Short duration earaches are very common in children and often is a reason for rushing to hospital with the baby around 3am.
Though common cause of ear ache all over world is wax or a foreign body insect or cotton or stick in ear... In infants the ear is most commonly aching due to common cold.
The nose block associated with common cold or rhinitis or adenoiditis or flu causes pressure and congestion of Eustachran tube opening in throat and causes pain in ear due to pressure buildup in middle ear.
Ear ache in infants is commonest reason of excess cry (after the infantile colic) in age 2 months to 2 years. Ear infections are often bacterial and may need good course of specific antibiotics.
Dont try to treat an ear issue without visiting a doctor as there are some serious infections like otitis media that need good course of antibiotics. Also some life threatening sequalae like bleeding, sepsis or tetanus may floow some cases and cannot be easily seen as other symptoms.
Never put any stick in ear.. Its the job of doctor to clean if felt necessary. Most kids dont need wax cleaning as ear pipe ot children is straight.
Analgesic ear drops give prompt.relief that antibiotic or antifungal ear drops. Wax dissolving doesn't help in pain as it only dissolves wax. Otoscope is a special instrument that may help doctor to see ear content if not easily seen. Leaky ears often get infected and is a sign of ear drum damage or perforation or rupture. Its always better to have cotton swab closing the ear during sleep and removing it after bath in morning to avoid insect or water getting in ear.
For details #whatsappdr 9869405747
Heard of developmemtal delay?/neurological delay?
Its important to understand for every parent that "Not noticing the delay in time" is real delay.
Often parents sit at home, saying he will learn sooner.. his mom or dad also learnt it late.. or whats the urgency etc
Please donot fall into a trap; by accepting delay in development or growth of a child normal; we are halting the progress of the child.
Visit your doctor, ask when to worry about a delay; when not to worry about a... delay. What is the maximum potential of the child? is he lagging behind peers of same age in certain areas of development? to what extent it is normal? what may happen if u donot note in time?
Its important for us to understand that any delay is rectifiable only if picked up early and intervened early by some brain training therapies; that your occupational therapist or pediatrician may guide about.
Certain delay if not noted in time may cause serious mental retardation. A common known reversible cause of developmental delay is dietary iodine deficiency related hypothyroidism; which gets reversed with near normal intellect once the disease is diagnosed and started on medications.#
There is a huge market stressing you from nutritional advertisements stating that marginal under performance can be related to iron or DHA or calcium or other micronutrient deficiency. Surely malnutrition is an important reason for developmental delay.
When a doctor assesses a child with labelled developmental delay like say delayed smile, delayed sitting, delayed rollover, delayed sitting, delayed standing walking running or comprehending in words or social interactions; the doctor has kept in mind all these causes to decide about action plan. Neverthless, the detailed neurological examination also helps a doctor to decide the need for evaluation of serious neurological disorders from cerebral palsy, autism, etc to neurodegenerative disorders and strokes.
Early Intervention therapy, helps child cope up with the lag and develop a step in milestone development by training the developing cortex using vaious sensory,vibrations/kinaesthetic senses.
vomiting 4-6 per day----> hardly 2-4 motions --> viral diarrhea---> treat vomiting and ensure hydrationa
no vomiting and frequent loose stools .. not watery but partly formed with no mucus and blood---> ileal diarrhea. giardiasis? may need specific meds.
no vomiting but watery diarrhea ---> treat as toxin producing bacterial enteritis
vomiting with watery stools ---> take as toxin producing viral infections
no vomiting and mucus in stools ---> bacterial or amebic dysentery
greenish motions ---> begining of viral diarrhea or malabsorption
loose sticky foul stools---> colitis/ enteritis mostly bacterial
Vomiting:... a often true symptom but wrongly labelled or wrongly interpreted by people makes doctors mismanage at times.
Anything that looks like vomiting need not be vomiting.
Something coming out of mouth.. say curdish milk in infants is called possetting... a normal phenomena.
If its frothy or spitting out.. beware it may be type of seizure if child is losing eye contact along with.
The term vomiting from inside often means retching reflux or at times throat discomfort.
Vomiting just before cough and immediately with food is often choking or gagging than vomiting as seen th throat or tonsil issues.
Vomiting little time after food can be food pipe or gut problems primarily infections.
Vomiting with infection doesnt last more than three days.
Vomiting with hyperacidity or neurological issues tend to recur unless properly treated.
Repeated vomits can also be due to hut obstruction or TB.
Vomiting lasting for weeks surely has a serioua problems.
Sometimes it canbe psychogenic especially in some adolescents.
In viral gastroenteritis its often with loose stools. In dysentery; vomitings are uncommon.
Vomiting that doesn't cause weight loss or is barely 2-3 times a day may not be serious unless known cause in background.
Vomiting with jaundice or yellow urine is likely to be waterborn hepatitis.
Vomiting after medicines and stale food is pretty common and most vomitings need chewable antiemetics with fluid support till the disease is understood. For details whatsap 9869405747
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In my experience, I feel that the name ASTHMA has always been taken with taboo by many people and doctors, so much so that people have developed myths that..'its incurable..' or 'its a lifelong disease needing life long treatment' 'medicines cause addiction' or once an inhaler always an inhalers'.. These myths are false; but due to this, many children and adults are taken to various different doctor and non doctor specialists; that keeps the patient incompletely cured and hence uncontrolled.
its time to control asthma. the very first way is to @know that what the child or person is suffering from is an asthma for sure@
This is very important. If its not asthma; how will it get controlled?
The rule of asthma diagnosis needs to be clearly understood that 'ASTHMA IS DIAGNOSIS BY EXCLUSION' and when we donot follow this; we donot get to other diagnoses and get mismanaged.
So when you are not happy with treatment of your asthma; its wiser to insist to your doctor to consider nonasthma diagnoses causing similar symptoms seriously. read more in OTA section at www.breathingdiary.com
Once we are certain, it is asthma; the control of asthma can easily be handed over in hands of parents provided:
1. patient/parent have understood the symptoms, disease profile, symptom prediction by peak flow metry and charting and need for charting the symptom diary. Simplest yet best symptom diary for asthma at www.breathingdiary.com
2.patient / parent can easily be trained into classification of symptoms and rescue medicine concept by simple training. All patients donot need inhalers or steroids all the time. Remember rule of S at www.breathingdiary.com, that dictates the need for steroids.
3. Also, parents should understand the need for 'duration', 'step up-down therapy' and tapering therapy and also the need for allergen detection and avoidance when possible will help the patient be symptom free almost all the time.
4.An early eye on detecting associated morbidities and allergies; milk free diet and simultaneous treatment of any morbidity if any will prevent further symptom exacerbations.
If the education is effectively imparted to the parents/patient and family, schools and community; the reactive airway disease will remain controlled and cured in most cases; instead of remaining a scare with its name as ASTHMA.
iron apple health - myth
often i see people consuming lots of apples.. also giving same to infants... boiled pureed and what not forms.. considering it is very healthy for kids for iron and calories... not true exactly.
Apple gives calories as equal as a banana... sixty calories for 120gm serving. See the cost effectiveness.
A water melon slice is equal to same. means cheaper fruits like banana and watermelon are richer in calories compared to apple. So why apple madness?
Age old saying is.. an apple a day keeps doctor away. its supposed to keep u healthy by keeping u low in calories. if u have an apple prior to a meal.. u may eat 180 calorie less. In short.. its a weight reducer.. so why punish kids with it when they need to gain weight.
Now coming to iron... are u maddened by apple content of iron cos it turna black when kept open to air... then again u r fooling urselves. iron requirement for adults is say 10mg per day for males and 20 mg per day for females.. and for kids its around 2mg per kg body weight per day. Now look at apple iron content its around 0.22 mg for medium size apple. now imagine how many apples you need to eat to make 20 mg per day.
Last but not the least ... apple is good source of vitamin C. that is ten mg.. oh yeah and the requirement for vit C per day is around 60 mg. so if u eat six apples a day.. you are sure to get malnourished.
Moral: Eat fruits... but for taste. dont go for fanatism.. dont expect a single diet source to give all. by having a single food in excess you are compromising on other dietary necessities.
so what to give kids?
wait for updated article on how much how often... till then basic feeding or diet issues discussed at www.infantfeeding.blogspot.in in question answer format.
They should to understand diagnosis, and shouldn't... to interfer in treatment.
Should patients read internet?
We often say; half knowledge is dangerous. Especially we hear in medical field.. media and doctors cribbing about patient reading lots of details on internet. They google the diseases and spoil their mind with lots of queries and bombard a doctor with lots of queries about chance possibilities.
All this is discouraged by many. I do not. A doctor should never be insecure about what patient needs or knows as long as all is done in good faith.
Give a second thought, how can knowledge be dangerous. Knowledge is always a piece of information that is searched for out of curiosity to know understand and to clear confusions when u feel u have no other choice left.
Its likely that there may be wrong books written so also the wrong information provided in media advertisements websites and internet. So its likely that information may be wrong or wrongly interpreted that exactly may harm.
So its responsibility of the doctor to insist for a special consultation to clear knowledge related confusions. The concerns of doctor is probably to save time from such discussions when patient has queries with medical jargon. And thats the reason the doctor insists you not to read nonsense.
No one can have complete knowledge of everything... medical science is not even close to complete knowledge in any disease. We know only the part or piece of available information. So practically every one has limited or half knowledge. Doctor's skill lies in improving his practice by trying for more knowledge and experience. So its the experience of a doctor that becomes key to effective therapy which has grown over years following his curiosity through knowledge.
Thus half knowledge can never kill or harm, its the practice of medicine by a doctor, paramedic,quack,pharmacist,nurse,patient or family member without having adequate experience (and qualification) is dangerous.
so read a lot, know a lot, ask a lot but donot practice/medicate on self or family member or a patient unless a doctor prescribes so.
whatever trivial issue it may look like, it need not be.
Read ask and clear your doubt... but follow only as per prescription.
nose issues.. is this allergic rhinitis? or infection?
since a week or more, the nose and cough issues have risen a bit in Mumbai. each time someone blows nose in, doesnt mean that its allergy. commonly most kids and adults get nose cough issues following viral fever. such viral cough cold often comes with fever at onset and cold is in the form of runny nose white or thin but not as thin as allergic rhinitis. though there is little sneezing and throat discomfort, its much less than seen in allergic rhinitis. Often viral fevers are associated with little change in speech or voice, either it becomes nasal.. or it becomes hoarse. whatever it is... all settles in a week or so unless complicated.
Allergic rhinitis is almost opposite entity.. sneezing and itching in nose or throat is almost always there in allergic rhinitis. runny nose can be thinnner and more continuous but at fixed time slots or on exposure to allergic item. this is not contagious. So if someone is continuously sneezing, practically he is not suffering from infection.
the treatment differs..
Often allergic rhinitis can be associated with chest tightness/breathlessness or stuffy chest called asthma or asthma like diseases.
appetite series: topic 1, post 1
1.why do a parent feel his/her child has no appetite?
2why does a mother feel her milk is not enough for baby?
3.why does a parent feel... why his/her child is not growing well?
will be upcoming topics.
1.1 Today lets understand why does a parent feel his /her child has no appetite.
Most often, feeling of child not having appetite is a subjective/personal interpretation by parent or neighbourhood by observing look behaviour or feeding or diet pattern of child, most parents expect their child to eat heavily on nutritious standard and bland diets...like the perception - that heavy (healthy) diet will keep you strong and protect from diseases.
so its not unusual to see parents forcing lots of vegetables fruits , 2 glass of milk a day and two chapati/breads three times a day.
when they donot find their child eating as per their expectations, parents feel the child is not having appetite.
Such a situation may also be because:
1.parents feeling of child not growing well (cause not found)
2.child really not growing well
3.child likes selective food/ diet which is not provided
4.child has problem in digestion/ excretion like say indigestion, constipation
5.infections mainly due to throat / tonsil and gut infections, TB
6. real lack of appetite
Of this, the last one is really rare and in almost all cases there is no clear need for appetite inducing medicines like cyproheptadine and may need serious evaluations.
1. parents feeling child not growing well: this is often a comparative interpretation, but if the doctor has checked weight and height of child and if its appropriate and if there is no illness often most doctors will advice on exercise, and balanced diet to maintain same growth pattern. i do appreciate parents concern,because these are the cases where the hidden reasons are not obvious and often after detailed history, a doctor may be able to find a reason for parents perceptions and specific treatment is likely to show results by treating the cause.
2. child really not growing well: continued in next post.. pls wait for same.
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