards to straighten the ear canal (back and up if your child is over 1 year old).</li><li>Gently put the tip of the thermometer in the ear until it stops. The tip should point to the space between the eye and the ear on the other side of the head.</li><li>Within two seconds you will hear a beep sound, take it out and read the temperature.</li><li>This is also a risky method as children tend to move a lot and might get hurt in the ear.</li></ul> Whenever you are using any type of thermometer or whichever the method you use, always be careful and hold the thermometer in place until you get the reading.

There are several thermometers available and different ways to measure the temperature during a fever.

Different types of thermometer to measure a child's fever

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?

Noisy breathing is mostly caused by a partial blockage or narrowing at some point in the airways (respiratory tract). This can occur in the mouth or nose, in the throat, in the larynx also called as a voice box, in the trachea (breathing tube), or further down into the lungs. It is created by turbulent, or irregular, airflow caused by the narrowed airway. This can create the collapse of surrounding tissues or can be a single fixed point of narrowing. One type of noisy breathing is Stertor. This implies a noise created in the nose or the back of the throat. It is typically low-pitched and most closely sounds like nasal congestion you might experience with a cold, or like the sound made with snoring. Stridor is a higher-pitched noise that occurs with obstruction in or just below the voice box. Determination of whether stridor occurs during inspiration, expiration, or both helps to define the level of obstruction. Wheezing is a high-pitched noise that occurs during expiration. Wheezing typically is due to narrowing, spasm, or obstruction of the smaller airways in the lungs. What Are Some Causes of Noisy Breathing?<ul><li>Infection- Viral or bacterial infections can cause swelling of the tissues in the airway (such as cold-causing nasal congestion) anywhere from the nose to the lungs. Depending on the type of infection, this could be treated with supportive care, medications, or more invasive intervention. Croup is an example of a viral infection that causes swelling and related narrowing of both the larynx and trachea.</li><li>Fixed narrowing of the airway at birth- certain conditions can cause a child to be born with a narrowed airway. This can occur at multiple points in the respiratory tract. An example of this includes congenital subglottic stenosis.</li><li>Abnormal swelling or growth within the respiratory tract can cause obstruction. Swelling or scarring can cause acquired subglottic stenosis. This could also include a cyst or vascular birthmark (hemangioma) in the airway. A foreign object or food item can be aspirated (sucked into) the airway and can cause obstruction and noisy breathing.</li><li>Floppy tissues in the respiratory tract can cause noisy breathing. This is because of the collapse of these tissues into the airway. This can partially obstruct airflow and cause a collapse of surrounding tissues. Examples of this include pharyngomalacia, laryngomalacia, tracheomalacia, and bronchomalacia.</li><li>Compression of the airway from an external structure. This can be due to a crossing blood vessel, the heart, or other structures outside of the airway that put pressure on the airway and cause collapse.</li><li>Spasm of the airways related to underlying medical conditions, like asthma, or due to irritants in the environment.</li><li>Problems with the vocal cords moving normally. This can occur with Vocal Cord Paralysis, or with Paradoxical Vocal Cord Dysfunction (PVCD)</li><li>Recurrent Respiratory Papillomatosis can cause a problem with the voice and can also cause noisy breathing.</li></ul> How Is Noisy Breathing Evaluated?Evaluation of noisy breathing starts with obtaining a history and performing a physical examination. This information is critical in narrowing down the cause of noisy breathing and in determining how severe the symptoms are. Important aspects of the history include whether it was present at birth, or has developed later on, and the time course over which it has developed. Certain characteristics of the noisy breathing help us to determine the location of narrowing. These include whether noisy breathing occurs on inspiration, expiration, or both. The pitch and loudness of noisy breathing is also an important factor. Depending on the history and examination findings, your Pediatric Otolaryngologist may recommend an In-Office Laryngoscopy/Nasopharyngoscopy or an Operative Laryngoscopy and Bronchoscopy. At times, certain X-Rays or other tests, like Sleep Studies and Swallowing Studies may be recommended. What Is the Treatment for Noisy Breathing?Many treatment options are available for noisy breathing and depend on the cause of the symptoms. At times, monitoring and supportive care are recommended. Certain medications may be helpful in treating symptoms or managing related conditions. For more severe issues, surgery may be recommended. Your Pediatric Otolaryngologist will discuss all possible treatment options with you and make recommendations for the most appropriate treatment. What Are Concerning Symptoms That I Should Look for in My Child with Noisy Breathing?It can be difficult for a parent or family member to discern the severity of a problem when there is noisy breathing. If you are concerned, we urge you to seek medical evaluation immediately. In particular, signs that indicate more severe conditions include: irritability, poor feeding, pulling in of the skin at the collar bone, between the ribs, or under the ribs, flaring of the nose, increasing effort to breathe, and poor weight gain or weight loss, especially in infants. Symptoms that should trigger emergent evaluation include pauses in the breathing, color change of the skin (particularly if the lips, face, or hands are turning blue), drooling, appearing lethargic or tired, or any other sudden change from a child’s normal breathing pattern. If any of these or other concerning signs develop, please seek immediate medical attention.

Noisy breathing is very common in children and can be a sign of many different conditions, some of which are very benign and some of which require urgent treatment.

What is Noisy Breathing or Stertor or Stridor or Wheezing

Ravina Sewani

In Vitro Fertilisation, commonly known as IVF, is a process that helps to overcome female infertility. In some cases, it can also help with male infertility. In IVF, the egg and sperm are fertilised outside the mother's body in a test tube. Hence the babies born through IVF are sometimes called as test tube babies. The fertilised embryo is them implanted in the mother's womb or another woman's womb. Steps of IVF:<ul><li>Egg production stimulated by hormone therapy</li><li>Egg retrieval from ovary</li><li>Sperm Sample Production - happens on the same day of egg retrieval</li><li>Fertilisation of egg and sperm in a test tube</li><li>Transferring fertilised eggs into the uterus</li></ul> The woman who wants to opt for IVF, is given fertility medications for 10 to 15 days. These medicines stimulate the ovaries to produce more eggs. For these 10-15 days, the woman is required to visit the doctor regularly for blood tests and ultrasounds. Once the stimulation period is over and sufficient eggs have been produced, the eggs are removed from the woman's body and are infused with the woman's partner's sperms in the laboratory. After three to five days, when the embryo reaches the 180 cells stage, one or more embryos are transferred back into the woman's uterus from the test tube. About two weeks later, you will be required visit your doctor to determine if the IVF was successful or not. Once the embryo is transferred to the womb, it develops inside the mother. The rest of the pregnancy happens in a normal way. Sometimes if the woman's womb is incapable of nursing the embryo, another woman's womb is implanted with the fertilised embryo. This is called surrogacy. Keep in mind that IVF cycle is time consuming and expensive. Things to keep in mind for a successful IVF:<ul><li>Maintain a healthy weight</li><li>Quit smoking</li><li>Limit your alcohol intake</li><li>Keep your blood pressure and diabetes in check</li></ul> Side effects of IVF:<ul><li>Emotional ups and downs during the IVF cycle</li><li>Cramping in the pelvic area</li><li>Breast tenderness.</li><li>Ovarian hyperstimulation syndrome (OHSS). This is very rare and it occurs when fertility drugs cause a woman to make too many eggs. The symptoms of OHSS are weight gain, swelling in the abdomen, dizziness, nausea, and vomiting.</li><li>A minute risk of multiple pregnancies or birth complications. Doctors generally implant more than one embryo during IVF to increase the chance of getting pregnant with multiple babies. This increases the risk of premature labour and underweight babies. To avoid these complications, some people and doctors opt for one embryo implantation.</li></ul> Who can opt for IVF?<ul><li>Unexplained infertility</li><li>Blocked fallopian tubes</li><li>Male factor infertility</li><li>Older patients who desire to have a child</li><li>Low ovarian reserve</li><li>Polycystic Ovary Syndrome (PCOS)</li><li>Endometriosis</li><li>Premature Ovarian Failure</li></ul>

Couples facing infertility problems can opt for IVF.

Opting for In Vitro Fertilisation (IVF) or test tube baby

Congestion occurs when extra fluids (mucus) accumulate in the nose and airways. Congestion may give your baby a blocked nose, noisy breathing or mild trouble in feeding. Mild congestion is common and is not much of a concern. But if your child breathes 60 breaths per minute, (s)he is struggling to catch breath. In this case, take them to a paediatrician immediately. Symptoms of congestion:<ul><li>Coughing</li><li>Wheezing</li><li>Grunting</li><li>Thick nasal mucus</li><li>Discoloured nasal mucus</li><li>Noisy breathing</li><li>Sniffing</li><li>Trouble eating</li></ul> Causes of congestion:<ul><li>Allergies</li><li>Cold/flu</li><li>Asthma</li><li>Premature birth</li><li>Pneumonia</li></ul> Treatment of congestion:<ul><li>Give your baby a warm bath but try to keep it short for 5-10 minutes and once you are done quickly wipe the baby's body, apply moisturiser and dress your baby as soon as possible.</li><li>Keep feeding your baby regularly and monitor for wet diapers.</li><li>Add one or two drops of saline to their nostrils.</li><li>Use a humidifier in the baby’s room by the bedside to keep away the dryness in weather. It will add moisture in the air of the room and will help clear congestion.</li><li>Gently massage their nasal bridge, forehead, temples, and cheekbones.</li><li>Remove potential allergens or pollutants from the home's air by vacuuming up pet hair, not burning candles or incense sticks and not smoking.</li><li>Wipe away excess mucus with a soft, dry tissue or cloth.</li></ul>

Congestion can make a child uneasy and cause difficulty in breathing.

Dealing with the problem of congestion.

Vomiting in young babies and small children is not rare. Vomiting is very common during early weeks when you have just introduced solids into their diet. But if your baby looks happy and healthy, you should stay assured that nothing is serious. Vomits can be either of the following three:Spitting up:<ul><li>Young babies tend to spit up milk or solids as soon as they are fed.</li><li>This is normal and there is nothing to worry about if the content that they spit is less.</li><li>As the oesophagus of children is still developing, milk can leak back up after a feed and come out of the baby's mouth or nose.</li></ul> This kind of vomiting resolves on its own as the baby grows and his/her digestive system matures. In case of frequent vomiting, paediatrician’s prescribed oral hydration solutions should be used. Reflux vomiting:This is due to the gastroesophageal reflux disease (GERD). Factors like obesity, eating spicy food, excess caffeine intake, overeating also contribute to GERD. Little tips to avoid or reduce reflux:<ul><li>Hold and feed your baby while (s)he is seated or in an upright position. Avoid feeding baby in a lying down position.</li><li>Feed your child in smaller portions.</li><li>Ensure that your baby doesn’t jump or bounce immediately after eating food.</li><li>Give your baby milk or water after feeding to reduce acid or indigestion.</li><li>Avoid giving spicy or fried food to your child.</li></ul> Projectile vomiting:Projectile vomiting is when the entire amount of last feed is forcefully vomited out. This could be due to a blockage caused by thickening of the muscle of the stomach. It could be due to some gastric infection or even the common cold.In any case, do not give over-the-counter medication to your baby. Consult your child’s paediatrician as early as possible. Causes of vomiting:<ul><li>Stress</li><li>Motion sickness</li><li>Gastroentritis (also known as stomach flu; caused by viruses)</li><li>Food poisoning</li><li>Food allergy</li><li>Concussion</li><li>Migraine</li></ul> You should consult the doctor in the following conditions:<ul><li>Vomiting for more than 12 hours.</li><li>Blood or bile in the vomit.</li><li>If your baby is losing weight or not gaining weight.</li><li>If there is persistent indigestion.</li><li>If the baby generally seems unwell.</li><li>If the baby remains fatigued all the time.</li></ul> Diagnosis: Physical examination, medical history, and in some cases blood tests help with the cause of vomiting. Treatment and Remedies:Give doctor's prescribed oral electrolyte solutions (ORS) to prevent dehydration and loss of nutrients in children.Usually medicines are not prescribed unless it's stomach flu.Do not give your child milk or milk products.Give them liquid diet. Example - fruit juices diluted with water, broth of vegetable or pulses (consult your child's paediatrician first). Prevention:<ul><li>Develop regular habit of washing hands in your child.</li><li>Check the food ingredients to see that the food doesn't have anything that might trigger your child's allergy.</li><li>Store and cook food properly to avoid the chances of food poisoning.</li></ul>

Here are Vomiting Causes, Types, Diagnosis, Treatment, Remedies, and Prevention.

All about vomiting

Stomach aches are of two types: Pathological and Functional. Pathological stomach aches have medical reasons behind it whereas functional stomach aches are mostly due to stress. Pathological Stomach ache: In pathological stomach ache, the child will also have other symptoms like severe fever, huge swollen belly, vomiting, problems in urine and stool. Here child is actually sick. Here the doctor can ask to get some blood work or urine stool reports done.Ultra scan of abdomen&nbsp;may be required. Such severe cases are generally not very common.<ul><li>From the history of your child, the doctor will be able to identify whether the child is suffering from functional pain or not. This kind of pain has a long history like it occurs over 15 days, 2 months, or so. Normally these types of pain are not considered severe. There is no particular reason behind it. There will be no pathological sign or symptom apart from pain.</li></ul> <ul><li>Sometimes constipation also leads to stomach ache: Constipation is again one of the major reasons behind child’s stomach pain. Generally after half an hour of the first food in the morning the child can get nature’s call. Now, when the child gets up, the mum is ready with a cup of milk and hurries up to get him/her ready for school. In that situation the child feels the stress causing him pain. There is no time to attend nature’s call and (s)he has to leave for school. When the child reaches school either the toilets are dirty or the teacher doesn’t allow the child to go. So to avoid these, the child suppresses his/her natural urge to go to the toilet and hence develops constipation. When (s)he gets back home there is no natural urge and constipation increases. Here, the doctor needs to check for constipation as a reason of stomach ache.</li></ul> <ul><li>Stomach ache and stomach worms: Stomach worms could also be one of the reasons of stomach ache. Children above one year up to the age of 12 years need to be given stomach worm medication after every six months even if there is no pain.</li></ul> Functional Stomach aches: The child can experience functional stomach pain due to stress. When the child experiences stress, certain chemicals are released in the stomach which can lead to stomach pain. So remember, when a child is complaining about stomach ache, (s)he is not lying or making things up. Situations under which child can experience stress and can complain of stomach ache:<ul><li>When a child has just woken up and (s)he sees his mom with a glass of milk.</li><li>When the child is trying to finish school work and the school bus arrives.</li><li>When the teacher scolds him/her in the school.</li><li>When other kids bully him/her in the school.</li><li>Sometimes there is sibling rivalry when you compare two children in the same house which can also lead to some stress resulting.</li><li>Ultimately all the stress in the body gets out in the form of stomach pain. So the child feels like avoiding school and any such situation which are uncomfortable for him/her. When the child is rescued from such situation or distracted, this pain is also relieved.</li><li>One thing that is important here is that how a parent treats the child during situations of stress. If the parent starts giving special treatments or pampers the child by allowing them to stay home after stomach ache complaints or if they say it is okay not to work, the child would know for sure that anytime (s)he doesn’t want to work or don’t want to do a thing (s)he can use this excuse of stomach pain.</li><li>Parents can instead, talk to the child, understand the problem and find out the reason behind stress. You can help your child calm down and explain to them that you are there for them if anything goes wrong.</li><li>Give some time to your child to accept changes and you will be good to go.</li></ul> Causes:<ul><li>Stress</li><li>Food intolerance</li><li>Food alergy</li><li>Injury</li><li>Constipation</li><li>Diarrhoea</li><li>Appendictis</li><li>Gas</li><li>Colic</li></ul> Symptoms of Stomach ache:<ul><li>Acts fussy or grumpy</li><li>Doesn’t sleep or eat</li><li>Cries more than usual</li><li>Diarrhea</li><li>Vomiting</li><li>Trouble being still (squirming or tensing up muscles)</li><li>Makes faces that show pain (squeezing eyes shut, grimacing)</li></ul> Diagnosis: Your child's doctor will first examine your child, take his/her medical history, and maybe do some tests. Treatment:<ul><li>The child’s lifestyle has to be improved.</li><li>Parents should check that the child is stress free.</li><li>Give the child suitable and balanced diet.</li><li>Avoid giving outside food or junk food from hotels and restaurants.</li><li>Parents should keep house atmosphere pleasant.</li><li>Gentle behaviour from parents can improve this condition.</li><li>If the stomach ache is followed by vomiting or diarrhea, it is better to consult a paediatrician.</li><li>The doctor may suggest some medicine or might give special instructions on eating to help with the bellyache.</li><li>If stress is the reason of stomach problems, the doctor may recommend a specialist, such as a psychologist.</li><li>If your child's stomach ache turns out to be due to appendicitis, an operation called an appendectomy needs to be performed.</li></ul> Prevention:<ul><li>Avoid overeating.</li><li>Give fiber-rich foods, such as fruits and vegetables to your child, so that the bowel movements are regular.</li><li>Give lots of fluids, especially water to your child.</li><li>Wash hands before eating.</li><li>Avoid eating right before bedtime.</li><li>Lots of sleep.</li></ul>

Here are Stomach ache Types, Symptoms, Causes, Diagnosis, Treatment and Prevention.

All about stomach aches

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.

hair lice health concerns

Following article(s) will help solve your concern.