ONLINE MEDICAL ADVICE: Expert Pediatrician, Child Health Specialist

RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-07-03T14:01:00.001+05:30

My son is 8 years old. When he was 2 yrs. he was suffering from Rickets. We had taken treatment and after sometime he was fine. From the last few days again there r symptoms of Rickets which we can easily look in his arms, elbows. Can u pl. suggest some treatment. I have started giving him calcium tablets. As his doctor has gone abroad for 10 days, pl. also advise me can it be harmful for him.

== rickets is unusal due to nutritiona reasons at this age. one cant see it easily too. if he is otherwise normal , i should doubt the diagnosis fo rickets and /or think of some other diagnosis that may eb present along with.
only nutritional rickets respond well to calcium and vitamin D supplementations. pls detail me the evaluations on what rounds he was aclled a rickets case. also if possible email me the pics at this website below.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Detailed Query: My son is 8 years old. When he was 2 yrs. he was suffering from Rickets. We had taken treatment and after sometime he was fine. From the last few days again there r symptoms of Rickets which we can easily look in his arms, elbows. Can u pl. suggest some treatment. I have started giving him calcium tablets. As his doctor has gone abroad for 10 days, pl. also advise me can it be harmful for him.
> --
>

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feeding advice, 8 kg toddler

2009-06-13T19:56:00.001+05:30

1) How to increase my baby's intake of food , my baby of 16 months weight 8.6 kg does not eat , take only 3 servings in a day of each 1 wati of nachani ( breakfast ) , rice( lunch) , and again rice (at night ) . She does not take fruit juice and vegetable soups , I am really worried - does there is any tonic to increase the appetite ?

there are tonics but they are not recommended. you may visit my site http://infantfeeding.blogspot.com for further reading and download a CDC booklet there. increase the frequency of feeds.. offre feeds to chidl 6-8 times a day. keep the bowl in play area. dont worry even if child doesnt eat. let it just be there. small feeds.. mroe often will increase assimilation of food.

2) isthe weight of 8.6 kg is ok with a baby girl of 16 months.

ok. not bad. though technically less. i m not much concerned unless teh growth and dvelopment is affected or weight is too low. or if there is a weight loss.

3) How to increase my baby's resistance power ? she gets ill frequently - which daily food to be given to her to increase her resistance power so that she will not ill and always strong in health . Is there any medicine / tonic on daily basis to be given to baby to increase my babay's resistance power ?

you neeed to specify illness. frequent illness will reduce appetite so does the chronic illness. if it is surely there every month mroe than 5 days.. it needs evaluation. for strength.. take teh child to a garden and tecah basic exercises.. practice every day. everything in life cant be cured by tonics. dont fall prey to tonics that increase resistance power. diet is teh best tonic. resistance power is raised by high protein diet.

you may however give, mineral calcium or iron supplements after discussing with your doc.

4) I do not believe on the lady of Day Care who says she eats very well ( 3 chapatties + rice two time and fruits ) ( as this does not reflect on increase in weight of my baby ) , If I give up my job (which is good one in monetary terms and very convenient ) for 5 years and fully concentrate on my baby does her health improve ?

well, activity plays a major role in spending the energy.. so surely weight will be maintained. if you just want to increase weight, it can surely be done at any age in future too. but at present you should chart serial weights on growth charts and document growth faltering if an y . if there is serial weight gain.. no worry.

we leave her day care at 8 AM and pick her at 6 PM evening . But as her weight is not increasing and she does not look fat compared to other babies of her age , I am worried and thinking to leave the job. Pl tell will this help us ?

== dont compare too much. well, thinking to leave job.. is individual decision you would way with attention to child and your financial or career needs. i dont think it has any to do with weight. visit your pediatrician with a serial weight charted on a growth chart.

5) pl tell what ideal diet ( VEG ) should be for my baby girl ? please tell me as per following , so that she will not ill and always be strong by mind and health.

remeber there is nothing like an ideal diet. there are just recommendations and guidelines.

diet for a toddler should eb decided from what the child likes, whats cooked at home and what variety of dietary practices you follow. one simple rule that is most important is small quantity more frequent and calorie and protein rich diet.. no bottle feeding.

Diet Plan

such plans i had already written at http://infantfeeding.blogspot.com

7.30 AM :----------( please tell name of menu as I do not understand which food has protine , Iron , calcium , vitamine or fat ) foods rich in calcium are ragii, soya, fish etc. ragi si also rich in iron. best will be to give diet to child the way you find comfortable .. add vitamins minerals and calcium as supplements. avoid milk based diets in toddlers.

9 AM :------------

12 PM:-----------

3 PM:-------------

6PM:--------------

9PM:--------------

How much water ( ml ) in a day baby should drink :-

a 8 kg baby may drink minimum 3 glasses of water in a day. water requirement increases in summer and with semisolid diets. be liberal about water intake. if its too low or too high .. pls consult a doctor.

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feeding a low birth weight infant RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-02-26T11:56:00.001+05:30

My daughter is born at 37th week with weight 1.75kgs. And Doc has done so many tests to find why she is so small for her gestational age. and everything came normal. so we just thought it is just genetics.
===common cause of low birth weight is poor maternal weight gain. other cuasess are some intrauterine infections and some genetic syndromes. even problems of placenta and mother's hypertension may at times cause low birth weight. whatever the cause, that cant be reversed right now, so we should concentrate on treating.

i will pump milk and gives her through bottle. she used to cry for hunger untill she finishes her 2 months. At her 4months oppintment she weighs 3.37kgs.
======= she has remained as a intrauterine growth retarded baby, so as per that her growth potential will be relatively slow. she may remain smaller on growth charts, but should show a consistently rising birth weight, to catchup with other kids of same age by one year. if she doesnt gain weight consistently, we need to evaluate. She has almost doubled the weight by this age, so i feel .. thats no bad. you did enough efforts to have good growth. many enzyme disorders get ruled out when one documents a progressive weight gain.
>
> At her 2 months oppintment doc thought she is not gaining much weight and she put tube in her nose to feed. we kept > untill 2 weeks and she was vomiting a lot so we thought its not good idea and we removed that.
== feeding by tube is always a more reliable option. in many cases i even recommend putting a gastrostomy tube.. with a small operation till weight gain is adequate. if the weight gain is not enough, it may cause further growth failure and child may succumb to many infections and morbidities.

from then on doc advised us to add infant formula to breastmilk.
=== a calculated supervised feeding is always preferable when weight gain is crucial.

And now she doesn\\\'t even cry for hunger anymore even if we wait 4 hours. So we feed her every 2 hours. and she takes 40ml in half hour.
=== good. she may not have energy to cry. but do burp well after each feed. keep her semierect or held on shoulders to avoid aspirations/reflux. max feed at one time over 30 minutes should not exceed 60 ml for 4 kg body weight.

she only sucks while she is sleeping. she doesn\\\'t suck while she is awake
=======suck reflex starts disappearing sooner by this age. in addition she may be getting fatigued with prolonged suck. this classically is observed in many neurological waeknesses, underlying heart diseases etc all need not be picked up with investigations easily each time.

and she only swallowes what ever drips from the bottle.
===use a smaller spoon or dropper that a botle. save the infants energy wasted in sucking efforts, weight gain will be better.

we repented a lot going with that tube option.
===why do you feel so, if you face any probs with doc, discuss with me and we can sort soem solutions. learn the correct method of tube feeding when you opt for it.

from then she doesn\\\'t like milk at all.
=== she does drink.. as you said she swallows drops. if she is alert and active she has least reasons not to drink. common reasons at this age being cheek/ throat infections like fungal candidiasis, inability or weakness to suck. check again.. she should take better with a small spoon. feed slowly and for long time.

and it is very hard for us to feed when she is awake.
===id it that cos you feel she doesnt suck? whatever trickles from the bottle, she surely will be swallowing as she does in sleep. its another indication to try spoon feeds in propped up posture.

And doctor in USA keep on insisting us to put tube in her stomach to feed. We don\\\'t know whether it is a good idea to go with that option.and doc always asks us to visit so many specilists all the time.
=== its good idea to get rapid weight gain without hassles and other feeding related issues.
>
> she is able to lift her head and she smiles when we smile and her eyes will fallow us. she poops and she is having wet diapers.
======== good.. keep a close watch on milestones. many low birth weight abbies have delayed milestones. its important to pick up earliest as then only it can be modified. so visit a developmental therapist at least 4 times in next 2 months. have the development periodically assessed.
>
> Doc put her on prevacid for acid reflux at 2 months oppintment as she is vomiting once daily.from then on she is having gagging and once in a while cough.
===all this can avoided by feeding her in semierect posture holding her in arms.. and trying feeds with dropper or small spoon and letting the feed trickle along cheeks form the angle of mouth.
>
> 1. can you please let us know whether she is fine with her weight for that age?(she doubled her weight by 41/2 months).
=== she is just ok but needs a close supervision and weight management with feeding.
> 2. when can i start semi solids and fruit juices to her?do we need to go by months or weight to start these?
===by 6 months should be fine.
> 3. what are the foods that make them gain more weight? semi solids? or fruits? or milk as i want to go with only more calories food.
> calculated feeds.. like say well prepared formula feeds.
>
> I would really appreciate all your help.
=== read further details at http://infantfeeding.blogspot.com

>
> Thank you so much
> Ji
> ---------------------------------------------------------------------
> Visitor Ip: 170.35.224.63

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> >

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Cough and Cold particularly in Winter RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-02-26T11:08:00.001+05:30

I have a girl baby who is suffering from Cough and Cold. She is two and a half years old. When she got birth she was suffering from Pneumonia. From that period she is suffering Caugh and Cold particularly in Winter. We have used lots of Anti-biotic as per doctor\\\'s advice but she has not got total cure. I want advice how she will get rid of from this disease.

the common diseases that resemble cold cough in winter are asthma, bronchiolitis, tonsillitis, adenoids and pneumonias. has the child gaining weight otherwise? if no, its likely to be chronic tonsiloadenoditis. if the symptoms are more in night and early morning, you are closer to asthma. if its only acute event with high fever, you are closer to pneumonia. discuss this with your doctor.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Detailed Query: > ---------------------------------------------------------------------
> Visitor Ip: 121.247.229.3
>

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PROLONGED INFECTIONS IN THROAT AND LUNGS RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-02-23T12:40:00.001+05:30

REGULAR PAEDIATRICIANS WHO WE CONSULT HAVE BEEN INSISTING THAT HE IS SUFFERING FROM NORMAL INFECTIONS IN THROAT AND LUNGS. BUT THE CONDITION OF THE CHILD IS NOT IMPROVING AT ALL INSPITE OF USING SEVERAL MEDICINES LIKE AZITHRAL, PCEF ETC., ALONG WITH NEBULISATION, NASAL DROPS.
>
> WHAT COULD BE THE PROBABLE REASON FOR SUCH PROLONGED PERIOD OF ILLNESS? WHAT DO YOU SUGGEST THE MEDICATION SHOULD BE?",""

Two common reasons:
1. unresolved infection with persistant focus as in adenoids and tonsils
2. no infection, but condition like allergy like say asthma or allergic rhinitis.
it would have beene asier fro me if you had mentioned age, number of episodes in last 6 months, presenece of fever with each episode, and anytime if any antibiotic therapy taken for 10 days or more.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Visitor Ip: 60.243.173.227
> ***

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3.3 year old boy who does not eat anything properly

2009-02-15T14:03:00.001+05:30

have a 3.3 year old boy who does not eat anything properly, and does not take even liquid foods, he looks so week and lean and we are very much worried about him.I agree that this is the most commonest questions.....but still as a parent we cannot see him growing so weak at this stage.His is 12 or 13 Kgs as of now, please suggest what medications have to be followed, I m also attaching his recent picture

all this feeling may also be related to his feeding and diet habits since birth. so accordingly for indian settings 13 kg for 3 years isnt bad.. but surely is low. more commonly with low intake its common to have various vitamin mineral and calcium deficiency. as this has happened over 3 years, it can be changed like magic in 2 months, but surely within an year of dietary reforms and supplements you may find gain in weight.
another common thing that needs to be ruled out in suspected not gaining weight is common infections like throat infections, adenoids, tonsils, TB etc and/or any long standing illness.
please write back at the site with his details of diet per day on ana average, say 15 days back. i will surely eb able to suggets something. also read http://infantfeeding.blogspot.com
also read http://drpeds.blogspot.com/2008/12/1-year-old-not-eating-re-feedback-via.html

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

>
> Visitor Ip: 117.200.17.29
>

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5 month old with cold

2009-02-14T17:04:00.001+05:30

My five month old infant had a cold a week ago (running nose, mild fever 99 degrees). He recovered on his own, without any medicines.
=== its like soem sort fo acute bronchiolitis or rhinitis. in most such cases runny nose settles but coughmay last 10 days.

For 6 days now, he has cough whenever he sleeps (day time or night time). It has become more severe for the last two nights. I would say it is wet cough as there is some sound of phlegm. He does not have running nose, fever or any other problem. He takes feeds well (breast fed).
=== well most such coughs get relieved when you make them slep on side. it may be due to stridor, low calcium, secretions and occasionally asthma at this age. practising side or erect posturefor 2 weeks will settle matters in most cases without meds.

He also has nasal congestion...he cannot sleep in a room with the fan running, even if he is not directly in the breeze. Is this ok?
=== again, its liek nose gettingd ried and crusted.. that means there some secretions that are getting thick and stuck inside. while sleeping under fan, make him sleep on one side, let teh fan eb on head end of bed or moisten his nose before sleeping and make him sleep with a pillow so no direct blast gets inside. you may also reduce the fan speed.

We use Nasoclear 2-3 times every night - but that does not help for the cough - he wakes up almost every one hour at night and during day time naps every 20 minutes. After feeds, while burping, he invariably coughs.
=== nasoclear(normal saline) is very safe, so you may use any number of times, u may use it as a spray too. keeping nose clean with ear buds does help. occasionally cough alone can eb due to refluc disease, but i dont find that likely given this situations. burping cough is common, and burping is a good habit.

Should this be treated or will it pass on its own?
=== he may need to be evaluated if teh cough is distressing and dosnt relieve on comforting or taking him on shoulder and patting on back.

I tried applying Vicks only on the soles of the feet and covering them with socks (a friend told me about this) to stop the cough but not much effect.
==- its good.. children feel comfortable when some mild irritant diverts their attention. but has no effect on cough.

We did not apply Vicks on chest or nose as we were scared to try on him.
== well its safer in small quantities especially mixed with water.. but legally i wont say that.

Do help, I am worried. By the way, I have a four year old who probably brought the virus from school - she had a viral infection after my infant son had the cold - I had throat congestion also last week.
== get throat tested for strepts, gargling is good habit to keep throat clean. iust surely viral, read www.pediatricianonline.in for more details about treating cold at home.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

>>
>
> Visitor Ip: 122.172.38.207
>

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8 month old not feeding

2009-02-13T19:01:00.001+05:30

Dear Doctor,
> I have an 11 month baby (I am the father). He sufferred from severe diarrhea and vomiting when he was 8 months old (Seems rota virus).
=== loose motions are common in infants and are commonly due to contamination with feeding or putting hands in mouth. loose motions of long duration may cause loss of absorbing mucosa that may take 2 weeks to heal, thus causing poor intake and poor weight gain. adequate zinc therapy for 14 days as advised by a doctor may help heal gut faster.

After that, his weight has not really gained well.
=== hard efforts need to be put increasing frequency and quantity of feeds. read details at http://infantfeeding.blogspot.com the feeds should be smaller with a smaller spoon but calorie rich.

> He is 8.3 kg now.
== its not a bad weight for indian settings, but is surely on lower side at 1 year age. even increased activity by this age make them gain weight slowly.

He many times throw\\\\\\\'s up (Vomits) whatever he has eaten. So, he is refusing to basically eat anything now... whenever he eats... he eats in small quatities (like 75 ml of milk is enough for him).
=== the thing he needs to learn is chewing. provide small quantities with mashed semisolids.. try this repeatedly. avoid large quantity in smaller duration. if vomiting is 5 times a day, the child may need evaluation for say reflux disease.

> Has frequent throwing in past week created a fear of food in him ?
== its not a fear factor. it may be that he just doesnt like teh type of feed you offer him. at this age kids prefer sticky liquids like say soups porridges etc.

> My wife is really worried. Please suggest ?
== sure., feel free to reply at the site.
> Thanks,

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Detailed Query:
>

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R5 year, repeated febrile seizure

2009-02-13T18:44:00.001+05:30

my girl 5 years 6 months old, weiht 21 Kgs, She has history convulsion.Since 8 months olds, until now, she has 13 times convulsion,
=== in such conditions its important to know the milestones in the child. most often they are likely to be delayed. convulsions withd elayed milestones seem to be refractory at times.
Last convulsion On March 2008, degres 38.4 celcius.We alreday prepare at home, ibuprofen 12.5mg supository, paracetamol 125 mg syrup , and Diazepam supository (this is to be given if she has convulsion).
======= so it was treated as a febrile seizure, usually febrile seizures dont come so often. [;s read about febrile seizures: at http://drpeds.blogspot.com/search/label/febrile%20seizure%20query
>
> Question:
>
> 1.When this convulsion will be go away?
=== when it has been diagnosed and evaluated properly. at times she may need long duration of anticonvulsants. like say clobazam therapy.

> 2. I have read in one literature (fibrile seizure=convulsion is caused by not enough Ca (calcium), so please advise from what kind of food to be given ( contain much calcium) if need calcium?
=== rather low calcium is a common cause of seizure than febrile seizure even if it comes with fever. not food, but cAlcium and vitamin D supplements are more imortant in preventing them.
> 3.Some time she tell us that she has painful in calf of leg and thigh of leg,the paitfil is not continue, but some time come with range.we care of this, because one time when she said pain in his calf , after that she get Pain with 37.7 degres
=== pain in calf is more common with low calcium and/or fever. regular calcium supplements may help this overcome.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

>
>
> M
>

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some more short queries

2009-01-21T00:27:00.002+05:30

Detailed Query: Just potty trained my 3 year old son. How do I get him to pee standing? I\\\'m his father.

first make him comfortable with the toilet environment.
take his clothes off, run the tap and encourage him to pass.
you may stand next to him! this works very well.

================================

juices, smashed feeds, vegetables, oat milk etc for 6 month old

Is oatmeal meal preffered for a 6.5 month baby?
=== no. prefered diet is rice based cereals. also read infant weaning at http://infantfeeding.blogspot.com

> In fruits which fruits are good, i tried apple but he had a cough, banana causes cold i heard from inlaws, which ones to give which will not cause baby a problem?
=== all fruits are ok.. but they should be more of juicy forms and later mashed up. juices for 6-8 months. dont use chilled frsh juices. medium ripe bananas can be used.. if you steam them a bit before feeds.. you wont get cold. pomegranates can cause constipation. chiku and pinapple juices are good too.
Are juices prefered or smashed fruits?
juices.. thicker juices and later after a month.. smashed feeds.

Which green leafy vegetables are prefered?
all are fine. avoid coriander, you may use spinach, alfaalfa, methi, etc, but use them as soups. avoid leafy fragments that can stick to throat. u may add salt or pepper fro soups. or may mix with beet or carrot juices.

======================================================

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Subject: Feedback via the Ask Health Query to Dr SK. Get answered for free.
> From: burst@emailmeform.com
> Date: Mon, 19 Jan 2009 04:10:53 -0500
>
> Name:
> Email Address:
> Hide email address:
> Detailed Query:
> ---------------------------------------------------------------------
> Visitor Ip: 210.18.83.86
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pureed feeds to soilds switch over, age 1 year

2009-01-21T00:18:00.001+05:30

My son is 1yr old his birthday was on the 3rd Jan, we have started to give him pure food when he was 6months old but now he is refusing the pure food and wants to eat from our food which means solid food. My problem is than now I cant measure if he is getting enough food...
> His diet is based on:
> breakfast : 4 spoolfull rice cereal with hot water, at around 11.00 banana and orage
> At around 1/2.00- usually 1 cup of pure vegetables mixed with fish / chicken or meat, but as i told you above he is refusing this type of food
> at around 3.00 he drink breast milk
> at around 4.30 he takes a cup of yogurt
> and at around 7 - again pure food ( when he get it)
> and then he drinks breast milk to sleep
> this is his diet, do you think that he is doing well by eating these goods and what about the portion of his solid food?

read infant feeding articles at http://infantfeeding.blogspot.com
you need to taper milk further, promote him eating dietary solids but see to it that he wont take nut or particles that can cause choking. feed him easy to chew and easy to swallow, overcooked solids mixed ro mashed with potatoes, fish, chicken etc
offer feeds 6-8 times a day, if he is growing well with good weight and milestones.. its likely that you are giving enough. no need to measure things, just see to it that he doesnt remain hungry.

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diet 6 month old, weaning, complementary feeding, introducing solids

2009-01-15T19:26:00.001+05:30

you can give me the details something like in morning formula milk, then semi solid, then some liquid, then some semisolid, should this be the right way to feed the baby who is not breastfed? What combination of semisolids can be give other than dal & rice?

non milk diet should start gaining momentum, that doesnt mean that it should be only solids.
the process of gradual introduction of nonmilk diets in an infant is called complementary feeding which means the feeding to be added as complement to the breastfeeding in intial phases as breast milk isnt enough in quality and quantity after 6 months age.

we divide the next 6 months into 3 phases of each 2 month.
first 2 months : 6-8 month: introduction of liquids.. fruits juices soups porridges. a new tem should be started slowly and in small quantity to replace a complete feed with it by 2 weeks. so in 2 months phase you may add 1 soup feed, i juice feed, and 1 porrdige feed. many moms prefer adding daal water rice water etc .

middle 2 months: 8-10 months: introduction to semisolids: semisoldis are added after intially making teh liquid feeds thicker by adding cereals , and juices and later by mashing up teh cooked or soft solids in the dsame. like say potato milk, banana milk, fruit juice bases kheers, liquid upmas, thicker porridges. many moms prefer to make khimtee adding daal powders rice powders and raagi or nachni powders. adding soya and sago is also very useful.

last 3 months: 10-12 months: introduction to solids: thicker feeds and easily palatable solids.. for soft chewing exercises can eb added as teeth have started comimg up. so soft peices of bananas and potaoes etc can be chewed easily by the baby . daal may be added with rice. upma, idli, dosa, fish , chicken all may be tried.

now you wanted to know exactly what and how much.
most 100 ml feeds contain on ana verage caloric density upto 70 cal per 100 ml.
a 6 month old will usually require upto 700ml per day that is upto 7-8 feeds of 80-100 ml (3 Oz) each. extra is bonus., giving upto 600 cal per day.

if you are formula feeding. you may switch over to gradually cereal formulas with rice and later wheats. but i prefer you to feed with spoon, and more preferably regular dietary items than tin feeds.

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> Detailed Query: Hi,
>
> I wanted a routine for a day for the 6 month babys feed.
>
> you can give me the details something like in morning formula milk, then semi solid, then some liquid, then some semisolid, should this be the right way to feed the baby who is not breastfed? What combination of semisolids can be give other than dal & rice?
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one limb weakness or limping.. paralysis? polio? RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-01-12T18:09:00.001+05:30

Date: Mon, 12 Jan 2009 05:30:09 -0500
>
> > Detailed Query: Hi,
> Hope you be fine. No doubt you are doing a fine job of providing the guidance to parents about the problems of their children. It is appreciable.
>
> A few days ago my 2.25 yrs old girl fell ill with cough, cold, fever and mild asthma. She was on medication (Syp. Cefixime and Ventoline (ventoline nebulizer)).
> One day she was nebulized with ventoline and then selpt in the afternoon, when she awake, she was trembling and could not walk without support. I was horrified that it might not be polio. My local specialist assured me that there was not a danger of polio but might be a physical problem related to jumping or playing around.
>
> At the first hour of the problem, my baby would walk with right foot straight ahead but the left foot slightly away from the body line as well as direction of foot was not aligned to that of the walking.
>
> Now even after 4 days my child is having the problem, not to that extent but the gate is not smooth and a limping can be seen in walking.
>
> Please tell me sir what to do and what might be the reason of this.
>
> I\'ll be very thankful for this.
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it doesnt appear to be related to the medicines. What you are trying to describe is what we call as a focal neurological deficit. given the fact that whatever you are trying to describe as verbatim true, you are talking about weakness in left leg from hip down with difficulty in walking. my impression would have been more accurate if i had a video or pic of patient to support this.
A doctor may call this as monoplegia or monparesis, if it is without pain. If its painful, there may be plenty other reasons from trauma abscess to infections like say in the joint.. psoas abscess etc.

as all started with a fever and then weakness, a definite attempt should be made by a pediatrician to examine this child for any neurological signs, weakness of arm and any other evidence to support weakness.
prima facie this case appears like an acute flaccid paralysis and hence should also be seen by local health authorities/ medical officers to evaluate further like say stool samples for polio tests.
weakness can be confirmed black and white by studying EMG or muscle graph and polio can be confirmed by nerve conduction studies.
believe me its almost impossible to make such diagnosis only on the short history provided.

for medical students: http://www.uwo.ca/cns/resident/pocketbook/approach/acute_flaccid_paralysis.htm

gait disturbances videos:
you may copy paste the following link to se if it matches this video showing weakness...
http://in.youtube.com/watch?v=Ze5CvbXm_no
or another like this
http://in.youtube.com/watch?v=CuA1wOxytv0

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6 months feeding travel RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-01-09T19:46:00.001+05:30

I have a 6 month old baby. i will go to denmark on 1feb leaving the baby with his grandma.
> Will there be any health problems for him as i will not be available to him? as i breasfeed at night.
> I started semi solids also but what is the best way to smash food(is it the mixer?)

yes you can use mixer. if permissible even baby can fly with care taker. but if not possible, baby can be taken care of on formula feeds , calculated, prepared and administered meticulously, start trials right now so that in 2 weeks he will be more comfortable off breast milk. read breast feeding tips at following link:
http://drpeds.blogspot.com/search/label/feeding

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> Date: Fri, 9 Jan 2009 03:04:13 -0500
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common cold, infant, recurrent coldRE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-01-08T19:49:00.001+05:30

my son is 10.1/2months old from the month of november18 he is having cough cold my docter first give him koflet and tixylic but because of these medicine he get little bit caure not fully after sometime in the mth of dec16 he again sufring from cold with fever and these time doc give hin crocin suspension and zrcod syrup his fever get caure but not the cold and i night his cougfhing and because of these he want be able to sleep propperly he feel un consious for these we have to take him in our hands and try to relas him so that he can sleep for these we went to doc now these time he give him amrolite-s 3/4th tsp 3times a day and after these medicine he did vomiting and and loose motion anot every day but he did once in a day today 5th january he is sufring from clod and cough and on the 5jan evining he did vominting anf after that he did watery loose motion and again int the night 3clock he did vomiting and loose motion means from yesterdat evening did twice today moring we went to doc he said becsause he is having cough in his chest that why he is vomtted and loose motion happpen and doc give him the same medicine for five days with new medicine enterogermina once in a daily. i want to know that wahtever my doc give the treament for my child is ok or he is doing vominting and loose motion because of cough and cold or because of teeth coming or come thing else please let me know because i don\\\\\\\\\\\\\\\'t my chid get suffer more with this problem

have faith in your doctor. discuss things openly. clarify all doubts. what i feel is that the child probably had a runny nose and throat inflammed.. that made u feel cough in chest (the noisy breathing), vomiting (due to discomfortful swallowing), and reduced intake. loose motions can eb related to runny nose or cough. The symptoms of restlessness are also due to the nose block.
what the kid may need is a nebulisation with normal saline to make nose and throat clear.. insist on semisolids or liquid feeds for few days. ensure hydration, as long as there is no fever its likely that symptoms will settle with conservative therapy. cough may last for few more days, but if fever persists or recurs.. the child may need some mroe tests or a repeat doctor visit in emergency.
read serious symptoms/danger signs at http://drpeds.blogspot.com/2006/11/emergency-serious-danger-symptoms.html

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throat infection cold cough loose motions RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-01-08T19:00:00.001+05:30

My Baby is 7 months old and she has got cold along with dry cough 5 days back and causing lot of inconvenience to her. She is not able to sleep well.
=== all may be related to nose block or itchiness or inflammation in throat. that needs to be taken care off. its like say a viral infection. read how to manage cold or runny nose at http://drpeds.blogspot.com/2005/06/common-cold-treating-running-nose.html
>
> We are giving DM-P3,Lanol,OFM Suspension from past 3 days 3 times a day but there is no progress and now she is not showing interest towards food and her motions are loose and watery and color is dasrk green.
=== if she has developed loose stools during the course of throat infection its very likely that the loose stools are less than 5 a day and they are related to throat infection making mucus pass through stools too. not interest towards eating may be related to throat infection/nose block or gut infection.

>
> Please advice us whether it can be curable?
=== yes! its curable . (dont think of anything incurable in life otherwise there will be no hopes.) discuss with your doctor regarding need for any nebulisation, decongestants or cough suppresants if any. also get stool tetsedfor infection. read dehydration and management at www.rehydrate.org a open discussion with your doc regarding therapy may help. read danger signs at http://drpeds.blogspot.com/2006/11/emergency-serious-danger-symptoms.html when you may need to visit a hospital as it can be life thretening.

do we need to change medicine? How long will it take for her to come back to normal state, what is she suffering from?
you need not unless youd co feels so. any serious sign may make your doctor change medicines. she is suffering most likely from a rhinopharyngitis with parenteral diarrhea. if she has any breathless ness, sensorium change or convulsion, the diagnosis may change.

feel free to reply back with docs follow up.
>

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10 month old not eating RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2009-01-04T12:01:00.001+05:30

My baby girl is 10 and 1/2 months old. Her weight is 7.8 kg and height is 75 cm. She doesn\\\'t like to eat, but very active. Her doctor advises me to feed Cypon drops. But I am not sure how good this medicine is. What are the side effects? Can I give this medicine to my baby?

her weight and height isnt bad for indian standards. what she needs is a good switch over to complementary feeding. most times children dont loose appetite unless they suffer from infection, but the common reason why they dont eat is they dont know how to eat and swallow. practically start with semisolids with spoon feeding and intake will improve.
if the "no weight gain" persists for one month she may be evaluated to document all is fine. and in such cases a doctor may prescribe cypon drops.
cypon is an antihistaminic used to increase appetite.It may cause sleepiness. (read here http://www.answers.com/cyproheptadine&r=67)
you may give this medicine to a baby only if advised by some doctor.
Practically I dont feel any need to give this to your baby. What you need is to understand different diets that can be planned for an infant.
read here : http://drpeds.blogspot.com/2006/03/diet-for-1-yr-old-baby.html

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1 year old not eating ... RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-31T18:00:00.001+05:30

have a 1 yr old and have been struggling with her lack of appetite for about 5 months now.
=== what the child is taking in, if its not enough, the child wont gain weight adeqaute for age. so its must to chart his weight and height on growth charts and compare it with previous weight and height.check them here http://www.who.int/childgrowth/standards/en/

We have to force all feedings. She fights, spits and cries at each meal.
==== this is a common complaint by most parents in following situations: 1. child is fed with something which he/she may not like, may not know, may not have been trained to chew or swallow or is not uniform in consistency. 2. child had enough intake and so he may not accept any more. 3. spitters: child is suffering from repeated throat infections/tonsils or adenoids/ that make swallowing painful and children wont take much in. 4. vomiters: child suffering from reflux disease ro hyperacidity or some related vomiting disease. 5. child has constipation that needs to be tackled first.
this needs to be understood and differentiated from refusal to feeds, that may eb associated with acute serious illness.

I\\\'ve seen the pediatrician about this atleast once a month and they have not run any tests, prescribed any vitamins or giving me any helpful advice.
=== tests dont come positive very often, so may nto be needed. vitamins and supplements only fill up if any of them is deficient, they dont add on to calories nor they can replace diet.

All they ssuggested was that I give her pediasure,
=== that is a monotonous calorie and protein rich diet.

Cypon Drops,which I do , but again it is forced on her.
=== that improves appetite, but not required in most cases as appetite is not affected in these cases. teh kids may be hungry but just dont like the food or find it painful.

Can you suggest anything or is there anything over the counter that can buy to help increase her appetite?..
=== let me be sure, she has good appetite then no neds are required. if there is no appetite its important to look for reasons of loss of appetite like common gut infections.

> Since from the birth she is having most of the time she is taking cold and Cough Medicines. Like maxtra, nasoclear, cosopin, prospan, Every 15-20 days she takes her food with good interest but after the cycle she starts throwing out her food.
=== all is suggesting me like adenoiditis, you may ask for a "digital x ray neck - soft tissue lateral" to confirm same. even otherwise, a good eradication of infection of throat with at least 10 day course once with an antibiotic may eb adviced by your doc. apart from that dietary modifications like easily palatable selisolids and calorie rich supplements with spoon may eb added. an average 1year old kid may need upto 100 cal that is equivanent to 150ml that is 5 oz 6-7 feeds a day.

> Please guide us..

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

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vomiting loose motions greenish.. posetting

2008-12-27T19:49:00.001+05:30

my son is 2.5 months old,when he was 2 months of age, all of a sudden he refused to drink milk(he is completely breastfeeded), === what you must have observed is that he gives up breast within seconds or minutes of latching rather than refusing breast. this is a common problem from age 2 to 7 months, as with growing weight child sucking power increases and the infant expects a large amount of milk which definitely doesnt get through any nipple, so he gets frustrated and gives up .. he may end up swallowing lots of air in return. persisting with feeding helps him understand the situation and modify feeding at breast. breast milk output reduces if the duration of frequency of latching reduces. when we asked the Dr. he told us that its because he is having low calcium(its 7.5- range is 8.35 to 10)so he gave him calcium gluconate inj. but orally. === low calcium is very common in India .. so is elsewhere. Practically most indians need calcium supplements for growing bones, but that doesnt cause these problems. also he gave him Atarax drops for 15 days(coz he always trys to vomit something but doesn't come outside anything)and === well, i feel thats not required. as the vomiting you describe is called posetting, that is normal for the age. infants take out small quantity of curdy milk few minutes to hour after feed. thats normal (GER or gastroesophageal reflex) as long as child doesnt learn to stand. so lets not call it as vomiting. Ciza syp for 1 month.but i gave atarax drops only, and doesn't gave ciza syp, as i read that its side effects are dangerous for infant. === good! may be both arent required. but as i havent seen the patient, i wont advice you against the prscription of your doctor. Both are good drugs definitely for adults. I thought cisapride (ciza) pediatric preparations are banned. (http://www.pharmabiz.com/article/detnews.asp?Arch=a&articleid=8699&sectionid=19) my sons starts drinking milk after 4-5 days.till dt time we were giving him through spoon. === well, another common cause of vomiting is common cold or throat discomfort or sores. whatever, it were seemed settled. but after these 4 days he starts passing green stool, with ivory colored DAANE (in the shape of udad dal)in it. == lets call it mucus flakes.. (it can also be undigested curdish milk). that may be part of throat infection.. mucus getting swallowed and passed as white flakes. when we asked our Dr, he told us that he has intestine infection,but m not clear how he can diagnose without examination of his stool. and m afraid what to do now?whether to give him the prescribed medicine or change the Dr. plz help its urgent. === well, one shouldnt doubt a doctor.. you went to him because you had faith in him. its always better to ask everything in details and clear your doubts. read: http://drpeds.blogspot.com/2005/06/what-parent-would-like-to-know-about.html

urgent things shouldnot be posted at this site, for all urhgent issues one should visit emergency department of a hospital. note: during this period my son put on weight avg 20gms a day, before that he was gaining avg 40gm weight per day. === I am happy at least he is gaining despite all this. keep it up. get stools tested for routine microscopy. get him treated if any infection is confirmed on stool test. if its milk indigestion, you cal also get stool tested for Ph and reducing substances. dont expect every test to come positive (its good.. if it doesnt come positive). maintain quality feeding.. slow and frequent. Your doctor may add zinc supplements, and sometimes antibiotics like may be say septran or ofloxacin etc also he is gastric from his 5th day of age till now,and while passing gas he also passes a small amt of potty == this is normal in breast fed or formula fed infants. this is called gastrocolic reflex.. to pass small stools after feeds or with feeds. gases are better tackled by burping after feeds. so his Dr. gave him Walamycin for this when he was 22 days old.but we don't have any result. == no worry for that. you may use simethicone(antiflatulant) drops under medical supervision, its meant for gases. and also gave Siloderm cream to apply on anal area which is red, till now. == i am worried about this. redness at anal area can occur if motions are watery and the skin remains wet for long or is cleaned with rubbing method or if it gets in addition infected by bacteria or fungus. solution is to keep the skin dry and use some antiseptic ro antifungal powders under medical advice. redness itself also can cause loose small stools. His normal yellowish potty(before the latest problem starts) also included those white daane. === so its like part of undigested milk that neednt be worry unless stool is loose or the test shows some infection or mucus. feel free to write back. Pediatrics, paediatrician online

vomiting loose motions dehydration throat infection or stomach flue RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-27T19:17:00.001+05:30

My baby is 9 months old, 18 lbs from a birth weight of 10lbs. she does not have a great appetite and always liked to have small meals.
=== she likes to eat small but may ask more often .. she is a slow feeder. by 9 months need is around say 900 ml per day. that is 30 oz in a day. so on average 4 oz feeds 8 times a day.

4 days ago she started vomiting if I feed her more than say 3 or 4 table spoons of anything.
=== common cause of vomiting without motions at this age is throat or adenoid or ear infection.. practically thus area may get inflamed and may cause pain and difficulty ins wallowing thus refusing most intake, but may accept if given small quantities. so if she takes only 1 0z (5 table spoons) at atime not a problem, wait till its swallowed.. burp her around to make her comfortable and after 10 minutes try again 1 oz. feed when she is erect . feed with a small spooon or dropper. take care of runny nose or nose block or throat pain if any.

2 days later she starts to look tired, cranky and just not as active as normal.
=== so she has got partly dehydrated or just had less calories.. or may be if added fever.. all alone or together can give rise to such sick feeling. she needs to build hger reserves in such situations by giving her enough rest comfort and fluids. keep a watch on danger signs and also those mentioned at www.rehydrate.org

her bowel mouvement is looser and today her stool looks dark green. she poops about 2 or 3 times a day. I wouldn\\\\\\\\\\\\\\\'t call it diarreha just looser than normal and green today.
=== yes. i tooo agree. it may not be diarrhea. usually diarrhea will have more than 3 stools.. but the stools you describe with the kind of symptoms she is having may be due to early diarrhea or just a throat infection when the swallowed secretions make gut move faster. whatever the reason, you need to hydrate her well to prevent dehydration.

I have to mention that my husband had the stomach flu and has been vomiting/diarrhea.
=== this makes me worry. get him tested and treated for same. encourage washing hads as a healthy practice in family. lookf ro a common source of infecion of throat or gut. take adequate precauions like say.. wash hands trim nails, boil water and utensils used for baby, discourage mouthing toys and thumb.

.
=== ya.. no one knows whats going behind the nose. check for any painful points or nodes around throat ro jaw or ear, that may help.
encourage frequent semisolid feeds. if fever you may need some symtomatic measures. a normal saline nebulisation or a dose of antivomiting medicines like say domstal or ondem etc as prescribed your doctor may help in giving comfort to throat or control vomiting respectively. understand oral rehydration at www.rehydrate.org

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> >
> First, I\\\\\\\\\\\\\\\'d like to thank you for the time you have allocated to all of us worried mothers. I can assure you that it is very much appreciated.
>
> My baby is 9 months old, 18 lbs from a birth weight of 10lbs. she does not have a great appetite and always liked to have small meals. 4 days ago she started vomiting if I feed her more than say 3 or 4 table spoons of anything. 2 days later she starts to look tired, cranky and just not as active as normal. her bowel mouvement is looser and today her stool looks dark green. she poops about 2 or 3 times a day. I wouldn\\\\\\\\\\\\\\\'t call it diarreha just looser than normal and green today.I have to mention that my husband had the stomach flu and has been vomiting/diarrhea. I don\\\\\\\\\\\\\\\'t think she has a throat infection as it does not seem red but who knows.
>
> please any advise will help a lot.
>
> thx again
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> Visitor Ip: 204.191.129.237
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phimosis .. prepucial stenosis.. urinary infections . RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-25T00:35:00.001+05:30

> My son is 2 years old his urine hole is very small and the skin is not going up whenever i instead to clean he is not alowing me to do, but this i have noticed in his 5th month itself i have checked with doctors they ask me to do some exercise, but iam a working women my mother in law was taken care that time she refused it to do now i resigned my job to take care him can you advice me to clear this issue without any surgery

=== what one should understand is that phimosis to a great extent is normal in infants and may be upto 2 years. the skin need not roll back or the urine opening of glans penis need not be easily seen this is phimosis). with age and growth of body parts.. prepucial (foreskin) skin grows and or gets loose and looks like adult prepuce.
what is important medically is to understand when can it create a problem.
1. when it gets infected.
2. when it pains
3. when it causes bleeding
4.cause ballooning or prepuce .. suggestive of prepucial stenosis
5. poor stream of urine.. dribbling urine.. may suggets meatal stenosis
6. passing urine again and again after few minutes.. may suggest urinary tract obstructionb.. like say posterior urtethral valves.

all these can cause dysuria or urinary discomfort or urinary tract infection and may be associated with each other.
In long run.. untretaed or undetected.. has potential to cause permanant kidney damage in the form of backpressure hydronephrosis and failure.
Treatment of such conditions mainly includes:
1. treatment of urinary infection with antibiotics for 10 days, then some tests to locate exact problem
2. care about phimosis
3. management of complications if any like kidney damage

So regarding care about phimosis:
Important points are: 1.cleaning the genitals while bathing, to note for any pain or urinary discomfort. 2. avoiding unnecessary complete withdral of foreskin. 3. using lubricant gelly like xylocaine or glycerine to smoothen roll over in case if there is any preputial narrowing (alwasy under medical gundance and supervision). 4. rolloing forward the foreskin .. if any withdrawn. 5. many a times exercising same for 4 weeks, improves the situation in most cases, except when there is infection ro any significal congenital anomaly.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

>

> ---------------------------------------------------------------------
> Visitor Ip: 122.165.33.65
> ***

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fever delirium seizure RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-24T19:24:00.001+05:30

My son is 25 month older on 1st december he got heavy fever temp 102 when i waiting for doctor his eyes suddenly stopped and he didnt show any reaction, when i call his name there no reaction, imeadiatly i shown him to the doctor he sad its a kind of fix upto five years for any children its use to come when heavy temparature is, but he asked is that any one got the same problem with our family, yes the same problem is there with my husband elder brother still he was suffereing with nerves problem, i am worried about this can you please advice me in this

=== lets call it a fever induced delirium, whihc has potential to trigger a febrile convulsion. Many a times high temperature can make one go into delirious or altered stat.. sometimes momentarily and sometimes as a seizure.. moreoften in children below 6 year age.
read febrile seizure at this site.

if the seizure had been with the fever, at the rise of fever and with no more than 1 day fever history; it is more likely to be a febrile seizure. however in developing countries hypocalcemia and tuberculosis is so common that they may get precipitated with fever as convulsions.

read how to manage fever at http://drpeds.blogspot.com/2005/06/managing-fever-in-children.html

treatment remains same even if second opinion is taken. if the seizures are febrile by definition as above; main therapy is to prevent the fever from coming and also from rising it beyond 99 with prompt therapy. regardiung how to manage fever, please read details at my blog http://drpeds.blogspot.com

if there is associated calcium deficiency or rickets or evidence or suspicion of infection like tuberculosis, it is prudent to evaluate in this direction continuing treatment for fever which may be an added antibiotic after an expert consultation.

SOme patients do need neuroimaging like MRI scan or EEG (brain graph), to decide further therapy. repeated febrile seizures may be started on drugs like clobazam for short or long term depending on clinical settings and reports.

what is more important for parents is the precautions one is supposed to take to prevent seizure from complicating at home and also learning to treat the seizure or convulsion at home.

As soon as you notice a seizure, turn the child on one side so that he wont aspirate secretions, loosen the clothes donot hold the patient tight. donot spray water or any other thing on face. keep rectal diazepam suppository handy which your doc may teach you how to use it in an emergency , that can help tackle seizure by introducing the medicine in correct dosage in the child's rectum through anus. This tricks needs to be learnt by parent or care taker. its prudent to give such therapy at home; after medical advice demosntration after a thorough consultation in individual case.

if the seizure is not tackled properly it may cause some permanant damage. seizure in a child whose milestones are delayed, usually is because of some permanant damage at brain. exntent of damamge decided extent of normalcy.
The risk in febrile seizure is the possibility of meningitis so the doctor may ask for brain fluid test or a spine tap or he may start on antibiotics.

antibiotics may be started by doctor if he suspected bacterial infection. It maynot be bacteria each time. What is mor eimportant is getting down fever and getting down to root of covulsion, that may need some further tests like EEG Scan etc.

for more info pls write back.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> > Detailed Query: Hello Doctor
>
>
>
> Thanks & Regards
>
> ---------------------------------------------------------------------
> Visitor Ip: 122.165.33.65

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MY 17 MONTH OLD DAUGHTER HAS A RUNNY NOSE, BAD CHESTY COUGH, SNEEZING, NOT EATING, IRRITABLE, WHINGING. IT STARTED AS A COUGH 2DAYS AGO, YESTERDAY IT BECAME WORSE AND TODAY ITS EVEN WORSE, SHOULD I SEE MY DOCTOR Feedback via the Ask Health Query to Dr S

2008-12-21T19:23:00.001+05:30

MY 17 MONTH OLD DAUGHTER HAS A RUNNY NOSE, BAD CHESTY COUGH, SNEEZING, NOT EATING, IRRITABLE, WHINGING. IT STARTED AS A COUGH 2DAYS AGO, YESTERDAY IT BECAME WORSE AND TODAY ITS EVEN WORSE, SHOULD I SEE MY DOCTOR OR WAIT TILL TOMMORROW? HER TEMP IS AROUND 36`C

you should always see a doctor in such situations, as the child may get exhausted at any time. Your child is mroe likely suffering from adenoiditis or a just rhinopharyngitis. Nose block and post nasal drip makes a child extremely irritated in these situations and sometimes there may eb wheezing. Pneumonia in certain cases has similar onset, so its prudent to visit a doctor earliest.
read an article on runny nose at www.pediatricianonline.in or click here http://drpeds.blogspot.com/2005/06/common-cold-treating-running-nose.html

http://drpeds.blogspot.com/2007/11/tonsilloadenoiditis-is-there-any.html

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> Detailed Query: > ---------------------------------------------------------------------
> Visitor Ip: 58.106.90.166
>

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18 month old baby has been vomiting for 2 weeks RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-21T09:41:00.001+05:30

My 18 month old baby has been vomiting for 2 weeks now, but only once a day. He runs around all day like nothing is wrong and then stars crying thats when I know it will happen. There is no gaging before, and no coughing. He really hasnt lost weight, but hardly eats. He was breast fed for the first 6 months and then bottle fed the next 6. He did use to spit up alot when breast fed. I listened to his tummy and it sounded like it was bubbling, could the stomach flu be causing this? Thanks for your time.

My 18 month old baby has been vomiting for 2 weeks now, but only once a day.

=== He is vomiting daily. but only once. commonly related to over feeding9with respect to stomach capacity-or over eating in short time) or allergy or acidity-reflux. The first cause is more seen in infants and last one is common after 2 years age, and more often in school children. At times, tonsillitis and throat infection do cause such vomitings but they have reduced solids intake and recurrent respiratory problems.

He runs around all day like nothing is wrong and then stars crying thats when I know it will happen.

=== such crying or discomfort is usual when stomach contents come out under force and that may be associated with feeling of nausea too. running followed by vomitting is commonly reflux out of a full stomach, that sets some antiperistalsis. running is not recommended after meals at any age.

There is no gaging before, and no coughing.

=== rules out adenoids or tonsils or throat infection on a larger scale if there is no throat discomfort too.

He really hasnt lost weight, but hardly eats.

==== if he has gained wieght for age or near to it, and surely not lost it.. currently his intake (low) and vomiting arent much enough to affect his nutrition, but over days it may. hardly eats or fussy eating is common with acidity-reflux, adenoids, and constipation. One may call this as anorexia.

many a times i find that children prefer small quantity more often than just 3-4 large feeds or meals. if he spits .. its important to make his diet more palatable and also make him understand the importance of chewing. if he is eating calorie junks and / or drinking more milk.. its likely that his appetite may get killed due to full stomach.

He was breast fed for the first 6 months and then bottle fed the next 6. He did use to spit up alot when breast fed.

=== thats like reflux or posseting, that may be normal till a year age. bottle feeding may at times be a reason for throat infections say tonsilitis or adenoditis. what is his currant diet? what he likes and dislikes? does he anytime complain of stomach pain or indigestion?

I listened to his tummy and it sounded like it was bubbling,

=== its seen in stomach flu (gastroenteritis), but surely can be with any reason for vomiting.

persistant vomiting may require investigations like stomach pH, sonography abdomen or at times a scopy.

could the stomach flu be causing this? Thanks for your time.

== Given the description, it doesnt look like a stomach flue but more like acidity or reflux. any history of throat complaints will make ruling out tonsils or adenoids moreimp in this case, though that seems unlikely.

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

> > Detailed Query: My 18 month old baby has been vomiting for 2 weeks now, but only once a day. He runs around all day like nothing is wrong and then stars crying thats when I know it will happen. There is no gaging before, and no coughing. He really hasnt lost weight, but hardly eats. He was breast fed for the first 6 months and then bottle fed the next 6. He did use to spit up alot when breast fed. I listened to his tummy and it sounded like it was bubbling, could the stomach flu be causing this? Thanks for your time.
> ---------------------------------------------------------------------
> Visitor Ip: 98.127.154.206
> ***

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what should be the correct weight and height. RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

2008-12-18T19:17:00.001+05:30

dr. my son is 11 years old and his weight is 60 kgs. and quite tall also. he is found of eatng maggie, chocolates, etc. i wanted to know according to his age whether its overweight? if so then what is should be the correct weight and height. pls advise me dr.

calculate free BMI at:
http://www.freebmicalculator.net/

or
http://www.freebmicalculator.net/index.php?version=M
enter the height and weight
and get yourself classified as underweight normal weight overweight or obesity.
check the percentiles at CDC growth charts.
http://www.cdc.gov/GrowthCharts/

feel free to ask any further. your detailed info will help me analyze the situation more better. ** Your email reply won't reach me if you are not in my address book, so do not reply to this email. If you feel like commenting answering or replying .. for further communication; please do repaste this answer and query along with as i donot store the communications all the time. however you may comment at website if it gets published at www.pediatricianonline.in ** Disclaimer: The contents of this blog/mail are for informational purposes only and should not be construed as medical advice or substitute for professional care. This is not a professional or clinical consultation. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. An examination or decision by a doctor can not be completed unless he/she had personally examined the patient through professional consultation. However this site/mail will help you understand problems, discrepancies and clarify doubts and misunderstandings; and will discuss various therapy options in given hypothetical situations. http://health.groups.yahoo.com/group/paediatrics

>
> Visitor Ip: 202.70.199.81
> *** Text Database Entry ***
> "",">
> tks",""

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