Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual s life needs to be considered in the diagnosis and treatment of ADHD. 

Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan. 

The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy. 

I personally support Psychotherapy. Specialized educational planning based on the child s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child s progress is essential. 

Symptoms in children and teenagers 

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:

Inattentiveness: having a short attention span and being easily distracted making careless mistakes   for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks 
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger 
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline. 

Related conditions in children and teenagers 

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as: 

anxiety disorder   which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness 
oppositional defiant disorder (ODD)   this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers 
conduct disorder   this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals 
depression 
sleep problems   finding it difficult to get to sleep at night, and having irregular sleeping patterns 
autistic spectrum disorder (ASD)   this affects social interaction, communication, interests and behaviour 
epilepsy   a condition that affects the brain and causes repeated fits or seizures 
Tourette s syndrome   a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics 
learning difficulties   such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD. 
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms. 

Some specialists have suggested the following list of symptoms associated with ADHD in adults: 

carelessness and lack of attention to detail 
continually starting new tasks before finishing old ones 
poor organisational skills 
inability to focus or prioritise 
continually losing or misplacing things 
forgetfulness 
restlessness and edginess 
difficulty keeping quiet and speaking out of turn 
blurting out responses and often interrupting others 
mood swings, irritability and a quick temper 
inability to deal with stress 
extreme impatience 
taking risks in activities, often with little or no regard for personal safety or the safety of others   for example, driving dangerously 
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include: 

personality disorders   conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others 
bipolar disorder   a condition that affects your moods, which can swing from one extreme to another 
obsessive-compulsive disorder (OCD)   a condition that causes obsessive thoughts and compulsive behaviour 
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. 

Attention Deficit Hyperactivity Disorder (ADHD) - A Guide!

A baby should be breastfed for at least the first few months after birth. Breastfeeding has a number of benefits for both the mother and child. Apart from being the best source of nutrition for the baby, it also helps the mother and child bond. 

Here are a few benefits of breastfeeding your baby.

Nutrition: No formula can be compared to the nutrition provided by a mother s milk. The first milk produced by a mother s breasts is known as colostrum which is rich in antibodies and proteins. Breast milk is made up of the perfect mix of proteins, vitamins and essential fats. It is also easier to digest as compared to formula feeds.
Immunity boost: A mother s milk is rich in antibodies and helps strengthen the newborn child s immunity. These antibodies also help lower the baby s risk of developing asthma or allergies later in life. Babies that are breastfed are also said to have a lower risk of suffering from ear infections, respiratory problems and diarrhoea. It also plays an important role in lowering chances of sudden infant death syndrome. Breastfeeding is also said to protect babies from certain types of cancer in infancy and later stages,
Bonding: While being breastfed, a baby is held close to the mother and has skin to skin contact. This makes the baby feel secure and helps him or her to bond with the mother. For the mother, this process can also help fight postpartum depression and help reconnect with the baby.
Healthy weight: Babies who are breastfed are said to be less likely to develop obesity. This is because breast milk has lower levels of insulin as compared to formula and babies who are breastfed have higher level of appetite and fat regulating hormone called leptin. As they grow, these babies put on a healthy amount of weight, but refrain from overeating and have healthier eating patterns. This helps maintain a healthy BMI and prevents diseases like diabetes etc.
Boosts intelligence: Studies show that babies who were breastfed for the first six months have a higher IQ than those who were not. Thus, breastfeeding is said to play a significant role in cognitive development. There are two main reasons for this. Firstly, breast milk is said to fatty acids that are not available in formulas, Secondly, the emotional bonding between mother and child is also said to contribute towards boosting IQ levels.

Breast feeding - Why it is Important for Your Baby?

A genetic disorder, Down s Syndrome is caused due to extra genetic material during cell division. It is the faulty arrangement of chromosomes which results in the Down s Syndrome. It approximately affects one in 800 births around the world, across a wide spectrum of race, gender, region, and socio-economy. Since it is a naturally occurring condition whose underlying cause cannot be controlled or regulated, there is nothing one can do to undo this condition. Instead, people with Down s Syndrome, because they are generally socially and intellectually underdeveloped, are equipped with learnings and interventions related to life-skills from very early in life and striving towards making them independent. Various therapies can be incorporated for improving the overall quality of life of the people born with Down s Syndrome.

Occupational Therapy and Down s Syndrome -

Development of motor skills is delayed in the children born with Down s Syndrome. This is due to their certain physical characteristics like low muscle tone (hypotonia), loose ligaments or ligamentous laxity making the joints extra flexible, and decreased strength.

The aim of the Occupational Therapy for children born with Down s Syndrome is to facilitate or enable the development of movement patterns optimally, as against accelerating the rate of development which is a general assumption. It helps in achieving developmental milestones in an efficient manner. Occupational Therapy hence helps children in developing a good or correct posture, aligning their foot properly for proper balance and movement, improving their walking pattern, and helping them generally through developing fine and gross motor skills for carrying out daily activities.

Moreover, Occupational Therapy helps in teaching self-care skills like getting dressed, eating, toileting writing, using a computer, etc. For teenagers, Occupational Therapy helps in identifying suitable skills, careers, jobs, and vocations to match with strengths, capabilities, and interests. Sensory integration activities help in teaching the child to produce an appropriate response to any situation, and in developing attention and concentration.

Occupational Therapy Assessment -

Children with Down s Syndrome have delayed gross and fine motor skills, and lack basic cognitive and communication skills among many other issues they face due to their condition. Occupational Therapy addresses all these shortcomings of development for comprehensive management of the disease.

Occupational Therapy checks the sensorimotor components like muscular tone, strength, endurance, coordination, balance, range of motion, hand function, and posture. It also checks the perceptual and cognitive components like memory, attention, figure-ground, and directionality. For checking social skills, areas like peer relationship, verbal and non- verbal communication, and group interaction are assessed.

According to the assessment results, intervention strategies and fun activities are devised for the child to promote optimal function of motor senses.

Take Away -

Down s Syndrome cannot be cured but can be managed through methods like Occupational Therapy which helps in teaching basic life skills for making the patients confident and independent to face the world on their own.

Down Syndrome - Know How Occupational Therapy Can Help!

How to Dry Baby's Hair?
Baby towels often have a hood attached to it that can be used to gently blot your baby's hair. Do not rub as the baby's hairs are fine and very delicate and vulnerable to damage. Also, never try to blow-dry a baby's hair, as babies' skin is very much sensitive than an adult's skin and can be very easily burnt. Their hair also dries very fast on its own.
How to Comb Baby's Hair?
Comb your baby's hair with a soft-bristle brush or a tooth brush that won't snag on tangles or pull your baby's hair. Avoid headbands or ponytails, as they pull your baby's hair back too tight, which can damage hairs.
Cradle Cap-Should I worry?
Cradle cap refers to the fleshy, red flakes on the scalp of baby. This is not harmful but some may be bothered by it.  Before a bath, massage  a little bit of coconut oil  into your baby's scalp to loosen the dry skin. Gently rub the oil into your baby's scalp with a ultra soft brush or wash cloth to release the flakes. Always wash your baby's hair with a gentle baby shampoo. Cradle cap should get better on its own. If it sticks around or spreads to the face of baby, or neck or other parts of the body, you should see your doctor.
What Oil should I Apply on My Baby's Hair?
Many new parents try to apply baby oil in the newborns scalp under the impression that it will lead to hair growth. This is a biggest misconception. Baby oil actually causes dryness of the scalp and clogs the pores of the head. Often the cause of cradle cap in babies is the usage of the baby oil. For healthy hair growth it would suffice coconut oil is applied onto your infant's hair and scalp.
When should I Plan the First Haircut?
There is no particular set time for a first haircut as it will not harm hair growth of the baby. Whenever you feel your child needs a trim, you should go ahead and get it done.
Why my Baby has Bald Spots? What Should I Do?
Sometimes babies have bald spots on their head because children lie in the supine position most of the time. Encourage the "tummy time" when your baby is awake, to allow their head to round out and prevent bald patches.

How to Dry and Comb Your Baby's Hair?

Lactose intolerance is a condition wherein you are not able to digest lactose, which is a sugar found in milk. Other foods that contain lactose include cheese and ice-cream. Inadequate production of the lactase enzyme in children causes lactose intolerance. This enzyme is produced in the intestine that helps in the digestion of lactose.


Lactose intolerance is often confused with milk intolerance. The symptoms are similar but they do not share the same cause. Milk allergy is an adverse reaction towards milk and it is a problem of the immune system, whereas lactose intolerance involves the digestive system.


Symptoms-
The symptoms of lactose intolerance are:
Bloating; on consumption of milk over a period of time
Diarrhea is also very common
Stomach pain
Nausea


Diagnosis-
It is self -diagnosable; just strike out foods containing lactose from your child s diet and see if the symptoms get better with time. If the symptoms happen to fade away gradually, then it certainly must ve been lactose intolerance.
However, it can be tricky as many non-dairy products also contain lactose.
If the child is lactose intolerant, then he/she might have to undergo a lactose breath test. This is used to test the levels of hydrogen in the child s breath after the child consumes a lactose solution. Usually, hydrogen levels are low in one s breath. However, if the lactose solution is not digested properly, then it will lead to a temporary increase in the levels of hydrogen in the breath, thus indicating lactose intolerance.


Treatment-
This disorder does not have a cure; so in case your child has lactose intolerance, you need to adjust his/her diet accordingly. Over-the-counter lactase is also available that helps in digesting lactose based foods. You can also go for the  lactose- free  milk variety for your child.


Lactose Intolerance in Kids

Why is breastfeeding so good for your baby and you

Breast milk is the best for babies and the benefits of breastfeeding are one too many. Breast milk not only supplies your baby with its requirement of vitamins and nutrients, but also gets the substances which fight diseases, making your baby healthy and strong. 
Benefits of breastfeeding are:

1. Protects Your Body - Breastfeeding induces some changes in your body which you might not be very delighted to accept, but are for the sake of your baby. Did you know, these very changes benefit you as well. Studies have proved that women who breastfeed are protected against breast and ovarian cancer. The longer you feed, the more protected you are.
2. Reduces Stress - Adding to the benefits of breastfeeding you can derive, is the fact that it helps you reduce stress. It also lessens your risk of postpartum depression. Breastfeeding has been found to be relaxing since it releases the hormone called oxytocin. This release also helps the uterus contract.
3. Averts Risk For Baby - A breastfed baby has lower risk of sudden infant death syndrome.
4. Reduces Obesity Risk In Baby - Breastfed babies have lower chances of obesity. They are good at judging when their tummies are full and therefore stop drinking on time. This leads to healthy growth pattern. Compared to babies who are fed on formula, breastfed babies gain weight at slower speed, hence reducing chances of obesity later in life.
5. Increases Cognitive Skills - Multiple researches have shown that there is a direct relationship between cognitive development and breastfeeding.
6. Enhances Baby’s Immunity - Breastfeed babies are also said to be better protected from developing allergies as immune factors like secretory igA is present only in breast milk. It creates a protective layer on the babys intestinal tract. Babies who aren't breastfeed are known to fall sick pretty frequently as formula diet doesn't build their immunity as mother's milk does.

If you would like to consult with me privately, please click on 'Consult'.
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Why Is Breastfeeding Is A Saviour For Your Baby & You | World Breastfeeding Week

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