Why Drugs Are Used

Why Drugs Are Used





Treatment of an infection is necessary only when the type or severity of symptoms shows that the immune system has not overcome the infection.



Bacterial infection can be treated with antibiotic or anti­bacterial drugs. Some of these drugs kill the infecting bacteria; others simply prevent them from multiplying.

Unnecessary use of antibiotics may result in the development of resistant bacteria.

Some antibiotics can be used to treat a broad range of infections, while others are effective against particular types of bacteria or in a certain part of the body. Antibiotics are most commonly given by mouth, or by injection in severe infections, but they may be applied topically for a local action.



Anti-viral drugs are used for severe viral infections that threaten body organs or survival. Anti-viral may be used in topical preparations, given by mouth, or administered in hospital by injection.



Other drugs used to fight infection include anti-protozoal drugs for protozoal infections such as malaria; anti-fungal drugs for infection by fungi and yeasts, including Candida (thrush); and anthelmintics to eradicate worm and fluke infestations. Infestation by skin parasites is usually treated with the topical application of insecticides.







Major Drug Groups



• Antibiotics and anti-bacterial drugs (including drugs for meningitis, drug treatment for Hansen's disease (Leprosy), and anti-tubercular drugs)

• Anti-viral drugs

• Vaccines and immunizations

• Anti-protozoal drugs (including anti-malarial drugs)

• Anti-fungal drugs

• Anthelminthic drugs

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PREMATURITY

CAUSE AND PREVENTION OF PREMATURITY





The incidents of prematurity are increasing day by day, throughout the world. Although for the most part the cause is unknown, there are a few obvious reasons for prematurity



INFANT VOMITING



Cervical incompetence



This probably is the only condition which is avoidable. But, until it has occurred once, there is no way of predicting and so preventing it. In this, the cervix is too weak to stay closed for the duration, generally giving way in the latter weeks of the second trimester. The incidence is higher in women who have had abortions.



Multiple pregnancies



Women who are carrying two or more babies are predisposed to premature birth, commonly occurring between 30 and 34 weeks.



Foetal abnormality



NAPPY RUSH



If an abnormality is detected by screening methods, such as ultrasound or amniocentesis. It may alert your doctor to the possibility of pre-term labour occurring.



Induction and caesarean section



Certain conditions, including pre-eclampsia and antepartum haemmorhage. Sometimes call for induction or caesarean, to save the lives of mother and/ or baby. Likewise, pre-existing maternal conditions, such as diabetes, epilepsy and kidney diseases, or serious illness may indicate intervention in the pregnancy.



INFANT COMPLICATIONS



Hydramnions



This rare condition, in which there is an excess of amniotic fluid, is most likely to occur where the uterus is carrying identical twins, although occasionally it is associated with diabetes,



Uterine abnormalities



Usually large fibroids muscle tumours in the uterine wall are the rare cause of pre-term labour. A congential abnormality in the size or shape of the uterus may prevent it from carrying a foetus for the full term.



Maternal age



Mother under the age of 20 years may have a predisposition to premature labour



Hereditary factors



If your mother delivered her baby prematurely, there is a slight chance that you will have inherited this trait.



INFANT TRUSH

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Prevention of pre-term birth

Where the reason is unknown, generally nothing can be done to prevent the start of premature labour. However, sometimes it can be halted if the baby is considered too young to survive.



If cervical incompetence caused a pre-term birth previously, a second may be avoided by the insertion of a cervical stitch at about 14 weeks gestation, to be removed a couple of weeks before expected delivery date or when labour starts, whichever happens first.



Drugs can be given to lower blood pressure, obviating the need for induction. However, once labour has started, intervention is usually not undertaken.





If premature labour begins for no apparent reason, a woman will be admitted to hospital where drugs may be administered to stop contraction temporarily. During this respite, the mother will be treated with a drug which will cross the placenta and work on developing the baby’s lungs.



When a woman has had a previous pre-term labour, she may be advised to abstain from intercourse for the final two months. This is because prostaglandins in semen are believed to trigger contractions.



Some doctors suggest that patients expecting multiple birth take to their beds as a safeguard from about 30 to 34 weeks of for the rest of their pregnancy.

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BABY MASSAGE AND BATHING

Massage is a marvelous way to enhance the natural bonding between the mother and the new born baby as touch is a natural way to establish contact between both. All babies instantly respond to cuddling and caressing. You must have noticed how a baby tightly curls its hands and feet when touched. In the case of babies, no essential oil is used, but only light vegetable oil, like sweet almond, sunflower and baby oil or olive oil, are used.



Advantages and significant points about massage



Unless Okayed by an aroma-therapist, no essential oil should be added to massage oil.



Do not expose the baby’s tender skin to strong or biting cold, cold winds and snow fall.



Warm your hands before the massage. It is still better if oil is also slightly warmed.



Gently stroke baby’s tender body and do not exert any pressure.



Do not massage when the baby is weeping or is ill or even when he resists any type of touch.



Room should be warm, quiet and without any draughts.



Massage relieves babies of colic, alleviates wind, improves digestion, cures coughs and colds etc.



Keep movements gently and smooth flowing.



Massage builds up general resistance of body.



Do not apply any oil on the baby’s eyes and face.



Do not massage immediately before, during or after a feed.





Make sure that massage helps your baby to feel lighter and better and that no discomfort or agitation is caused to her, if the baby weeps or cries during the massage, it means the massage area is either painful or too sensitive. In such a situation stop massaging. You may restart when the baby feels comfortable.



Procedure



Take a large sized towel and spread half portion on your legs or lap and other half under the baby’s back out. ensure there are no wrinkles or folds. Lay the baby on its back, or lay her in the position that makes her feel comfortable. Apply some oil, about 5 ml, to your palms and then apply gently and softly over the frontal portion of the body. Ensure that your hands are warm, the room is also warm and quiet and also there are no draughts. You can massage baby’s body either before the bath or after the bath. But the ideal time is said to be one hour before the bath.

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Frontal massage of the baby

· Gently and slowly apply a little oil on the front of the body, from shoulder to feet, but avoid the face. Now lightly stroke down the chest and abdomen using the tips of your fingers. By your light and delightful strokes, you can calm your baby’s body at any time. Remember, the touch of hands on the body will cheer up the baby and will show her happiness through gentle laughter of innocent smiles. Let the legs be kept in a straight line but if she curls them up, let her do so. It is a sign that she is enjoying the movements.

Keep the pressure very light. Move both your hands smoothly in circular strokes over the abdomen, working up the baby’s right side across and down the left side. Keep your movements continuous by lifting your left hand when your arms across. Now repeat such circular movement many a time

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Baby massage Left side

Left side



· If your baby lets you, gently stretch out both the arms to the sides, spreading hands and fingers. Then gently squeeze out along the arms and, with light and circular thumb movements massage the palms and wrist before you finish your movements, do not forget to stretch out each finger with a light pull.



Now move on to legs and feet, but work out only on and leg at a time. Supporting baby’s leg with both your hands, gently squeeze and release the fleshy part of his thigh. Thereafter, support the leg with one hand and stroke the leg, from knee to the thigh and back down again.

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Babay massage Right side

Right side



· Now move your supporting hand behind the ankle. Then gently smooth palm of your hand over top of baby’s foot—that is from toe to ankle and back again. As you reach the toes, stretch each toe very gently, without exerting any force/pressure. The same step should be repeated 4-5 times on the baby’s other leg also.

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Baby’s back side massage

· Now turn the baby over onto the front. Then start to stroke her entire back side so that applied oil is evenly distributed to the whole of the back side. After applying the oil evenly over her back side, work up your strokes around baby’s side also and then up the legs, back and over the arms. If you massage her back side, as suggested. It will have a very calming impact on the baby’s spinal nerves, because soothing effect always cheers the baby up



· To stimulate the blood circulation, gently knead and squeeze the buttocks. For this you should make a loose fist and rotate over the baby’s buttocks in circular movements.



Now gently stroke up one side of the back to the shoulders and down again. Repeat the suggested movements on the other side of the back also.



Now bring both your hand’s around the sides of your baby and , then using your thumbs, massage gently up the back to the base of the neck. You should also massage baby’s shoulders with the help of thumbs.



Finally, before you finish up, repeat the feather strokes that were used at the beginning of the massage, by working all over the back, from neck to buttocks.

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BABY’S CRY AND SLEEP

Sleep problem are the most common and disturbing in a baby’s first year of life. The overtired baby or infant can be almost impossible to manage in the daytime and the frequent waker at night can put a strain on family relationships.



There are two types of sleep: Active and Passive. Active sleep is associated with body movements, muscle jerking eye movements and dreaming. Contrastingly, passive sleep is deep and restful, without body movement or dreams.



These two types of sleep occur together in cycle which last about 50 minutes at birth 75 minutes by 4 years of age. This is the reason so many babies wake or becomes very restless an hour after being put to bed.



The new born sleeps about 17 to 20 hours a day. The sleep periods usually don’t last more than five hours and wakeful period not more than two or three hours. By three months, 70 percent of babies sleep about eight hours a night. Hunger and feeding are closely related to sleep in the early weeks and many babies wake screaming with hunger. Once the baby is 6 or 8 weeks old, hunger is less of a driving force and your baby will begin to wake before an occasional feed and not automatically expect food. MORE

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Bathing the baby

Bath time gives your baby the opportunity to enjoy herself by kicking and splashing in the water. It should be happy time for mother and baby and if you are well prepared, it will be a relaxing time.



Most babies are bathed every day but if you are rushing or you are still not very confident with your newborn baby, topping and tailing can done instead of daily bathing.



To do this, wash the baby’s bottom from front to back with cotton wool. Swab her eyes. Make sure you use different cotton wool swabs for each eye otherwise infections can spread from one to the other. Topping and tailing is also part of the bathing routine.



Some mother prefer to soap up their babies before placing them in the bath. When you place her in the bath cradle your arm and support her head on your forearm, use your free hand to splash water and play with her.



Tickle some water over her head and wash her head gently with soap or baby shampoo. Use gentle circular motion to wash her scalp and dry head by stroking it with towel.



Wash your babies arms underarms feat and allow her to enjoy her bathing for some times. Rinse the soap off and gently lift her out of the bath and pat her dry with towel.



Dry all creases before redressing your baby.



When you bathe or change the nappy of the new born baby, always clean the umbilical cord with a cotton bud. The more often you clean the cord with methylated spirits, the sooner it will fall off.



The kitchen sink, a hand basin or the laundry tub can be substitute for a baby bath.



Choosing the right time for bathing your baby influences how much she will enjoy the water. Hungry babies usually object to bath because, obviously, they would prefer a bath may regurgitate some of their food during their bath, so, feed her half an hour before bathing her.

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Baby cry and sleep 4

By 4 months, hunger rarely dictates the day sleep patterns. By this time nearly all babies will wait for food; hunger will not produce screaming. But temper may add the noise factor.



If a baby is over stimulated, overtired and unrelaxed she will fight being put down to sleep and will wake frequently. In the early months, a baby will not sleep unless she is fed sufficiently and then allowed to pass happily into sleep. Any pressure from the parents reflects on the baby; she will object, become sleepless and cry.





By 6 to 8 weeks some babies required a play period after feeds before they will sleep. This required the parents to recognize the baby’s desire for sleep, which may not be an easy thing to do. When the baby is 3 or 4 months old, the afternoon sleep period will begin to shorten, for most babies of about 3 months, the number of day sleeps is generally related to the number of feeds. The change from two to one day sleep depends on the individual child and usually occurs soon after the first birthday.



The total cessation of day sleeps also occurs at individual ages and can occur anywhere between 18 months and 5 years of age. For the poor sleeper, especially at 3 to 4 months old it may be important to establish a ritual about going to sleep. It is essential this ritual is established in the early weeks and during the first year.





A special cuddling position, a lullaby, being put down to sleep in a particular position, music playing near the baby’s head and knocking, patting or stroking may be part of ritual. Sucking and rocking during the first year almost always improves sleep and so too does music or pulsating sound. MORE

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Baby cry and sleep 3

Prematurely born babies have unsettled sleep patterns compared to normal term babies and can take longer for them to adopt sleep patterns which are satisfactory to parents. You can indicate to your child when she should go to sleep but it is impossible to make him sleep unless he wants so.



Tiredness and fatigue can build up to a situation of continued over-tiredness. All parents at some time experience the overtired baby who cannot be cuddled, who screams, who wont be soothed and wont feed. Tiredness can also be important in producing a colicky baby who cries continuously.



The 9 month year old baby sleeps only one hour a day may be too over tired to stop her perpetual motion, which can become controllable.



Constant crying and sleeplessness could also be caused by a physical disorder. Discomfort or pain can be caused by a wet nappy, an open pin or wind. Wind occurs because the baby swallows air as she feeds. Burping can help bring the wind up. This can be done by holding the baby with her head on your shoulder and gently rubbing the back.



Babies also cry when they don’t conserve heat well and may be cold. The over-anxious mother who goes into the baby’s room constantly to see if she is all right is disturbing her sleep. The baby is almost always aware of the mother’s presence and may wake up and be unable to go back to sleep.



Night waking can begin again after 6 months with teething or no obvious reason. Parents can often pat the child back to mobility, will wake at night with talking and singing but this only becomes a problem if the parents join the baby and she expects them to come when she calls. Disturbed sleep patterns can also be induced by the new surroundings of holidays or by the anxiety of a maternal separation.



If your baby wakes frequently, let her cry it out so she learns night time is for sleeping. This does not apply to babies who are not mobile and it does not work for those parents who can’t stand to hear their infants screaming.

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BABY GROWTH PATTERN

FIRST MONTH:



Can be breast-fed or bottle-fed, sleeps most of the time and weeps when hungry, has to pass urine/stools, keep first closed.



SECOND MONTH:



Smiles when looked up; can lie on stomach and raise neck also.



THIRD MONTH:



Smiles more and it looks very attractive



FOURTH MONTH:



Turns head to the directions from where sound is coming; smiles when looked at or when called create noises.



FIFTH MONTH:



Tries to catch toys or colorful objects and is attracted by dark colours. Especially red, green, yellow and blue.



SIXTH MONTH:



starts cutting lower teeth(two), raises head from the pillow, laughs and smiles, is able to sit (but only when support is provided), can itself turns to another side and holds feeding bottle.



SEVENTH MONTH:



Tries to put all things into the mouth, watching and hears with great interest when others talk, can sit for a few minutes without support. If held and supported by arms/hands, tries to get up and dance/jump, can take water or milk with a cup.



EIGHTH MONTH:



starts speaking ‘Ma-Ma’ ‘Pa-Pa’, ‘Da-Da’etc. cuts two (frontal) upper teeth.



NINTH TO TWELVE MONTH:



Can sit without any support, starts toddling, can stand with some support, laughs heartily and feels happy with child-like response, when fondled or called. Some kids try to walk also, can point to some object with a point finger but some of them fall while trying to walk. At the age of one, some children learn to walk by them or with support. Some children start standing and walking even without any support.



12-15 MONTH:



Can get up and start to walk, learns to play with toys, starts speaking words like ‘Dada’Mama’Papa’ etc , starts to understand, learns to hold spoon and tries to eat also.



18 MONTHS:



An 18-month year old child can walk, go up and down the stairs, can throw and collect a ball, sit in the chair without any support. Starts to imitate her mother and other elders, does not resist in changing cloths, can herself remove her socks, attains control over urine and stools but may pass urine at night (Enuresis which is quite common in winter)





24 MONTH:



A two year old child can run, can herself get into chair, can call her mother and express her demands , watch her toys and other playing with interest and attention, intently listens to voices, can ascend stairs without anybody’s support.



The above progressive stages are merely indicators to general stage of a child development. Some children cut their teeth quite early or late, some learns to walk while others do not respond. Patterns also vary from child to child.

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Diet for the Child

Following suggestions are given simply as a guide to infantile diet but requirement of each infant/child are different, hence there is no need to firmly stick to the given pattern.



1st Month: Only Milk can be given to the baby.



2nd Month: Milk, a teaspoon of sweet lime/orange juice, or curd.



3rd Month: Rice and curd, milk, soup of pulses, crushed banana, juice of pomegranate or apple. But do not mix up juices of two fruit, milk.



4th and 5th Month: Wheat dishes cooked in dhal, green cooked vegetables can be given.



6th Month: Thin gruel of khichri, kheer of sooji or saboodana. Milk 2-3 times.



7th and 8th Month: Chapatti mashed in dal, soup of vegetables, curd, paneer , milk





NOTE



During summer give lemon juice, honey or sugar mixed water, to which some salt also may be added. You may also give lassi, curd.

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Height of infant

Height is generally dependent on standard of food, opportunity for mental and physical growth, physical activity or games. It is believed that height does not grow after 18-20 years. Generally, height must commensurate with weight and age. Hormonal secretions play a major role in containing or increasing of height. Following data will simply give a general view on height (From birth to 2nd year).





Do not get anxious if your child does not measure up to the indications given above. Some children grow rapidly, while the others may grow gradually or in phases.

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Weight of a Child

Weight of a child decreases after birth but again starts increasing after 10-20 days, when weight again measures up to original weight(what was actual at the time of birth). A child gains about 28 grams (about one ounce) per day during the first three months. As a general rule, a child’s weight almost doubles between 5-6 months, but at the end of one year his weight is thrice the weight which was actually at his birth time. Weight gain is faster and quicker in male children than the female children. Weight of each child should be measured after every fortnight during the first 3 months and thereafter once in each month. Growth pattern and weight gain/loss depends on many mental, physical factors which vary from one child to another. Following table will give an average of weight.







5% weight, when compared to the above table, should be taken as normal but any deviation, on higher or lower side should also not cause any anxiety. If a child is quite active, and is also mentally sound and alert and has no physical problem, there should be no cause for undue anxiety, as growth pattern differs in each child. Some healthy-looking children have been seen to be less mentally alert and vice versa. But a close watch needs to be kept on sudden weight loss or gain. If there are abnormal growths, consult your doctor and follow his advice.

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DENTAL DEVELOPMENT IN BABY

A common source of parental concern is regarding the teething of their child. They are worried as to when the child will cut her first tooth. As it is true with all types of development, there is no fixed or ideal time when the first tooth should erupt. In some children, it may erupt as 5 month, while in others, it may not erupt up to the age of 1 year. there is nothing wrong wit your child if her tooth doesn’t come out by 1 year. Most of the parents think that their child is deficient in calcium and/or vitamin-D, which may be true, but only in a few cases, in majority of cases, it is just a normal variant and hence no intervention is required.





Parents also attribute a lot of things to teething. Every complaint at the time of teething is attributed to it. Thus if the child has fever, irritability, diarrhea etc, the parents usually blame it on teething. Problems like fever, vomiting etc. cannot be attributed to teething. It is sure that during the teething phase, there is irritation on the gums of the child and to reduce it, she puts foreign objects in her mouth and chew on them. These foreign objects may be an indirect source of infection in the child and cause diarrhea.





There are two types of teeth: deciduous or milk teeth and the permanent teeth. There are 20 milk teeth and 32 permanent teeth. The milk teeth start erupting from the age of 5 months onwards and first tooth to come is usually the lower central incisor.



A simple way of remember the eruption of milk teeth is that by 6 months there are 0 teeth; by 12 months, 6 teeth; by 18 months, 12 teeth, and by 24 months, 16 teeth. The last 4 teeth make their appearance by 2 and one by 2 – 3 years.

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COMPLICLATIONS DURING TEETHING

It is repeated that headache, fever and colic cause abnormal discomfort in the child, hence control these symptoms first. But if diarrhea also persists and frequency of stools passed is too great, give Electral power (ORS) dissolved in (boiled and then cooled down) water so that sodium-glucose-water levels stay within normal limits. As for Allopathic drugs to control diarrhea, consult a physician for proper medicine, dosage and frequency--- above all the side-effects--- which are many. If Electral power is not handy, mix 2 teaspoons of sugar, a pinch of salt in 1 liter of boiled and cooled water and feed to the infant as frequently as needed.





Ayurvedic physicians recommend massage of honey and borax (Suhaga) powder---500 mg of suhaga to 2 tsp of honey. This compound, if given too quickly or in large quantity, will spill over to stomach and cause loose motion. But when the child is having constipation, this compound is said to remove constipation.



In summer, the child should be given plenty of oral fluids and protected from heat, hot winds and exposure. In winter, keep the feet, abdomen and chest fully covered with woolen garments and do not let her be exposed to cold winds. All these measures are meant to be observed in a routine manner but, when the child is cutting teeth, her danger of exposure to changing thermic conditions should be fully guarded.

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SOME COMMON COMPLICATIONS OF INFANTS

A mother should be fully conversant with some of the disorders, detailed hereunder and take preventive or corrective steps so that the disorders do not assume serious proportions.





INFANT HICCOUGH/HICCUP



Some children, through not all of them, develop hiccoughs after taking milk and it is natural and does not constitute a disease. But if hiccough last for longer span and continue unabated, it does exhaust the little one, especially when breathing gets interrupted; and in this condition a doctor must be consulted for medical advice. Generally such hiccups subside automatically after a few minutes when no treatment is called for. According to some experts, hiccough is a healthy sigh for a baby, and the same disappears if some lukewarm water is given to the infant.

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INFANT WEEPING

It is no disease but merely a pointer to some discomfort felt by the baby like



Pain in the stomach



Locking up of wind in the abdomen and gurgling sound



Constipation



Redness and swelling of anus due to acidity



When bladder is empty but had not been voided



Fever or pain in the body



Nappy rash



Cold bed or exposure to cold or when his cloths get saturated with stool or urine



Pain in the ear



In some cases the child may weep even without any visible and/ or apparent cause, but it is height of imprudence to attribute every weep of child as a demand for feeding. If a child draws up her legs and does not bear her abdomen to be touched with hand, even when mild pressure is applied abdomen which might bloat. Some children are relieved after the passage of wind. But colic pain generally disappears by the 3rd month.



The baby will cry if urine or stool is not passed. This situation can be easily countered by passage of urine/stool. If the stools are hard, she will have pain while passing stools and there may be some redness also in and around the anus. Give some quantity of water (boiled and then cooled)



If there is a pain in the ear the child will try to touch her ear. Pain in ear can also be due to some injury or blockage of nose or wax accumulation. Do not touch the ear. Rather have the child examined by a specialist.





Baby’s nappies should be changed as soon they become spoiled by sweat, stool or urine. When it is winter, the child will cry more due to cold and wet nappy. Even otherwise, if a child lies in wet clothes, he will develop itching, rashes and pain.

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INFANT NASAL BLOCKADE AND COUGH

Blockade of either or both the nasal passage cause breathing problems, especially when the child has breathe through her mouth. If there is cough also, it will make even mouth-breathing difficult. If cough is stingy and tenacious, she won’t be able to cough up the sputum and, thus, feel choked. When all these problems combine the child feels gagged, suffocated and tired. To cure these complications, insert a drop of saline water in each nostril or use Nasivion paediatric nasal drop. Give 2.5 ml of Tyxylax syrup after an interval of 4-6 hours. Vicks vaporub or steam inhalation will facilitate passage of mucus by liquefying the phlegm. If the child vomits while coughing, exhausts and faint, the body turns blue, it points to whooping cough/bronchitis/broncho-pneumonia which all must be treated by a child specialist.

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VOMITING OF MILK BY INFANT

Almost all the infants vomit 2-3 spoon quantity of ingested milk and there is nothing unusual in it. Vomiting may be caused by feeding with milk in excess of the required quantity, putting pressure on his stomach, moving him to and fro or letting him lie on his stomach or keeping his head low. If such undesirable situation is not allowed to occur, no vomiting may occur. If the child has pain irritation in his throat and coughs frequently, even then he may vomit. If the child could belch, no such vomiting can occur. Uncurdled milk is simply a regurgitation and flows from side(s) of the mouth. But if there is yellow or greenish vomit, consult a doctor. But repeated and frequent vomiting is a serious complication which must be investigated by a specialist. In a few children, the pyloric orifice is at fault which may be the cause of vomiting. Surgery should be resorted to as an ultimate option.

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INFANT’S NAPPY RUSH

The term applies to red skin which occurs due to the nappy being too tight or saturated with urine. Add some boric acid, (say 500 mg to half tumbler of water) to water and wash the skin and then dry up with a soft towel or cloth. You may apply some baby cream or Vaseline. In summer, the child often sweats a lot--- in that condition also do as is advised above. Never tie a wet nappy to the child, as it may cause itching, irritation and other skin diseases.

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INFANT’S SUMMER RASHES/ERUPTIONS

During summer, small pimples appear on face, neck, shoulders, skin folds which can be treated by keeping the child under moderate to cool temperature, with minimum clothes on body. Apply Johnson’s baby powder over the whole body, but make sure the powder does not fall into eyes, ears and nostrils. Do not use powder in excess as it may cause dryness to the skin, nor apply any other oil or ointment or cream. Simple hygiene and keeping the infant’s skin dry will keep away many skin problems

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INFANT’S TRUSH

It is a fungus diseases which appears in the mouth of infants. There could be white spots inside the cheeks, on the tongue, gums or soft palate due to which the child has pain feels restless and gives up milk. It is caused by dirty and unwashed nipple and feedings bottle. Consult a paediatrician for treatment.



It is a fungus diseases which appears in the mouth of infants. There could be white spots inside the cheeks, on the tongue, gums or soft palate due to which the child has pain feels restless and gives up milk. It is caused by dirty and unwashed nipple and feedings bottle. Consult a paediatrician for treatment.

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INFANT’S CRADLE CAP

Sometimes white, grayish or light brownish crust appears on the head which is known as cradle cap. Massage the head with baby oil or olive oil so as to soften the crust which will get removed when the child’s head is shampooed. If no relief is noticed, consult your doctor.





Sometimes white, grayish or light brownish crust appears on the head which is known as cradle cap. Massage the head with baby oil or olive oil so as to soften the crust which will get removed when the child’s head is shampooed. If no relief is noticed, consult your doctor.

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INFANT’S WATERING FROM EYES

A thin tube permeates from eyes to nose which, at the time of birth--- remains either blocked or undeveloped due to which water flows from one or both the eyes. This tube is known as ‘lachrymal’ or ‘tear duct’. Though there is no harm to vision it disturbs the child and her parents. Generally this duct opens of its own within 6-9 months. At time, infection may also be the cause when some mucus may appear, thus agglutinating the eyelids. Wash the eyes with lukewarm water and put a drop of soframycin eye drops (diluted) in each eye. It is better to consult a doctor to ensure if there is some other complication or not.

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SWELLING OF NIPPLES

Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.



Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.





Swelling can occur in both male and female children. Sometimes when nipples are pressed, some amount of milk also ooze out which is due to hormonal effect that the infant imbibes from the mother. There is nothing unusual or unnatural in it, as it disappears as the age advances.

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SOME COMPLICATED INFANT DISORDERS

Here we have discussed those disorders which should be noticed by parents and should be treated properly by a physician.



WHEEZING



Wheezing is a sound created during respiration and is pointer to some infection or/and obstruction in the nasal passage, chest and lungs. There is a feeling of choking and dyspnoea (breathlessness), tightness of chest—especially on lying down, more so in the morning and at night, use nebulisers or nasal drops to clean the respiratory tract. In some cases antibiotics like Ampicillin, Amoxycilline etc may be required but dosage must be guided and determined by a doctor and never of your own.



In any case, another attack should be warded off. Spasms may be caused while dusting, cleaning carpets, furniture’s, walls and floor, by odours arising from the kitchen, by gas leakage, smoke/smoking. Complaints is more commonly found in children, and if they are allergic to some triggers, they have to be taken care of properly

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MARASMUS

This is a severe wasting disease of infant when the body weight falls below ¾th of that of expected age. The skin shrivels, the infant gives an aged look and looks much older, is apathetic and paled and body temperature remains much below normal.





Causes





Wrong feeding and malnutrition



Protein deficiency



Repeated vomiting and diarrhea



Metabolic disorders



Severe disease of heart, kidneys, lungs, or urinary passage



Some chronic parasitic or bacterial disease



Lack of breast feed, arising due to maternal rejection of an infant or the child may herself refuse to take breast milk



Actual treatment can be started only the underlying cause has been discerned or located, but, in all cases irrespective of the cause, start giving fluids and nourishment, apart from good nursing and care. If the disease continues and lingers on for a longer period, without being detected and treated, it may prove fatal.

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RICKETS

In this condition, a child’s bones do not harden and are ill/malformed due to deficiency of Vitamin-D that helps Calcium salts to get deposited in the bones so that the bones could become rigid. Lack of Calcium absorption results in softer bones which bend and gets deshaped. Renal rickets surfaces due to impaired rental function---the bones are malformed due to excretion of bone-forming minerals in the urine. If this condition occurs in adults, it is called Osteomyelitis. Best and cheapest source of Vitamin-D is sunshine which, if not available, may be compensated through related Vitamin. Consult a doctor about actual treatment, dosage, frequency and duration of medication. Mothers who are deprived of sunlight are also victims of these diseases (called Osteomyelitis)

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POLIO OR INFANTILE PARALYSIS (Poliomyelitis)

This situation due to an infection virus (diseases) that affects the central nervous system. The virus is excreted in the fasces of an infected person, thus the disease is very common where there is extremely poor sanitation. But breakout of disease in epidemic form often occurs even where there are hygienic conditions, where people have not been immunized against the disease during infancy. Symptoms commence 7-12 days after infection but, in majority of cases paralysis may not occur. There should be no degree of confusion as to the type of paralysis which explained as follows:



Abortive Poliomyelitis



Only intestines and throat are infected and general symptoms are influenza or stomach upset.



Non-paralytic Poliomyelitis



In this type, symptoms are accompanied by stiffness of muscles—in particular, muscles of neck and back.



Paralytic Poliomyelitis



It is not very common.



Bulbar Palsy



Here breathing is affected due to involvement of muscles of respiratory system.

Symptoms of milder form of disease are followed by weakness and ultimately paralysis of the muscles. Best form of treatment is by giving Polio drops to the infant in earlier months. Once the infection sets in, the symptoms cannot be treated or reversed expect by resorting to supportive methods.

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PNEUMONIA/BRONCHO-PNEUMOIA/PNEUMONITIS

This disease is caused by bacteria due to which there is inflammation of the lung. Air sacs fill up with pus so that air is excluded and the kung becomes solid. The symptoms depend upon the amount of lung involved and the virulence of bacteria but most common symptom include pain in chest and cough, apart from that there are shadows in X-ray (of chest). Broncho-pneumonia is the commonest form which is quite a serious type. In lobar pneumonia, whole lobes of either or both the lungs are affected due to strains of streptococcus pneumonia but hypostatic pneumonia develops in dependent parts of the lung in those who are otherwise ill, chilled or immobilized.



Whatever be the type of infection, no case should be handled by a layman due to its serious complication. These bacteria that cause pneumonia or any type of it are sensitive to antibiotics and timely treatment can ensure quicker recovery.

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DIPHTHEIA

It is an acute, highly contagious infection, caused by the bacteria coryne bacterium diphtheria, generally affecting the throat but occasionally other mucus membranes and the skin. The disease is spread by direct contact with a patient or a carrier or by contaminated food. After an incubation period sore throat, weakness, and mild fever develop. Later a soft grey membrane forms across the throat, constricting the air passage and causing difficulty in breathing and swallowing. A tracheostomy may be necessary. Bacteria multiply in that infected area and release a toxin into the blood stream, which damage heart and nerves. Death from heart failure or general collapse can follow within four days but disease, complete recovery required prolonged bed rest. An effective immunization programmer has now made diphtheria rare.

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MEASLES (Rubella, morbilli)

It is said that measles appear at the infancy stage but, in some cases, it may surface in elderly people also. It is a highly infectious disease that tends to appear in epidemics every 2-3 years and mainly affect children.





Progress of the disease is as follows



After 7-14 days of incubation period, symptoms like cold, followed by a high fever develop, along with appearance of small red spots on the inner side of the mouth.



On the 3rd to 5th day, a slightly elevated pink rash develops---first of all behind the ears, then on the face and other parts, and it lasts for 3-5 days.



The patient continues to remain infectious throughout this period.



In majority of cases symptoms disappear and subside but the patient becomes susceptible to infection of the middle ear and pneumonia.



Complete recovery is generally seen within 2-4 weeks.



The child must be immunized by vaccination. Unless and until the patient does not have pneumonia, there is hardly any danger to life, but more complicated cause need medical care and proper treatment, through in general progression of the disease; hardly any medicine is called for. But, other children and attendants should be careful about spread of infection. The children must be kept away from the ailing patient.

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MUMPS (Infectious Parotids)

It is a common virus infection that affect children mainly between 5-15 years of age, through some adults have also been seen to be suffering from this infection but. It is quite a rare occurrence. Onset and progress of disease is as follows.



· Symptom appears 2-3 weeks after the exposure.



· Fever, headache, vomiting may be the fore running symptoms which might precede a typical swelling of the parotid salivary glands.



· Gland on one side of the face, swells up days before the other but, at times, only one side gets affected.



· Almost all the symptoms disappear within 3-5 days but the patient remains infectious until swelling has fully disappeared.



· The infection may even spread to other salivary glands and from there to brain, testicles and pancreas.



· In adult males,, mumps may even cause sterility and render them impotent.



In fact, mumps may not appear if the infant was immunized at the infancy stage. If, in spite of immunization, mumps appear, their period of invasion and intensity is much less, and no medicine is called for, expect control of high fever efforts should be made to see that the infection does not spread to other vestal organ. Paediatric drops of paracetamol, given 6 hourly, will control fever and pain but no medicine is called for, except control of high fever.

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MENINGITIS

Meningitis is the inflammation of the meninges due to infection by bacteria or viruses which are responsible for TB, syphilis and/or pneumonia.



Symptoms



Intense headache and fever



Loss of appetite



Intolerance to sound and light



Rigidity of muscles---especially of the neck



Convulsion





If meningitis is caused by bacteria, it can be treated with sulphonamides or antibiotics, whereas viral meningitis does not respond to treatment/drugs. In the latter condition, complete rest-in-bed, quiet and darkness is only treatment. This condition may be complicated by cerebrospinal fever, for which read the following information. Both the conditions are quite serious and must be treated in a hospital only and not at any other places nor by a non-medico or a layman.

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CEREBROSPINAL FEVER

It is also called Spotted fever and is a type of meningitis, caused by the bacterium Neisseria meningitides. The bacteria are transmitted by sneezing and coughing. The disease occurs mostly in overcrowded areas and children are mainly the victims than the adults.



After an incubation period of 3-5 days, symptoms develop and appear suddenly when there is fever, severe headache; stiffness in the neck’s muscle and rash of small red spots appears on the trunk. Quite often the ailment enters a chronic stage when blindness, deafness and mental deterioration of serious nature may develop. Treatment, if given in time, is possible with sulphonamide or penicillin drugs but otherwise death may occur. This disease should also be treated in a hospital under the care and supervision of qualified doctors and staff but never by a layman.

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WHOOPING COUGH (Pertussis)

Whooping cough is a well known disease that occurs, in most cases, during childhood. If a child has already been given DTP vaccine (which is given in a combined form), such an immunization will reduce the incidence and severity of attack and if the attack comes, its duration and severity/intensity would be far less. It is believed that an attack also usually confers immunity.



Symptomatic Causes and progress of disease



It is contagious disease caused by the infection of mucus membranes by the bacterium Hemophilus pertussis



It primarily affects children, though older children or even adults could also be the victims.



After an incubation period of 1-2 weeks, mild fever, cough, catarrh and loss of appetite develop and persist for 1-2 weeks.



Cough becomes paroxysmal when short bouts of cough follow in an almost quick succession, and followed by involuntary drawing in of the breath which produce the whooping sound.



After each paroxysm there is vomiting, bleeding from mouth and nose. This state lasts for about 2 weeks and the child remains infectious throughout.



The foregoing stage lasts for 2-3 weeks after which symptoms starts declining but cough may persist for another few weeks.



During an attack, the child may even turn blue which indicates lack of oxygen and poor circulation.



Though whooping cough is seldom serious and generally poses no danger to life, but the child remains exposed and susceptible to T.B. and pneumonia which complication can create further health problems. As soon as above-mentioned initial symptoms are noticed, consult a doctor for prompt and requisite treatment but never administer any drug or home remedy of your own.

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MALARIA

It is claimed that malaria, like small pox, has also been eradicated but there are still confirmed and declared Malaria zones or belts in our country where recurrence of malaria still exists.





Malaria infection is caused by presence of the parasite known as protozoa of the genus plasmodium transmitted into the red blood cells. Malaria disease is transmitted by the female mosquito called anopheles. Malaria is mainly confined to subtropical and tropical zone/areas.



Parasites in the blood of an infected person are taken into the stomach of the mosquito as it feeds. Here they multiply and then invade the salivary glands.



In order to ensure whether one is suffering from malaria or not, required blood test is called for. But if the patient is already loaded with quinine, the clinical investigation may reveal a negative result. Dosage, safeguards and duration and frequency of medicine should be under expert guidance of a doctor only.

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SOME MORE COMMON CHILDHOOD DISEASES

TONSILS



Tonsils may be enlarge normally. Parents believe that removal of tonsils is a magic cure for frequently occurring cough, cold etc. besides surgery, homeopathic treatment can be considered.



ASTHMA



It is a chronic recurrent disorder with negative psychological consequences on the parents and child. The treatment is to inhale bronchodilators (rather than oral) and steroids.





CONVULSIONS



Febrile Convulsion is benign and the child outgrows them 5 years of age. These fits have no ill effects on the longer term development of the child. Recurrent convulsions are termed Epilepsy. Fortunately, excellent anticonvulsants are available to control epilepsy. They are given lead as normal a life as possible.





HERNIA



The only treatment is surgery. There is no medical cure. Wearing belts in order to keep the hernia in check may help a little.



UNDESCENDED TESTES



Testes that have been seen or felt in the scrotum at any time are retractile and normal. On the other hand, truly undescended testis lies in the abdomen and should be brought into the scrotum by operation before the child is 3-4 years old, as the testis after that may atrophy and lose its function. Some children are bone with one testis only. A single testis can carry on the function of reproduction and the person won’t be sterile.





SQUINT



A condition in which the child appears cross eyed is not to be taken lightly, particularly if the child is older than 6 months as one eye can become functionally blind.





MYOPIA



The first complaint often comes during school going when the child may not be able to see the blackboard clearly. The child may not complain because of shyness. So all parents should check periodically whether the child’s vision is good.

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RESPIRATORY INFECTION AND DIARRHEA

Hygiene of body, food items should be proper and if it is the case of a child, this should be best. A little exposure to harmful bacteria may lead to several disorders and complications.



DIARRHEA IN CHILDREN



Diarrhea in children can be fatal due to loss of water and salts from the body via stools. The risk is more in young children as their body is small, thus the loss is very fast and becomes life threatening.



Diarrhea as such leaves the children not merely dehydrated but also malnourished. It makes her more prone to other disease.



Thus, it is important that every child gets very good care during episodes of diarrhea.



The focus of care is essentially on two things



· Prevent dehydration and replace lost fluids and salts at the earliest.



· Maintain good nutrition for the child.

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diarrhea

As soon as the child starts having loose motions, don’t wait for anything. Immediately start giving some home available fluids like pulses water, rice water, coconut water, light tea, lemon-sugar water. You can also fetch a packet of Oral dehydration Salts (ORS) from the nearest health facility. Follows the instruction given on the packet to make it. Generally, one packet is to be dissolved in one liter of safe drinking water.





This advice must be sought as soon as possible if the child has any one of the following symptoms.



· Blood/mucus in stool



· Child is having excessive vomiting



· Child is not getting better with ORS



· Child is not passing urine





Once a child recovers from diarrhea, give her/him extra food for at least one week.



Do remember that most of the diarrhea episodes are self limiting and get well on their own, without any medication. Infact, don’t give any anti-diarrhoeal medication to the child on your own. Seek the help of a specialist.

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ACUTE RESPIRATORY INFECTION IN CHILDREN

It is important to take some precautions if your child gets an attack of ARI since there are a lot of children claims lives because of this disease.



A child with common cold often becomes irritated and refuses the feeds. She/he often has fever, running nose, blocked nose. If these symptoms are noticed, it is advised to seek help of a doctor. Meanwhile, you can start giving steam inhalation to the child and apply some soothing balm on the forehead, chest and nose to alleviate headache and clear the blocked nose.



For steam inhalation, boil 3-4 mugs of water in a bowl. Sit on a chair with the child on your lap. Put the bowl with steaming water on the floor and cover yourself with the child and bowl in a tent of a bed sheet. Sit there for about 10-15 minutes even if the child crises. Alternatively you can close all the doors and windows and then boil water in a bowl on an electric heater in the room itself. Allow the steam to spread in the room for about 30 minutes.



Keep a watch on the child’s breathing rate. If the breathing becomes difficult, rapid and there is retraction of the ribs while breathing. It is a warning that you must see a paediatrician at the earliest. It can be pneumonia which will surely require antibiotics for its treatment. Pneumonia can be life-threatening.



As in diarrhea, continue normal feeding of the child during an attack of ARI. Never reduce or stop feeding the child.

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CONSTIPATION AND ITS TREATMENT

Constipation is a condition in which the bowels are evacuated at a longer interval or with difficulty. What the right interval should be, is difficult to generalize since it varies from person to person. Some evacuate their bowels once, others twice a day, while there are others who seek this pleasure only once in 2 or 3 days and yet have sound health.





Some may have constipation on account of the change of environment or emotional tension, but the normal rhythm returns after a few days, and should not be a source of worry. The most important cause of constipation are a disregard of the call to pass motion and an improper diet. When the rectum is full, it sends signals to the intestine through the central nervous system for their movement and if this is repeatedly ignored, it gradually leads to failure of the rectum to signal the urge. The diet should contain a reasonable amount of non absorbable material (fiber) to form a bulk which acts as a stimulus for the intestinal movement. Highly spicy food stuff may stimulate the bowel to cause a complete evacuation, but this is followed by inactivity of the intestine and constipation.



Remedy for constipation



If you are suffering from constipation, and have been taking purgatives, try to stop these gradually. Your system will probably return to normal if you take enough vegetables, fruits etc. however, if you are the worrying type, you may take a mild laxative only as temporary measure without making it a habit. Remember, disregarding the call for motion is the worst you can do to your constipation. Do not Waite unnecessarily. Rush to the toilet wherever you are, whether at a party or in the kitchen.

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ABDOMINAL PAIN AND ITS TREATMENT

Abdominal pain, one of the most frequently occurring symptom, may originate from any organ in the abdomen, like the stomach, intestine, appendix, gall bladder, pancreas and kidneys. There are number of causes for this and therefore, any patient of abdominal pain of recent onset requires early and through evaluation for accurate diagnosis. However, the commonest source of abdominal pain in the region of stomach and intestine is the gastrointestinal tract which consists of the stomach and intestines because it deals with outside materials, i.e. the food and drinks that we take.



Various household remedies like massage, hot water fomentation, churan, ajwain, jalijeera, and sometimes even purgative are tried, but their success is usually limited for the abdominal pain. Therefore patients takes one of the preparations mentioned as pain killer which provides immediate relief.



ANTISPASMODICS



These are Atropine or its synthetic substitute (Anticholinergic drugs) and are used for relieving the spasm of the muscles of the intestine. The action of almost all these drugs is more or less the same. There are only slight differences in their potency or duration of action. There may be some adverse effect caused, and precautions to be observed, with these drugs.



COMBINATION



After antispasmodics, the next common ingredient in all these preparation is a pain reliever. Some contain a sedative or a tranquillizer as well. Pain relievers may not be of much help unless the spasm is reduced. Undiagnosed pain precludes the use of Phenolphthalein, a purgative, even if it is associated with constipation. Phenolphthalein itself aggravates gripping pain, being irritant in nature. All these combination have no greater value than the use of antispasmodics alone, apart from increasing the cost and side effects. Some important drugs are Meftal Spas, Proxyvon, and Colimex. Use only after taking advice from your paediatrician.

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STOMACH-ACHE AND GAS WITH TREATMENT PLAN

The distress or stomach-ache after eating is actually classified in two ways:



Distress appearing immediately after eating (postprandial distress): symptoms arise half an hour after a meal, such as abdominal bloating, distension, fullness or pressure.



Intestinal distress: Here symptoms usually start half an hour after eating and continue for several hours depending up on person to person. They may involve the stomach, small or large intestine with additional symptoms such as abdominal pain and cramp and/or anal flatus.



Excess gas in the stomach and intestine is quite distressing and it is due to the disordered intestinal movements which delays the passage of gas through the bowel. Drugs might provide a symptomatic relief in the following ways.



The active ingredients may lower the surface tension of the stomach contents to facilitate the action of digestive juices, which will speed up the digestion and the passage of food contents from the stomach into the intestine.



The active ingredients may speed up stomach emptying by changing the stomach’s acidity or increasing the contractions of smooth muscles of the stomach or by some other mechanisms.



The commonly available preparations, usually is combination, may contain the following ingredients.



Antiflatulents

Carminative Oils

Antacids

Sodium Bicarbonate

Charcoal

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GENERAL CAUTION ON ADMINISTRATION OF MEDICINES

Complete course of preventive vaccination and the not skip over or delay.



Never give any medicine on empty stomach or soon after feeding nor disturb a child when he is asleep or continue to weep.



Best way to give medicine orally to a little child is by dropper fill the dropper from the spoon. Pick your baby up and lean her back slightly on your arm. Support her head and hold her free arm, so she cant swipe at the dropper.



Never exceed the stated and recommended dose nor give an adult dose to a child. Give only paediatric preparations.



Stop use of medicine when the child had fully recovered but some medicines are to be given for a specific period. Hence do not cut short the treatment mid-way.



Give medicines either dissolved in water or with some palatable vehicle but avoid giving tablets straightaway on the tongue as they might gag her or cause respiration problem.



Capsule medicines generally adhere and stick to the soft palate or throat and, thus, may choke her, hence, use liquid/tablet from instead.



Do not mix any medicine with child’s feed. In some cases some medicines may be mixed with mother’s milk. If the child is breast feed. And then give. But follow your doctor’s advice.



Do not insert any eye drop or ear drop without consulting with neither your physician nor any corticosteroid preparations as eye or ear drops are as an ointment.



Be careful to apply only baby cream, baby soap, baby oil and never use any other soap, shampoo, cream or oil which the elders use.



In nausea and vomiting, avoid giving any feed as the child may vomit the same.



Do not use too hot or too cold a vehicle (like water) while giving any medicine.



The list does not end here there are many other cautions which elders know by their experience.

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TOILET TRAINING FOR YOUR CHILD

Forcing stubborn children to use the toilet is an utter waste of time. This is one area where they alone have complete control and if you are to succeed; only cunning will suffice. It is pointless for, example, to start urine training until the child is sensible enough to realize when she’s wet. Padded diapers like Huggies or pampers do help when you are visiting or away from home, but constant dampness accompanied by chill leads to rashes.



Once children know when they are wet, most will train themselves and need no more than gentle encouragement.



Bowel training is rarely worth considering before 18 months and 2 years is about the right age. Disregard all those boring people who claim that their child was fully trained at 12 months. As mentioned before. This particular achievement is a result of toilet timing not toilet training and is nothing more than an interesting reflex of the child’s



The first goal is to them to sit on the pot or toilet two or three times a day. This is best achieved by fun rather than force. Encourage them by enthusiasm. Read a story while they sit or even resort to those little rewards that rot the teeth. Use a pot or toilet with a seat shaped like child’s bottom and aim for sit of about five minutes. Never make a fuss if they refuse.



Once they are sitting comfortably (and regular) then it’s time to begin. A small psychological nudge is now called for.



“Dear John, you are almost 2 now and 2- years- old big boys do poos on the potty”



Just relax and give it time. You will be surprised at your success.

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FEEDING YOUR CHILD

Small children are on the whole no admirers of five star cookery, so it’s unwise to be too ambitious in your cooking projects. You could very well find that your hours of slaving away in the kitchen will be greeted by little more than a loud “Yuk” and no amount of hassling or aeroplane noise will get the food down the throat.





Here is some choice feeding tidbits from our toddler taming technique which should make gastronomic life simpler:



The concept of a varied mixed diet is lot on most young children. Neither they nor their stomach, mind a bit of nourishing monotony.



Food is there to be enjoyed, do not use to feed some parental obsession. Good health is not measured by the enormity of intake, it is seen as energy and a mischievous zest for life.



Children tastes are different from adults. There is no reason why they should enjoy the same sort of food as your sophisticated palate has grown used to.



While it makes for simpler life if your child eats three meals a day along with the rest of the family, healthy snacks throughout the day are just as nutritious and if that’s the only way you are going to get her to eat, then as that stage it’s better left like that.



If the child is very fussy, you don’t have to confine her to strips of raw celery, carrots and raisins. Sandwiches, cheese and biscuits, a cold sausage or small pieces of meat are equally good.



Remember, milk is a high calorie food. If the child is being given too much, the body won’t see the need for three big meals a day. If you want to make a more balanced feeding pattern, you may have to cut down on the milk.



If your child refuses her meal, you shouldn’t throw a tantrum. Put it aside, but don’t offer her any alternatives. When hunger pains return, re-introduce the meal. If she is hunger she will eat it eventually. If she ever catches wind of the fact that there may be an alternative to what have served up, your culinary life for the years to come will be made a hell when she demands a replacement meal.



If a child intends to eat, she will eat. Making aeroplane noises wont help your child’s appetite. Save the entertaining performance for play time.



Be assured that no child has ever starved to death through stubbornness, that’s a pastime reserved solely for adult activists.

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