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New Born Care

When can I give my first bath to my baby?
Avoid bathing in the hospital and till umbilical cords have fallen off. During this time, sponging with lukewarm water is enough.

How often can we bathe?
Giving bath 2-3 times a week is enough, and duration should not be more than 5-10 minutes. Use warm water and cotton wool.

  • Use a non-slip bath mat
  • Use warm (not hot) water, about 37°C or 38°C
  • Shampoo your baby’s hair last
  • Use a soft washcloth to gently clean your baby’s face, then their neck and body, leaving the genitals and bottom until last.
  • Try to avoid bubble baths– it can irritate skin and genitalia and may cause nappy rash.

Which soap is best for my kid?
Even if you don’t use any soap during the first m, then there are no issues. However, if you are using soap must look for the following things.

  • The pH of soap should be 5.5
  • Fragrance-free
  • A high moisturizer containing soap

Can I apply oil to my baby?
Use coconut oil – Note, your touch is more important than any oil. Avoid vigorous massage. Avoid massage immediately after feeding.

What about Powder application for my newborn baby?
No talcum powders. But you can use fragrance-free corn starch-based powder for your baby.

How to wipe/clean the potty of my baby?
Use lukewarm water with cotton balls. Avoid baby wipes.

What is the best sleep position for my kid?
Supine or lateral position is acceptable but avoids prone position because of the risk of SIDS (Sudden Infant Death syndrome)

Now you are always be treated as a mother-baby dyad. That’s the beauty of being a mother.

When can I give my first bath to my baby?
Avoid bathing in the hospital and till umbilical cords have fallen off. During this time, sponging with lukewarm water is enough.

What a mother should do immediately after Birth ?

  • ZERO SEPARATION– Always keep your baby in contact with skin (SKIN TO SKIN) to prevent hypothermia (Cold)
  • ROOMING IN– Always keep your babies by the side of the mother’s bed. This would help in improving the bonding between the mum and the newborn.
  • Cover the baby’s head with a cap. Cover the mother and baby with a warm cloth.

Breast Feeding: Always look for Signs of Hunger every 2 to 3 hours during 24 hours. Successful breastfeeding depends on two essential components

1. Correct Body Positioning

  • Be relaxed and comfortable
  • Sit straight with a well-supported back
  • Trunk facing forward and lap flat
  • Baby neck straight or bent slightly back and body straight
  • The baby body turned toward the mother
  • Baby body close to mother body and facing breast
  • The whole baby body supported

2. Correct Attachment

  • Chin touching breast
  • Mouth wide and open
  • Lower lip turned outward
  • More areola seen above the baby mouth

When should my baby get First feed after birth ?
Ideally, as soon as possible, your baby must get your first milk within one hour after birth.

Do I need to Wash my Breast Nipple before feeding ?
No. Your breast skin contains many good bacteria that help your newborn baby, and that bacteria also prevents local infection around the breast.

What should I eat while breastfeeding ?
Most mothers can eat whatever she wants to eat in their regular daily diet. The baby will taste through your milk, and they start to get ready for table foods when they are about six months old.

How long can we breastfeed my babies ?
You can continue breastfeeding even beyond two years of age; however, your baby would start learning to eat complimentary feed from 6 months.

Recommended Foods
Infants: Breast milk or normal infant formula
For older children —Normal food is usually best. This could include:

 

  • Bananas
  • Rice
  • Chicken or other lean meats
  • Whole grains
  • Potatoes
  • Apple sauce
  • Vegetables
  • Pastas
  • Low-fat cooked fish
  • Eggs
  • Cooked vegetables
  • Sugar-free cereals
  • Toasted bread
  • Yogurt & Cheese
  • ORS

Foods to Avoid (Infants and Children)

  • Caffeine (Tea,coffee)
  • Sugary foods
  • Carbonated beverages and juice drinks (All juices are high in sugar. They should generally be avoided or consumed in moderation
  • Sports & Soft drinks even if decarbonated.
  • Fried foods or those rich in fat (potato chips, French fries, pastries)
  • Ice cream, sherbet, and jellies
  • Dried fruits, fruits canned in syrup
  • Candy and chocolate
  • Very spicy foods

Note: Don’t dilute milk

Consult doctor immediately

  • Age: 6 months
  • History of premature birth
  • Concurrent illness
  • Fever >38*C for infants aged <3 months or >39*C for children aged 3–36 months
  • Visible blood in stool.
  • Frequent and substantial volumes of diarrhea.
  • Persistent vomiting.
  • Sunken eyes or decreased tears, dry mucous membranes, or decreased urine output).
  • Change in mental status (e.g., irritability, apathy, or lethargy).
 

Routine bathing in the hospital should not be done to prevent cross infection and hypothermia better be sponged.Bathing can be delayed till the cord falls & should not last more than 5 minutes.

Initial bath, sterile or potable clean water is sufficient.Soaps and cleansers are best avoided initially for few days.

Most of the time cavities are due to a diet high in sugary foods and a lack of brushing.
Every time someone eats, an acid reaction occurs which lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Tips for cavity prevention:
Limit frequency of meals and snacks.
Encourage brushing, flossing, and rinsing.
Avoid sticky foods.
Choose nutritious snacks.

12-month Discourage active toilet training until after 18-month visit.

24-month Evaluate the child’s readiness. Discuss night time enuresis if the child has daytime control.

Toilet training tips:

  • Adopt a positive, loving approach.
  • Keep the child in loose, easy-to-remove clothing.
  • Avoid battles over toilet training & repeated reminders.
  • Avoid flushing the toilet while the child is on it.
  • Teach boys to urinate sitting first; teach them to stand after successful bowel training is complete.
  • If the child is not making progress, training should be discontinued for a week or long.
  • Encouraging parents to resist external pressures (eg, pressure from grandparent, day care provider).
  • Get a potty chair & foot stool- The chair/toilets should be comfortable, with support for the child’s feet.
  • Allow the child to become familiar with the potty chair.
  • Place the potty chair in a convenient place for the child.
  • Do not pressure the child to use the potty chair if he or she is afraid of it.
  • Let the child sit on the potty chair first fully clothed once a day as a routine (try for a week), then try it with clothes off.
  • You can show the stool from the diaper and put it into the child’s potty chair so that he/she can see where it should go.
  • Encourage your child to sit on the toilet within 30 minutes of each meal (ie, for 5 to 10 minutes, two to three times per day). Do this every day.

Dietary advice to prevent constipation:

1. Adequate fluid: one litre or more water or other non-milk liquids per day.

2. Preferred food:

  • Whole grains, whole pulses & beans.
  • Green leafy vegetables (palak) & beans.
  • Fruits: Guava, pomegranates, date palm ,orange, apple with peel.
  • You should offer a new food 8 to 10 times before giving up.

Avoid:

  • Refined wheat flour(maida, biscuits,pasta)
  • Arhar, excess dhuli moong
  • Excess Milk diet/biscuits

Infants with constipation who are older than six months.

  • Fruit juice –Prune, apple, or pear juice. Amount- two to four ounces (60 to 120 mL) of 100 percent fruit juice per day for children 6 to 8 months old. You can give up to six ounces (180 mL) of fruit juice per day to infants 8 and 12 months old.

Note: Iron drops may sometimes cause constipation. Therefore, infants who need iron drops sometimes also need extra diet changes or treatments to make sure that they do not get constipated.

Dietary recommendations for children:

  • Fruit juice –Do not give more than four to six ounces (120 to 180 mL) of 100 percent fruit juice per day to children between one and six years of age; children older than seven years may drink up to two four-ounce (120 mL) servings per day.
  • Milk – Some children develop constipation because they are unable to tolerate the protein in cow’s milk.

Keep a diary of your child’s bowel movements, medicines, pain. This will help you and your child’s doctor or nurse figure out if there are triggers for constipation.

Symptoms:

  • No bowel movements for several days or are hard, dry and difficult to pass
  • Pain while having a bowel movement & Abdominal pain
  • Nausea, Poor appetite & Cranky behaviour.
  • Traces of liquid or clay-like stool in the child’s underwear — a sign that stool is backed up in the rectum.
  • Soiled underwear
  • Blood on the surface of hard stool

Aim:

  • More than 3 soft stool per week.
  • Good dietary compliance.
  • Dietary & behavior therapy to be continued.
  • Don’t stop medication for 6 month.

Dietary advice to prevent constipation:

  • Adequate fluid: one litre or more water or other non-milk liquids per day.
  • Fibre: Barley powder (2 to 10 ml/200 ml milk or juice), Popcorn with minimal salt, cucumber.

Preferred food:

  • Whole grains, whole pulses & beans.
  • Green leafy vegetables (palak) & beans.
  • Fruits: Guava, pomegranates, date palm ,orange, apple with peel & Raisins (overnight water soaked kishmish)
  • You should offer a new food 8 to 10 times before giving up.
  •  

Avoid:

  • Refined wheat flour(maida, biscuits,pasta)
  • Arhar, dhuli moong.
  • Milk diet/biscuits
  • Avoid saturated fats from red meat and dairy products.

Infants with constipation who are older than six months.

  • Fruit juice –Prune, apple, or pear juice. Amount- two to four ounces (60 to 120 mL) of 100 percent fruit juice per day for children 6 to 8 months old. You can give up to six ounces (180 mL) of fruit juice per day to infants 8 and 12 months old
  • High-fiber foods & vegetables (or purées), including apricots, sweet potatoes, pears, prunes, peaches, plums, beans, peas, broccoli, or spinach.

Note: Iron drops may sometimes cause constipation. Therefore, infants who need iron drops sometimes also need extra diet changes or treatments to make sure that they do not get constipated.

Dietary recommendations for children:

  • Fruit juice –Do not give more than four to six ounces (120 to 180 mL) of 100 percent fruit juice per day to children between one and six years of age; children older than seven years may drink up to two four-ounce (120 mL) servings per day.
  • Fluids –For children older than one year, enough fluid is defined as 32 ounces (960 mL) or more water or other non-milk liquids per day.
  • Milk – Some children develop constipation because they are unable to tolerate the protein in cow’s milk.

Keep a diary of your child’s bowel movements, medicines, pain. This will help you and your child’s doctor or nurse figure out if there are triggers for constipation.

  • Normal umbilicus: Dried with in 6-8 days; healed within 12-15 days
  • The umbilical cord must be kept open and dry.
  • The nappy should be folded well below the umbilical stump.
  • Dry the cord after bath by application of alcohol/spirit if required.
  • Do not use any other antiseptic or antibiotic powder.
  • Mild infection: Cleanse with alcohol

  • Serve balanced diet

    • One serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs.
    • Limiting the servings of sugars and starches

    Fluoridated toothpaste should be introduced when a child is 2-3 years of age.

    Avoid nursing children to sleep or putting anything other than water in their bed-time bottle.

     
      • Start good oral hygiene as soon as the first tooth has erupted.
      • Wipe the teeth gently with a clean, moist, soft cloth.
      • As babies grow and more teeth erupt, use a small brush with a non fluoridated cleaning agent.
      • Excessive ingestion of fluoride from toothpaste can cause staining of developing permanent teeth.
      • Toothbrush size should be appropriate and have soft, rounded bristles.
      • Ensure complete removal of food and plaque that can cause decay.
      • In case of – cold compress using finger if it is swollen. Give the child paracetamol for any pain.

      Tooth Brushing

      • Hold the brush at a 45 degree angle towards the gum line
      • Move the brush in a small circular motion at the gum line covering 1-2 teeth at a time
      • Brush the length of the tooth using a sweeping motion. Repeat this sweeping motion 3-4 times, or until all plaque is visibly removed, making sure to brush the fronts and backs of all teeth.
      • Brush the chewing surfaces by placing the toothbrush flat on the chewing surfaces and using a back and forth scrubbing motion.
      • Gently brush the tongue to remove debris.Brush each others teeth at the same time.
      • Give your child toothbrush choices for different days

A febrile convulsion (‘febrile’ means high body temperature) is a type of fit that children can have if they get a high temperature. Around one in 20 children will have at least one febrile convulsion. About one in four children who have a febrile convulsion will also have a close relative who has fits/seizures

Age of presentation: 6 to 60 months.

Most children only ever have one febrile convulsion. About three in every ten children will have another febrile convulsion during a separate illness.

After the convulsion has stopped, children usually fall into a deep sleep. They can be confused and upset when they wake up.

Home treatment: Be calm

  • Place the child on their side but do not try to stop their movement or convulsions. Loosen any tight clothing, especially around your child’s neck and chest.
  • Do not try to put your fingers or any object in your child’s mouth.
  • Do not slap or shake them, but stay with your child until the fit stops.
  • Seizures that last for more than five minutes require immediate treatment.

Paracetamol can decrease the discomfort of the child but do not reduce the risk of having a recurrent febrile seizure, because the seizure often occurs as the temperature is rising or falling.

Consult your doctor after convulsion stops because fever could be due to various reasons which require additional treatment after ruling out…..

  • Viral infection
  • Chest infections
  • Tonsillitis
  • Urinary infections.
  • Anemia: may require iron supplementation.

Iron deficiency has been shown to be associated with an increased risk of febrile seizures.

Risk of recurrence is high if your kid is less than 1yr of age, duration of fever <24 hr, family history of seizure.

“Take 3” Actions to Fight the Flu

Vaccinate

  • After 6 months of age (ENSURE YEARLY DOSE)
  • Only Injectable & not use the Nasal Spray Vaccine

Stop Germs

  • Avoid close contact with patient
  • Stay home for at least 24 hours after your fever is gone
  • Cover your nose and mouth with a tissue when you cough or sneeze.
  • Wash your Hands

Antiviral Drugs if your doctor prescribes them.

  • who are very sick with flu or people who are at high risk of serious flu complications
  • Deep aching pain in the muscles of the legs
  • Most pain occur in the middle of the night or in evening
  • Usually resolve in the morning
  • Respond to heat massage and analgesics
  • No joint involvement

Try warm water application & mild massage Give lots of Fluids Ensure Vitamin D

What’s Influenza or Flu?
FLU is a respiratory viral infection caused by influenza viruses. However,it’s a self-limiting illness and does not require hospitalization.

Then why has my pediatrician recommended the FLU vaccine?
Because it can cause significant health problems in individualhigh-risk children to avoid school absenteeism,it’s better to get FLU Vaccine yearly. And if at your high-risk home persons like grandparents, pregnant mother, any person on steroid can catch FLU illness from kids. So, to prevent the spread of disease,it’s mandatory to vaccinate all kids.

Is there any Nasal Flu vaccine?
Nowadays,it’s not recommended. Only injectable (Intramuscular) Vaccine is available.

What’s the dosing schedule of the FLU vaccine?

  • Children six months through eight years of age –require two doses of influenza vaccine.
  • Children ≥9 years of age –require only a single dose of influenza vaccine.
  • Dose: 0.5 ml Intramuscular
 

Common Iron Rich Foods

  • Chickpea (Chana Sag)
  • Spinach (Palak)
  • Amaranth (Kantewali Chaulai)
  • Onion Stalks (Pyaz ki kali)
  • Mustard Leaves (Sarson ka sag)
  • Fenugreek Leaves (Methi)
  • Mint (Pudina)
  • Colocasia leaves (Arvi Ka Sag)
  • Lentil Dal (Moong/masur)
  • Bengal Gram Whole (Kala chana)
  • Soyabean
  • Gingelly Seeds (Til)
  • Red Gram Dhal (Arhar)
  • Plantain Green (Kuchcha Kela)
  • Black GramDhal (Urad Dal or Kaskalay)
  • Water Melon (Tarbooz)
  • Pumpkin (Seethaphal)
  • Mutton Gosht

Common Vitamin C Rich Foods

  • Cabbage (Patta Gobhi)
  • Drumstick Leaves (Saijan Patta)
  • Coriander Leaves (Dhaniya)
  • Gooseberry (Amla)

Enhancer :
iron, present in meat, poultry, fish, and seafood

Vitamin C, present in fruits, juices, potatoes, Fermented or germinated food

Inhibitor:?
Tea, coffee, cocoa, Calcium, particularly from milk and milk products

AgeTextureFrequencyAverage amount of each mealAmount of raw green leafy vegetables (to be cooked and added to food) (g/day)
6-8 monthsStart with thick porridge, well mashed foods2-3 meals per day plus frequent breast feedsStart with 2-3 table spoon full25
9-11 monthsFinely chopped or mashed foods, and foods that baby can pick up3–4 meals plus breastfeed. Depending on appetite offer 1–2 snacks½ of a 250 ml cup/bowl25
12-23 monthsFamily foods, chopped or mashed if necessary3–4 meals plus breastfeed. Depending on appetite offer 1–2 snacks3/4 to one 250 ml cup/bowl40

If baby is not breastfed, give in addition: 1–2 cups of milk per day, and 1–2 extra meals per day.

Good sources of important nutrients

Zinc: Liver, flesh of animals, birds and fish, egg yolk.

Vitamin A: The darker the colour the more vitamin A

  • Breast milk, liver of all kinds, egg yolk
  • Orange-coloured fruits/vegetables – mango (but not oranges). Carrot, pumpkin, yellow sweet potato, red /orange peppers (but not tomatoes).
  • Dark-green leaves – spinach, amaranthus, kale, cassava leaves, sweet potato leaves, pumpkin leaves, broccoli.

Vitamin C: (cooking destroys some vitamin C)

fresh fruit – guava, orange, lemon, mandarin, mango, berries, melon, banana, tomato, peppers, green leaves and vegetables – spinach, amaranthus, kale, cassava leaves, sweet potato leaves, cabbage, broccoli, cauliflower baobab pulp fresh starchy roots and fruits are good sources if large amounts are eaten – potato, sweet potato,cassava, plantain.

Calcium:milk and milk products – cheese, yoghurt fish eaten with bones – small whole fish, pounded dried fish, canned fish

  • 80 % of Neonates develops jaundice during first 2 weeks.
  • Common causes- Prematurity/Mother Blood group Negative or O +ve/G6PD deficiency/Thyroid problem
  • Only 10% require Phototherapy Lights
  • Bilirubin Value more than 20 mg/dl might require blood change & hearing test (BERA)

Must get your newborn kid test for Blood-group/Thyroid/G6PD/Hearing

Learning Disability @2.5 to 4 years

  • Trouble with articulation, persistently mispronounces word
  • Trouble using correct verb tenses, plurals, or pronouns
  • Trouble rhyming, playing sound or word games
  • Knows colors, but cannot name them when asked
  • Difficulty telling an event or story in order or sequence
  • Difficulty cutting with scissors, tying shoes, or blowing nose
  • Clumsy, messy eater, poor at skipping, trouble learning motor skills
  • Overreacts or avoids sounds, touch, fabrics, foods, smells or lights

warnings signs vary with each child and all signs may not be present

Learning Disability @ 5 to 8 years

  • Persistently mispronounces words, and slow word finding when talking
  • Phonological awareness – Misses or changes sounds in words that are heard, spoken, or read
  • Reading and Spelling – Difficulty learning to sound-out words for reading and spelling
  • Reading is slow, effortful, & unpleasant
  • Errors when reading – e.g. says “was” for saw.
  • Handwriting – Awkward pencil grip, presses too hard on paper when writing, hand fatigues
  • Trouble concentrating at home and school; wears out before a task is done
  • Repeated difficulties or frustrations lead to lower self-esteem

prescribed.

If you use more than one kind of inhaled medicine at a time, the reliever medicine (such as asthalin) should be taken first to open the airways then use budecort or beclomethasone. This helps the other medicine(s) go deeper into the lungs, so they will work better

Metered dose inhaler (MDI) A metered dose inhaler is used with a spacing device, also called a spacer or holding chamber. It helps the mist reach deeply into the lungs. As small kid are not able to hold their breath for 10 seconds, they need to use a spacer with a mask.

Prepare the inhaler:

  • Remove caps from the inhaler and the spacer.
  • Shake the inhaler well (about 5 seconds) to mix the medicine and propellant.
  • Insert the inhaler into the spacer.

Using a spacer without a mask

  • Put the mouthpiece into your mouth, over your tongue, between your teeth and close your lips around it.
  • Breathe out slowly all the way.
  • Press down on the inhaler as you start to breathe in slowly and deeply through your mouth.
  • Hold your breath for 10 seconds(or count 1 to 10) to let the medicine stay in the lungs and airways.
  • Exhale slowly.
  • Wait about 1 minute between 2 puffs of the rescue medicine. There is no need to wait between puffs of the controller medicine.

Using a spacer with a mask

  • Put the mask over nose and mouth.
  • Press down on the inhaler.
  • Keep the mask sealed around the nose and mouth and breathe in and out for 3 to 5 breaths.

How do I know when an MDI is empty?

Don’t Run Out On a calendar, keep track of the number of doses you use in a day and subtract it from the number on the inhaler. Throw it away and get a new one when you reach zero. Some inhalers have counter windows so you know how many doses are left.

How do I care for the spacer? Remove medication inhaler from the spacer and set aside. Wash all parts of the spacer with mild soapy water and rinse thoroughly. Air dry the spacer, making sure it is dry before the next use.

MDI inhaler spacer – mask

Before using the inhaler for the first time it must be primed. Prime the inhaler by re¬leasing 1 to 2 sprays (or per the manufacturer’s direction) in to the air, and away from your face. If the inhaler has not been used for 7 days, you may need to prime it again

  • Remove cap on the medication inhaler and shake vigorously about 10 times (5 seconds).
  • Insert the inhaler into the spacer device with mask.
  • Pull the mask on to the face, covering the mouth and nose so the mask fits snuggly. Check for a tight seal.
  • Push down once on top of the inhaler to release 1 puff/spray of the medication into the device. Keep the mask in place while the child takes 6 breaths (30 to 60 seconds). It is okay if your child is crying during this process; they will still get the medication into their lungs.

Release only 1 puff/spray of medication into the chamber at a time. If additional puffs are ordered, wait 1 minute before giving another puff especially for rescue medication(eg-asthalin).

Clean the spacer at least once a week.

Remove the mask (if removable) and the rubber end that holds the metered dose inhaler onto the spacer. Wash all parts of the spacer with mild soapy water and rinse thoroughly. Air dry the spacer, making sure it is dry before the next use.

Tips

  • Rinse your mouth with water and spit it out after using a steroid (controller) inhaler.
  • If you use more than one kind of inhaled medicine at a time, the reliever medicine (such as asthalin) should be taken first to open the airways then use budecort or beclomethasone. This helps the other medicine(s) go deeper into the lungs, so they will work better.

What is a nebulizer?
A nebulizer treatment (“neb ”) gives medicine as a fine mist that is breathed into the lungs through a mask or a mouthpiece. You will have a nebulizer machine and a nebulizer cup to put the medicine in.

How to use a nebulizer machine
Hold the neb cup in an upright position for the whole treatment. The treatment will last about 10 minutes. Use either a facemask or a mouthpiece to deliver the medicine. Just blowing the medicine at the nose and mouth does not get the medicine into the lungs. Sometimes more than one medicine will be used. Check with your doctor about mixing the medicines together.

Face mask – a face mask should be used for younger children.

Mouthpiece – for older kids a mouthpiece can be used. Place the mouthpiece over the tongue and between the teeth. You should be able to see the mist at the opposite end disappear as the medicine is inhaled.

How should I care for the equipment?
Clean the parts of the nebulizer according to the directions that come with the machine.

  • Use at least SPF 15 and more (More the better)
  • For the best protection, apply sunscreen generously 30 minutes before going outdoors.
  • Don’t forget to protect ears, noses, lips, and the tops of feet.
  • Avoid applying around eyes.
  • Reapply after your child swims or exercises.

few serious sunburns can increase your child’s risk of skin cancer later in life

  • Children usually give up digit sucking by the age of four.
  • If the child continues past the age when their permanent teeth start to erupt, they may develop crooked teeth and a malformed roof of their mouth. This can also affect the position of the upper and lower jaw and can also affect speech.

Suggestions to break the habit:

  • Wait until the time is right (low stress).
  • Motivate your child (show examples of what could happen to their teeth and fingers/thumbs).
  • Use a reward system (small incentives will encourage your child to stick with it).
  • Between 4% and 10% of infants are born with some degree of tongue restriction, which can affect their ability to breastfeed.

Symptoms:

Baby symptoms: Frequent feedings, Shallow latch on breast, Sucking callous on lip, kids becomes fatigued quickly during feedings.

Mother complaining of– Painful breastfeeding, Breast still full of milk after feedings, Nipple trauma (Cracking, Bleeding, Creasing, Flattening).

Treatment: Frenectomy ( Removal of a frenum, which is a small fold of tissue that restricts the movement of tongue)

  • Up-to-date on routine vaccines, such as measles/mumps/rubella, Chicken Pox, and seasonal flu/Hepatitis A/Rabies/yellow fever.
  • Frequent handwashing with soap and water.
  • Eat and drink safely.
  • Keep away from animals.
  • Avoid sharing body fluids.
  • Zika infection during pregnancy can cause serious birth defects. Therefore, pregnant women should not travel to these country.
  • Must Get Travel health insurance.
  • Start taking active interest in monitoring TV viewing from early childhood, so that the good habits are formed early rather than taking a confrontational attitude later on.
  • Fix TV viewing hours per day / per week and adhere to them strictly. Maximum of 2 hours of TV viewing (including computer/video games) should be permitted on weekdays.
  • Make sure that there is enough time spent on exercise, sports or other physical activity. TV viewing comes only after sports and studies.
  • Approve the programs for viewing with your child as to what he/she should see & what he/she should not see. Settle the issue with mutual discussion. Use passwords/child lock to block the programmes which are not suited for child viewing.
  • Educational (Discovery, National Geographic), sports, entertainment and children’s programs should be included to various extents in the weekly programme so as to widen the child’s exposure. Use TV news as a medium of discussion to increase the child’s general knowledge.
  • While watching an advertisement, tell the child that what is shown is not necessarily correct. So be careful while buying and always evaluate the product before purchase.
  • Children and adults tend to over eat while watching TV. Mothers use the medium to encourage the child to eat more. This habit leads to obesity in later life. While watching food advertisements discuss the good values and other aspects of nutrition.
  • While viewing violent shows explain and reassure the child that violence is faked for TV and in real life it happens rarely.

Discuss consequences of violent action in real life:

  • Invariably the aggressor is punished at the end.
  • Discuss the pain and suffering of the victims and their families
  • Help children think of non-violent solutions to the episode in the serial.
  • Be a role model for your children by limiting your own TV viewing.
  • The ideal distance to watch television is about 3 ½ meters and should be in a straight line.
  • The lights should preferably be behind the TV set.

Vaccination at Birth
Your baby must get all three vaccines on day one of life.

  • BCG
  • OPV
  • Hepatitis

Vaccination during 6 weeks/10 weeks & 14 weeks (or 2/4/6 months of age)
Starting from 6 weeks, your baby needsa total of eight vaccines

  • DPT + HBV + IPV + HiB (Hexa)
  • Rotavirus Vaccine
  • Pneumonia Vaccine

There are two types of DPT combinationsin the market:DTaP (Acellular – Painless & Fever less)– Diphtheria and tetanus toxoids, and acellular pertussis, and another is DTwP(Whole Cell – Painful with Fever)– Diphtheria and tetanus toxoids, and whole-cell pertussis. It is approved for use as a three-dose series for children six weeks through four years of age. Both have good efficacy. However, DTaP vaccines have fewer local, systemic, and febrile reactions than DTwP vaccines. IAP (Indian Academy of Pediatrics)has approvedboth vaccines can be used for the kids.

https://iapindia.org/pdf/Indian-Pediatrics-December-2020-issue.pdf

Which one is better for my kid – I am Confused?
First of all, your kid should get all the vaccines. Both are excellent and productive vaccines; however, if you want less pain, swelling, and fever, you may opt for a painless (DTaP ) one. But if there is any history of Progressive or unstable neurologic disease (e.g., infantile spasms, uncontrolled seizures, progressive encephalopathy),it’s better to get a painless (DTaP ) one.

Should I get the Pneumococcal 13 or Pneumococcal 10 vaccine?
Few data are available to support the choice between the two currently available pneumococcal conjugate vaccines (PCVs), ten-valent PCV (PCV10) and 13-valent PCV (PCV13). PCV10 and PCV13 are similarly highly immunogenic when used in 2 + 1 schedule. The choice of vaccine might be influenced by factors such as the comparative magnitude of the antibody responses, price, and the relative importance of different serotypes in different settings.You must opt for anyone; however, if your baby is premature, then a vaccine with better coverage should be the choice.

Cause

  • Irritation of the outer vagina from bubble bath, shampoo or other soap.
  • Poor toilet hygiene -due to back-to-front wiping.
  • Occasionally secondarily infection & urinary infections.

Treatment
Hygiene

  • DO NOT OVERWASH THE AREA. Wash very gently.
  • Do not use soap/shampoo for washing. Use __________________________
  • Do not use bubble bath, perfumed soaps or creams.
  • Pat dry the vulva with a soft clean towel after bathing rather than rubbing.
  • Change underpants frequently if soiled.
  • Urinate (pee) before the bladder is full, avoid ‘hanging on’ and rinse the vulva with water after urinating.
  • Use soft white unscented toilet paper.

Baking Soda-Warm Water Soaks: if itching persistent

  • Add 2 ounces (60 ml) baking soda per tub of warm.
  • Soak for 20 minutes to remove irritants and to promote healing.
  • During soaks, be sure –spreads her legs and allows the water to cleanse the genital area  for 2 days.

Cream: After soaks, apply Cutisoft 1% cream twice for 1 or 2 days.

Consult doctor if:

  • Irritation persists on treatment over 48 hours.
  • Vaginal discharge or bleeding occurs.
  • Passing urine becomes painful.
  • Your child becomes worse.

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