Palak Vyas

In younger infants, there can be multiple reasons for reflux:<ul><li>Overfeeding</li><li>Weak abdomen muscles</li><li>Immature esophageal sphincter muscles</li><li>Slow digestive system</li><li>GERD - a digestive disease where the fluids and foods from the stomach come back up to the oesophagus</li></ul> Sleep solutions:<ul><li>Do not put your infant to bed immediately after feeding.</li><li>Make them burp.</li><li>Wait for 30 minutes before lying down your baby on bed for a nap or night sleep.</li><li>While you wait for 30 minutes, be sure to hold him/her upright.</li><li>Keep rocking your baby in standing position till (s)he sleeps naturally.</li><li>To avoid acid reflux, give your baby small but frequent feedings.</li><li>In case you are feeding with a bottle, take a closer look at the nipple size. It should not be too small or too big. If the hole is too small, the child keeps sucking hard and instead of milk (s)he sucks in air. If the hole is too big, (s)he won’t be able to take that much amount at a stroke.</li></ul>

Many children have a problem of reflux (spitting/vomiting out the food) when they go to sleep. Certain sleep positions will help with this problem.

Sleep solutions for babies with reflux or GERD

Ravina Sewani

Wheat allergy is an allergic reaction to foods containing wheat. Allergic reactions can be caused by eating wheat and also, in some cases, by inhaling wheat flour. Wheat is found in many foods, including some you might not suspect, such as soy sauce, ice cream and hot dogs. Wheat allergy sometimes is confused with celiac disease, but these conditions differ. Wheat allergy occurs when your body produces antibodies to proteins found in wheat. In celiac disease, a specific protein in wheat — gluten — causes a different kind of abnormal immune system reaction. Symptoms of wheat allergy:<ul><li>Swelling, itching or irritation of the mouth or throat</li><li>Hives, itchy rash or swelling of the skin</li><li>Nasal congestion</li><li>Headache</li><li>Difficulty breathing</li><li>Cramps, nausea or vomiting</li><li>Diarrhoea</li><li>Anaphylaxis</li></ul> Causes:Exposure to a wheat protein triggers the body's immune system for an allergic reaction. Your child can develop an allergy to any of the four classes of wheat proteins — albumin, globulin, gliadin and gluten. Sources of wheat proteins:<ul><li>Breads and bread crumbs</li><li>Cakes, muffins and cookies</li><li>Breakfast cereals</li><li>Pasta</li><li>Semolina</li><li>Soy sauce</li><li>Meat products, such as hot dogs</li><li>Dairy products, such as ice cream</li><li>Natural flavourings</li><li>Modified food starch</li><li>Vegetable gum</li><li>Cosmetics</li></ul> Risk factors:<ul><li>Family history: The chances of your child being allergic to wheat are higher if there is someone in the family who is allergic to wheat.</li><li>Age: Wheat allergy is most common in babies and toddlers, who have immature immune and digestive systems.</li></ul> Difference between Wheat Allergy and Celiac Disease:Wheat allergy involves an allergic response to any of the four proteins in wheat. Whereas, celiac disease is caused by gluten (a type of wheat protein). Celiac disease does not cause an immune response but rather causes a problem with the absorption of food in the intestines. Diagnosis:Symptoms of wheat allergy and celiac disease are overlapping hence an allergist can determine whether an allergy is present or not. You will be required to give your child's medical history, family's medical history combined with a skin-prick or a blood test. Prevention:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever (s)he goes to visit someone.</li><li>Inform your child’s school about your child’s allergy. You can also give the medicines prescribed by your child’s doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Always keep the allergy medication handy for your child.</li></ul> Treatment:<ul><li>The best way to prevent allergies of any sort in children is to avoid the source of the allergen.</li><li>In allergies, 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>

Some children can develop allergic reactions towards wheat and need to be fed on a different cereal.

Wheat allergy

Itching can result due to various reasons:<ul><li>Skin allergies</li><li>Food allergies</li><li>Dandruff</li><li>Skin disorder</li></ul> <ul><li>It is advisable to consult your paediatrician or doctor for itching before you apply any skin products to your child.</li></ul> Remedies for itching:<ul><li>Avoid scented soaps, lotions, and bubble baths.</li><li>Change out of wet or damp clothing immediately after exercising or swimming.</li><li>Moisturising the skin with a good moisturiser.</li><li>See a doctor when the itching persists for more than 2 weeks, when there is inflammation and when itching affects the entire body.</li></ul>

Itching, if not treated at the right time can intensify and irritate a child. It is better to consult your paediatrician at the right time.

Itching problem in children

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

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

In an egg allergy, the body mistakes the egg proteins as a threat which triggers the immune system to produce an allergic reaction to those proteins. An allergic reaction to the proteins in egg white or yolk or both is possible.Studies have shown that 2 out of 100 children are allergic to egg but around 70% of them outgrow the allergy by the time they reach adulthood.Egg proteins are found in raw, boiled/parboiled, poached, baked, or powdered form of eggs.It is advisable to avoid egg-based foods as it is difficult to completely separate the white from the yolk. Traces of yolk might be present in a few commercially available 'egg-white products'.Children with egg allergy can be safely vaccinated for MMR and Flu vaccine.Eggs can be introduced into your child’s diet by a scientific approach called “egg ladder”. Egg Ladder is a specific scientific food chart designed for the easy reintroduction of eggs in the diet and to induce egg tolerance to combat egg allergy. 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>The first thing is to not self-diagnose and assume your child to be allergic to eggs. Always rely on a healthcare expert's opinion before avoiding egg-based products.</li><li>A healthcare expert will examine your child's symptoms, his/her health history, and conduct other tests if required, to confirm whether your child has an egg allergy or not.</li><li>Egg allergy has very mild symptoms and is not known to cause severe reactions.</li></ul> Foods to avoid:<ul><li>In breastfed infants, the egg proteins from mother’s diet may transmit to the baby via breast milk and cause an egg allergy to develop an egg allergy.</li><li>Eggs from birds like quails, duck, geese, turkey as well if your child has an egg allergy need to be avoided.</li></ul> Other foods to avoid:<ul><li>Mayo or mayonnaise</li><li>Nougat</li><li>Marshmallows</li><li>Ice cream</li><li>Parents are usually also concerned about giving baked foods to children who have milk or egg allergies. Research indicates that 70%of children allergic to milk or egg can tolerate baked food as high temperature baking can destroy the allergens in milk and egg. Introduction of baked food is known to increase the tolerance to whole forms of milk/egg.</li><li>Always consult your child’s paediatrician to look for alternate sources of nutrition as avoiding milk and egg based foods may develop nutritional deficiency.</li></ul> Treating allergies:<ul><li>The best way to prevent allergies of any sort in children is to avoid the source of the allergen.</li><li>In allergies, 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> Precautions:<ul><li>Develop a habit of reading the food labels for ingredients and allergy information.</li><li>Teach your child to mention about the allergy whenever (s)he goes to visit someone.</li><li>Inform your child’s school about your child’s allergy. You can also give the medicines prescribed by your child’s doctor to the school which they can use in case of sudden allergic reactions.</li><li>Be careful about the possibility of cross-contact; especially when visiting a restaurant.</li><li>Always keep the allergy medication handy for your child.</li></ul> Egg allergy and vaccines:There are several contradictions revolving around developing egg allergies due to a few vaccines like the MMR vaccine, influenza vaccine and yellow fever vaccine. If your child is diagnosed with egg allergy, it is best to consult your child’s paediatrician and then get your child vaccinated.

Egg allergy is one of the most common allergies among all.

Egg Allergy

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

<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

In asthma, a person’s airways become inflamed, narrow and swell and produce extra mucus, which makes it difficult to breathe. If your child has asthma, their lungs and airways can easily get inflamed when they have a cold or are around things like pollen. Causes:<ul><li>Allergens: mould, pollen, animals</li><li>Irritants - cigarette smoke, air pollution, chemicals, odours</li><li>Weather: cold air, changes in weather</li><li>Stress: It can make your child short of breath and worsen their symptoms.</li><li>Airway Infections: This includes colds, pneumonia, and sinus infections.</li><li>Exercise</li></ul> Symptoms:<ul><li>A cough that doesn’t go away (this might be the only symptom sometimes)</li><li>Frequent coughing spells, especially during play or exercise, at night, in cold air, or while laughing or crying</li><li>A cough that gets worse after a viral infection</li><li>Less energy</li><li>Avoiding sports or social activities</li><li>Trouble sleeping because of coughing or breathing problems</li><li>Rapid breathing</li><li>Chest tightness or pain</li><li>Wheezing, a whistling sound when breathing in or out</li><li>Shortness of breath</li><li>Trouble eating, or grunting while eating (in infants)</li></ul> A severe asthma attack needs medical care right away. During severe asthma attack, watch for these signs:<ul><li>Stopping in the middle of a sentence to catch a breath</li><li>Using stomach muscles to breathe</li><li>Widened nostrils</li><li>Fast heartbeat</li><li>Sweating more than usual</li><li>Chest pain</li></ul>&nbsp;Risk Factors:<ul><li>Things that can make a child more likely to have asthma include:</li><li>Nasal allergies or eczema</li><li>A family history of asthma or allergies</li><li>Respiratory infections</li><li>Low birth weight</li><li>Exposure to second-hand tobacco smoke before or after birth.</li></ul> Diagnosis:<ul><li>Your child’s doctor will ask you a series of questions about medical history, symptoms, about any breathing problems your child may have had, family history of asthma, allergies, eczema, or other lung disease.</li><li>Physical exam: Your doctor will listen to your child's heart and lungs and look in their nose or eyes for signs of allergies.</li><li>Tests: Chest X-ray, allergy skin testing, blood tests</li></ul> Complications:<ul><li>Asthma can cause problems like:</li><li>Severe attacks, sometimes leading to ER visits or stays in the hospital</li><li>Fatigue</li><li>Stress, anxiety, and depression</li><li>Delays in growth or puberty</li><li>Damaged airways and lung infections</li><li>Death</li></ul> Treatment:<ul><li>There are two main types of asthma medications:</li><li>Quick-relief medication that help with sudden symptoms. Your child’s doctor will prescribe these for fast help during an asthma attack.</li><li>Long-acting medication that prevent airway inflammation and keep asthma under control. Your child’s doctor will probably ask your child to take these every day.</li><li>Children under 4 may be prescribed to take their medications through an asthma nebuliser. This device changes the medicine from a liquid to a mist that your child can breathe into their lungs. The doctor will tell you how often to give these breathing treatments. To use the nebuliser:</li></ul>Wash your hands.Put the medicine in the nebuliser.Connect the tubes from the compressor to the base.Attach the mouthpiece or mask.Turn the compressor on and watch for a light mist to come from the nebuliser.Put the mask on your child’s face, or put the mouthpiece in their mouth and have them close their lips around it.Have them breathe in and out until their treatment time is up.Turn the nebuliser off when the medicine is gone.Have your child cough to clear out any mucus. Prevention:<ul><li>To prevent asthma attacks or to keep them from getting worse, focus on known triggers with steps like these:</li><li>Don’t let anyone smoke near your child.</li><li>Clean bedding and carpets often to fight dust mites.</li><li>Keep pets out of your child’s bedroom.</li><li>Fix leaks and use dehumidifiers to prevent mould.</li><li>Don’t use scented cleaning products or candles.</li><li>Check daily air quality reports in your area.</li><li>Help your child stay at a healthy weight.</li><li>If exercise is a trigger, your child’s doctor might give them medicine to help keep their airways open during activity.</li><li>Make sure they get a flu shot every year.</li></ul>

Here are Asthma Symptoms, Causes, Diagnosis, Risk factors, Treatment, Prevention, and Complications.

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