Ravina Sewani

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

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

Squint eye in children

Cereal allergies are caused due to immune reactions against proteins present in cereals. Cereals are grains from the grass family like wheat, rice, oats, maize, barley, corn, and millet. Wheat allergy is the most common allergy among all. There are certain pseudo cereals like buckwheat, quinoa, chia seeds which belong to the non-grass family. Allergic reactions to these are very rare.Children who have eczema are at a greater risk of developing rice allergy.Children with an allergy to fruits like peach have more chances of developing allergic reactions against corn kernels.Gluten sensitive children are at a risk of developing allergic reactions to one or more cereals. Before ruling out other cereals on this basis, it is advisable to consult with your child’s paediatrician.Celiac disease is commonly misunderstood with cereal allergy because it shows similar symptoms like cereal allergy.Always keep the allergy medications handy; especially carry adrenaline auto injectors like EpiPen in case of history of severe allergic reactions or asthma. Gluten sensitivity and wheat allergy:<ul><li>Gluten sensitivity and wheat allergy are different. Gluten sensitivity results from a protein (gluten) present in wheat, rye, or barley. It is not life threatening like wheat allergy. This is called Non-Celiac Gluten Sensitivity (NCGS). It is diagnosed when the doctors are sure that the child neither has wheat allergy nor celiac disease.</li><li>Celiac disease is a serious form of gluten sensitivity and is a life-threatening autoimmune disease. Celiac disease causes inflammation of the small intestine due to adverse reaction to gluten. If this disease is not timely diagnosed, it can cause health issues due to malnutrition.</li><li>Wheat allergy, on the other hand, results from an immune response triggered due to any of the many proteins present in wheat. The allergic reactions to wheat range from mild to severe. Severe life-threatening allergic reactions are known as ‘anaphylaxis’ and require immediate medical attention. Anaphylaxis is a less common reaction of wheat allergy.</li></ul> 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>Diagnosis of wheat allergy is difficult as few of its symptoms overlap with that of celiac disease and gluten sensitivity. Hence, it is of utmost importance that you get your child diagnosed by a healthcare expert.</li><li>For diagnosis, the paediatrician will evaluate your child's medical/family history, existing conditions like asthma, eczema and other food allergies; along with a skin prick test, blood test or Oral Food Challenge.</li></ul> Precautions and Treatments:<ul><li>Your child must avoid consuming all wheat based foods and products; but can still enjoy rye and barley products unlike in gluten sensitivity.</li><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 he/she goes to visit someone.</li><li>Inform your child’s school about your child’s allergy to soy. You can also give the medicines prescribed by your doctor to the school which they can use in case of sudden allergic reactions.</li><li>Your child’s paediatrician might prescribe antihistamine medicines to fight against allergic reactions due to soy. Always give medications for allergy under proper guidance of the doctor.</li><li>Always keep the allergy medication handy for your child.</li></ul> Sources of wheat:<ul><li>Bread, pastas, cookies, baking mixes</li><li>Note that if your child is only allergic to wheat and is not gluten-sensitive, then you can give him/her other grains like rice, corn, quinoa, oats, rye, barley.</li><li>Also, buckwheat is not associated with wheat even though it sounds like a type of wheat so you can opt for that as well.</li></ul>

Among all the cereal allergies, the most common one is the allergy to wheat.

Cereal allergy

<ul><li>Most chemical head lice treatments aren't suitable for babies under two years old. So the best way to get rid of your little one's head lice is by wet-combing.</li></ul> 1. Make your child comfortable: Comb or brush any knots out of your child’s hair with an ordinary comb. Wet your child’s hair completely with plenty of water to straighten it so that the comb moves smoothly.2. Comb hair still using an ordinary comb.3. Change to a comb with fine teeth: Use a head lice comb and comb sections of your child's hair. Comb from the roots to the ends of the hair. Be careful while using lice comb so that it doesn’t hurt your child.4. After each comb, wipe the conditioner on to a paper towel or tissue. Check the tissue or paper towel for lice and eggs (a magnifying glass may help you to see them more easily).5. Repeat the combing for every part of the head, section by section. Comb each section at least 4 or 5 times before moving on to the next section.6. After you have combed the whole head, rinse out the conditioner.7. If you find lice or eggs, repeat these steps every day if you can manage it, but at least every 2 to 3 days. You can stop when you find no lice or eggs for 3 days in a row.8. Check the hair of everyone in the house twice a week for the next 2 weeks to make sure everyone stays clear. <ul><li>You can also use lice controlling medicated shampoos after concerning your paediatrician.</li></ul>

Children below 3 years usually do not suffer from hair lice. If they do, proper shampooing of their hair and an oil massage is helpful for them.

Treating hair lice

<ul><li>Moulds are small fungi and its spores float in the air and can thrive in moist environments - indoor or outdoor. It has a strong odour and develops a spongy layer on the surface which makes it easy to identify moulds.</li><li>Allergic reactions to mould are similar to hay fever symptoms so it is important to get the allergy diagnosed by a healthcare expert. The spores of mould may also cause symptoms of asthma in very sensitive children.</li><li>To prevent mould allergy in children, keep your surroundings clean. Treat the dampness or leaks at home if any, as this will reduce the humidity and hence prevent the formation of moulds in the house.</li><li>If your child is allergic to moulds, it is advisable to wear a mask at places where mould formation is known to take place or at places where humidity is high.</li><li>Treatment includes using antihistamine or medications for nasal problems.</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>

Allergy triggers to moulds in your child can be prevented by maintaining the hygiene around you.

Mould allergy

Good dental health includes cleaning teeth regularly.<ul><li>For an infant, using a soft cotton cloth is a better option. Wrap the cloth around your finger and clean the teeth and mouth using your finger. Get started with a soft toothbrush when the child turns 2. Use only rice-sized fluoride toothpaste.</li><li>Brush your child’s teeth twice a day, in the morning and before going to bed. For the babies of 6-9 months offering water to drink between the feeding is considered to be a better choice to keep their mouth clean.</li><li>After the age of 3, start using pea-sized toothpaste to clean the teeth. This amount of fluoride toothpaste is considered safe for children and helps to prevent tooth decay.</li></ul> Brushing properly:<ul><li>Get a small, child-sized, soft-bristled toothbrush. Soak the brush in warm water for a few minutes before brushing to make the bristles softer.</li><li>Apply a rice sized paste on the brush and get started with proper brushing habit, gradually increase the amount of toothpaste.</li><li>Brush the teeth for 2 minutes; concentrate on space between the teeth and black portion on the tooth. This is an area where cavities often first develop.</li><li>Replace toothbrush after 3 to 4 months and never share it with others.</li></ul>&nbsp;If your child does not like to brush his/her teeth try this:<ol><li>Become a role model and start the practice in early years of childhood. If you want your child to develop good dental care routine start brushing your teeth in front of kids twice a day.</li><li>If toothpaste is the cause of concern, try to eliminate it for a few days. Let the child brush the teeth with a wet brush, this is just to develop the habit of brushing once they get used to it you can get started with a small amount of toothpaste.</li></ol> Never lose your patience, remember this will make things difficult for both you and your child. Narrate stories and try to make it a fun loving activity rather than a daily practice.

Brushing habits should start in early years of childhood.

When and How to get started with brushing?

Palak Vyas

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

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

Gluten free diet for children or not

Few allergic reactions are known to worsen existing conditions like asthma and a few are known to cause asthma problems.Not all children develop asthma due to allergies. Children with a family history of asthma or children with eczema are at a higher risk of developing asthma.Asthma is a chronic inflammatory condition of the smaller air passages in the lungs. The common triggers of asthma:<ul><li>Cold or flu</li><li>Allergens like dust or pollen</li><li>Cigarette smoke or other irritants</li><li>Gastrointestinal reflux</li><li>Stress, continuous crying or laughing, physical activities are also known to trigger an asthma attack.</li></ul> Diagnosis of asthma is based on symptoms, family history and medical history of your child, previously known allergies, etc. followed by medical asthma tests which may include x- ray, blood tests or allergy tests. Please note, it is important to get your child diagnosed of asthma problem only by a healthcare expert. Symptoms of Asthma include:<ul><li>Coughing</li><li>Wheezing</li><li>Shortness of breath</li><li>Uncomfortable tightness in the chest</li></ul> Seek medical attention immediately if you notice these symptoms in your child:<ul><li>Gasping for breath or trouble speaking</li><li>Deep breath/inhalation that shows the abdomen sucked in</li><li>Increased rate of breathing</li><li>Given the close link between allergies and asthma, it is important to identify the source of allergy and manage it effectively.</li><li>Allergy shots (Immunotherapy) may be advised if your child's asthma is due to allergens like pollen or pet dander.</li><li>Asthma treatment is based on the severity and frequency. An inhaler with a holding chamber/spacer may be prescribed by your child’s paediatrician for a quick relief during an asthma attack. Always seek medical help if you think your child might have asthma.</li><li>According to studies, omega 3 fatty acids from fish oil are known to reduce inflammatory conditions like asthma in children. For children with fish allergies, an alternative source for omega 3 fatty acids is algae.</li></ul>

Asthma and allergy are closely related hence it is important to take proper precautions.

Asthma and Allergy

Massaging your baby’s scalp with suitable oil and the right technique will give your child all the benefits. Ensure that you apply oil on clean scalp and massage gently. Some of the benefits are:<ul><li>﻿It moisturises your baby’s hair and soothes dry scalp.</li><li>Helps in treating scalp problems like dandruff, scaly skin, a bacterial or fungal infection.</li><li>It hydrates your baby’s hair.</li><li>It prevents hair fall.</li><li>It strengthens hair roots.</li><li>If your baby has curly hair, applying oil softens hair strands.</li></ul>

Hair massage with oil is beneficial in several ways.

Benefits of applying oil in child’s hair

<ul><li>Yes! There is a difference in potty training boys and girls. Most parents start potty training their child when they are between 2-3 years old. Usually, a girl child is ready to start potty training when she is 18 months old or it can vary up to 4 years in some cases.</li><li>Girls tend to get started with potty training about 3 months earlier than boys. Boys take more time to get ready; at around 2 years they start and can be fully potty trained between 4 to 6 years of age. So they start later and take longer to train.</li><li>Boys have to learn two different ways and they easily accept this. To start with, teach them to use the potty while sitting and gradually they learn to use the toilet in standing position for peeing and in sitting position for potty.</li><li>Girls mature faster both physiologically and intellectually. They are quick with the concepts of language and understand better so their potty training is faster. They learn how to dress and undress and they have better control than boys.</li><li>Every child is unique. Regardless of gender, potty training will be different for everyone. Each child will be potty trained in his/her own time and in his/her own way.</li><li>It is important to reward your child for achieving this milestone of being potty trained.</li></ul>

You might have to adapt different approaches to potty train your girl child and boy child.

teeth cleaning health concerns

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