Cleft palate or palatoschisis is a common genetic abnormality that leads to a horde of problems and is presently a growing challenge to medicine practitioners. The major developmental stages affected due to this particular irregularity include feeding, speech development, dentition and maxillofacial growth which are rather important to the normal overall developmental pace of an individual. Even though the cleft palate deformity was defined centuries ago, no fixed management algorithm exists for patients suffering from the condition in the present day scenario.

Cleft palate may be successfully fixed using reconstructive surgery. Multiple specialists are involved in the reconstruction surgery including plastic surgeons, otolaryngologists, nutritionists, oromaxillofacial surgeons and speech pathologists. Some hospitals also consider psychological therapy for the patient and the family to help get through the emotional trauma and the issues faced due to developmental backlogs.

The treatment for cleft palate usually begins around 9 to 12 months of age. If left untreated, it may cause major deformities. It takes about some years before the whole procedure is completed although it depends on the type and severity of the deformity.

The process involves the administration of anaesthesia after which the palate repair closes the inner, middle and final layers and at the same time realigning of the palatal muscles in a technique called anintravelarveloplasty is conducted. This ensures that the muscles are adjusted in a normal position which facilitates the best functioning of the palate during feeding, swallowing and speaking. It is possible that the child might require more than one surgery to completely close the palate.

Some of the risks involved during the process include:
1. Abnormal reactions to the medications
2. Bleeding
3. Problems in breathing
4. Need for more surgery
5. Infection

Although complicated and time consuming, cleft palate must be given immediate attention to avoid serious developmental issues. The reconstruction surgery and therapy combined ensures a normal development for the child in the longer run, given the surgery was done at the correct time. The child would be required to remain at the hospital for about 5-7 days. Complete recovery takes a time period of 4 weeks. Keeping the wound of the surgery clean is of the utmost importance and it should not be strained.

How to Surgically Treat Cleft Palate

Which baby doesn't spit up their food! This is usually not a reason to worry, but if this spitting up is chronic and is accompanied by other symptoms it is known as Gastroesophageal reflux disease or GERD. Severe GERD can cause weight loss and breathing problems and thus, should not be ignored.

Reflux occurs when food is pushed out of the stomach and back up the esophagus. This is usually because the digestive system in babies is not yet fully developed. Vomiting often during the day is one of the most common symptoms of GERD. Other symptoms include:
- A persistent cough
- Choking or gagging while eating
- Refusing to eat
- Crying while feeding
- Heartburn
- Pain in the stomach

Most cases of GERD can be diagnosed by its symptoms and a look at the baby's medical history. In some cases, additional tests may be required, such as:

Barium swallow
The child is given a chalky substance to drink. This highlights the esophagus, stomach and upper part of the small intestines in a special X-ray. It is used to check if there are any blockages in the digestive system.
pH probe

A long, thin tube with a probe at one end is put down the child's throat. This is kept in the esophagus for 24 hours. The probe measures the levels of acidity in the stomach. This test is usually done when the child complains of breathing problems along with reflux.

Upper GI endoscopy
Here the doctor puts a thin, flexible tube down the child's throat. At one end of the tube is a camera that allows the doctor to look into the esophagus, stomach and small intestine.

Gastric emptying study
One of the causes of reflux is the slow emptying of the stomach. To check this, the doctor will mix a radioactive chemical with the baby's milk that allows a special camera to follow its path down the digestive system.

In most cases, GERD can be treated by making a few lifestyle changes. Some of these are:
- Raise the head of the baby's crib
- After feeding the baby, do not let him lie down, but hold him upright for half an hour or so.
- Change his feeding schedule
- Ask your doctor if you can try giving him solid food. Else, check if you can thicken his feed with cereal.
- Make the baby burp after feeding

Most infants outgrow this condition within a year, so do not stress yourself and enjoy life with your baby.

Gastro-Oesophageal Reflux In Babies

Growth hormone or somatropin is responsible for cell growth as well as reproduction. But insufficient somatropin production by the pituitary gland may result in lack in height. It is mostly caused by a serious brain injury, any prevalent medical condition or might occur as a birth defect.

Types
1. Congenital ghd - this form of ghd appears from at the time of birth itself.
2. Acquired ghd- ghd can be acquired during later life as a result of trauma, infection, tumor growth within the brain or radiation therapy.
3. Idiopathic ghd- idiopathic ghd is the third, and comparatively worst kind of ghd since it has no treatment.

Ghd is mostly permanent, but can also be transient. Read on to know how to detect whether you or your child is suffering from growth hormone deficiency (ghd).

Symptoms
Childhood onset
1. Restricted height- compared to other children of your child's age, he/she may be of shorter height, which is a rather conclusive sign to detect somatropin deficiency.
2. Chubby and comparatively younger appearance- your child may have a proportionate body, but if he/she is unnaturally chubby and has a baby-face compared to other children, he/she may be suffering from ghd.
3. Late puberty- your child's puberty maybe later than usual or even not appear at all, depending upon the gravity of the ghd.
4. Hypoglycemia and exaggerated jaundice- low blood sugar is amongst the most primary manifestations of ghd, along with extended duration of jaundice.
5. Micro-penis- micro penis condition is one of the incident signs of ghd, which later escalates to growth deficit as the infant gets older.

Adult onset
1. Fatigue- adults with ghd may experience extreme tiredness throughout the day, with reduced muscle strength.
2. Osteoporosis- osteoporosis, along with bodily deformities, is a common sign in adults with ghd.
3. Lipid abnormalities- a test of your lipid profile may reveal abnormalities in ldl cholesterol, insulin resistance, and impaired cardiac functions.

Tests to determine ghd
1. Physical test- a chart is drawn to determine the proportion of height and weight with respect to your age to detect anomalies.
2. Hand x-ray- a hand x-ray can determine whether the age of bones are at par with your age.
3. Mri-mri scan can determine the health of your brain and pituitary gland.
4. Test for other hormones- growth hormone may not be solely responsible for your health condition, so it is important to determine if other hormone levels are all normal.

Treatment
1. Hormone supplements- hormone supplements like corticosteroids (hydrocortisone or prednisone), levothyroxine (levoxyl, synthroid, etc), and others work to replenish the deficiency of pituitary hormones.
2. Growth hormone injection- gh is injected beneath your skin, to cure gdh. This is a long-term treatment and requires constant monitoring.

All About Growth Hormone Deficiency

Is your child undergoing Primary Immunodeficiency Disorders (PIDDs)? If you are tired of seeing your child suffering with regular cold and cough which could be solely due to a lack of nutrients in the diet, resulting in low immunity of the body. Adopting healthy habits by cutting back on junk food while including healthy items will help raise your child s immunity levels immensely. 

Some of the best foods to include in the diet to increase the immunity of your child are mentioned below:

Eggs, pulses, lean meats and other healthy protein: Immunity buildup may be disrupted if there isn t enough protein in your diet. Milk protein in cow s milk or dairy products like butter and cheese, animal protein in lean meats such as chicken and ovo-protein in eggs are highly beneficial and raise immunity levels.
Fish for immunity build up: Fish is a great immunity builder and also helps in making the brain work more efficiently. Fish meat contains lean proteins as well as essential Omega-3 acids which help properly regulate many functions within the body raising immunity.
Stay healthy with yogurt: There are a lot many flavored varieties of curd or yogurt that your child may like and which is also considered as a power food source. It helps reduce gastrointestinal illnesses. However, try and go for the less flavored ones as they would have lesser amounts of processed sugar.
Oats and Barley for your rescue: The reason why oats and barley are healthy alternatives, especially for children is because they are composed of beta-glucan (fibre containing antioxidants and antimicrobial properties). This helps in avoiding constipation thus cleaning the intestine and hence avoiding the buildup of harmful bacteria within the body.
Fruit toppings are delicious: Fruits are not limited to mangoes, apples and bananas only. Darker the color of the fruit, greater is the nutritional value. Berries, peaches, melons, pomegranates etc, can and should also be included in your fruit intake as they are healthy as well as tasty.
Vegetables can be tasty too: Growing children require leafy green vegetables for physical and mental development as they contain zinc, iron and folic acid. Foods like fenugreek leaves and spinach are an example of vitamin rich food items. You can include spinach and other vegetables in a clever manner by making the food interesting so that children would want to eat it willingly.
Carrots to fight infection: Carrots are beneficial for good eyesight and protection from infections. With carrot intake it becomes quite difficult for the bacteria and germs to ender the blood vessels. This can be made into a salad or craved figuring to make it interesting to the kids.

Immunity of Your Child - 7 Foods that Help Boost It!

Are you observing red, crusty patches on the surface of your infant s skin during his/her first month after birth? This is an indication of infant eczema. It is a dry, itchy skin condition which may occur on any part of your child s body and is commonly found on the cheeks, legs and arms. This condition is sometimes confused with cradle cap, which is another skin condition.

Causes-

Eczema usually runs in families and is hereditary. If you have eczema, it is likely that your child may have it too. Several problems in the skin barrier allow germs inside and moisture to go out. This is a common cause of eczema in infants. The condition occurs when the body makes insufficient fatty cells or ceramides. When there is not enough of these, the skin loses water and becomes extremely dry.

Does Eczema In Infants Go Away By Itself?

In many cases, infant eczema goes away on its own and most infants outgrow the condition by the time they are ready for school. However, some children do get eczema during their adulthood. This may continue for years without specific symptoms. Such children also tend to have dry skin.

Treatment-

Here are some home treatment options for infant eczema:

You should use moisturisers on your child. Moisturisers containing ceramides are a good option, which are available at all over-the-counter (OTC) stores by prescription. You can also opt for good moisturisers, fragrance-free creams and ointments like petroleum jelly. This helps in keeping your baby s skin in retaining natural moisture. Apply these after a bath.

A lukewarm bath is beneficial for your child. It helps in hydrating and cooling the skin. The water should not be very hot and the bath should not exceed 10 minutes. You can also add oatmeal soaking products to your baby s scrub for soothing itchiness.

You must use mild and unscented body soaps for your baby. This is because perfumed, antibacterial and deodorant soaps are rough for your baby s skin. Scrub some soap on areas of your child s body where there is dirt, such as the genitals, feet and hand. Do not rub or pat his/her skin.

Several medicines are also used for the treatment of infant eczema. These include hydrocortisone creams and ointments, which help in easing inflammation and itching. You should not apply these medicines in excess as they can thin the skin on the affected areas.

You should consult a doctor on observing any signs or symptoms of eczema on your child s skin. This will help in proper diagnosis of the problem and an early treatment plan will prevent further deterioration of the symptoms.

Eczema in Infants: What You Should Know?

Anger is a normal emotion. Children are as susceptible to anger as are adults. However, children may not understand how to deal with their anger properly. This can result in tantrums and violent behaviour. Telling a child not to get angry is not the solution to this problem. Instead, a child must be taught how to channelize his or her anger. Here are 5 tips that could help deal with aggressive behaviour.

Do not use physical punishments as a form of discipline: Children inculcate actions they see at home. While you may hit your child out of frustration when he or she does something wrong, the child may see this as an acceptable form of venting anger. Thus, hitting your child can indirectly reinforce a child s aggressive behaviour. Just as you do not expect your child to go about hitting other people, do not hit him yourself.
Develop a feeling vocabulary: A child s aggressive behaviour is usually the result of frustration at not being able to explain what he or she may be experiencing. Thus, encourage your child to develop a vocabulary to speak his mind. Teach them to use words like angry, frustrated, irritated and anxious. When your child says that he or she is angry, do not ignore him but encourage him to talk it out. You could also encourage them to find other creative outlets for their anger such as drawing and painting.
Praise good behaviour: All children seek appreciation. When your child deals with anger is a good way, praise him and reinforce the behaviour. This lets your child know that his behaviour is being noticed. Tell your child it is ok to be angry as long as it is dealt with in the right way.
Set firm limits: Children need limits to know what sort of behaviour is acceptable and what isn t. These limits should be kept very clear and consistent. The child s teachers and other caregivers should also be made aware of these rules along with the response to be given if the child breaks a rule. When a child does cross the limits set by you, they should be immediately reprimanded so that they understand their mistake.
Let your child cool off: It is no use trying to explain why something the child has done is wrong when they are in a state of anger. Instead, give them time to cool down by telling them to go to their room or sit down someplace. Once the child has cooled off, explain why his or her behaviour was wrong and discuss ways he or she could have dealt with the situation better. 

Aggressive Behaviour In Children - 5 Ways It Can Be Managed!

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