What is ADHD?

ADHD refers to attention-deficit hyperactivity disorder, which is a brain-related condition found among preschoolers, children, teenagers and in many cases extends well into adulthood. These individuals have significant impairment in academics as well as social situations and interpersonal relations. The child has difficulty sustaining attention, phases of hyper activeness and cannot control his/her impulses which make their day to day life at school and home difficult.

ADHD Symptoms

The symptoms of this disorder among children can be categorized under three headings.

1.Hyperactivity which includes

- Fidgets often
- Restlessness
- Inability to stay at one place runs around and tries to climb things
- Trouble playing quietly
- Excessive talking

2. Inattention, which can be divided into symptoms like

- Getting easily distracted
- Tendency to loose things
- Daydreaming
- Facing problems related to organizing things
- Not listening carefully
- Forgetting about daily activities, carelessness

3. Impulsiveness

- Interrupts others as they speak and talks out of turn
- Answers questions without listening to what has been asked
- Not being able to wait for their turn to come

Prevalence :

10-12% of school children before puberty are affected by one or more types of ADHD. ADHD especially hyperactivity is more prevalent in boys than in girls, with the ratio up to 9:1. Inattention and poor concentration are more commonly seen amongst girls. The rate of ADHD in parents and sibling of children with ADHD is 5-10 times higher than in the general population.

ADHD Causes

The probable causes of ADHD among children are,

1. Neurodevelopmental changes - Poorly developed activity of the brain particularly in the areas that control attention and concentration cause ADHD. This causes an imbalance in the neurotransmitters or the chemicals important for brain functioning and development.

2. Genetic Factors - genetic studies show that ADHD is largely hereditary in nature with a heritability of 75% approximately.



What are the Causes and Symptoms of ADHD?

Growth is the most important aspect of childhood, one that distinguishes children from adults. Growth is affected by a number of diseases and growth failure is often the first sign of a serious disease. Unfortunately children with growth failure present very late when no help is possible. 

Why to worry?

Growth is the best marker of health and growth failure may be caused by a seious disease. Moreover children with short stature have lower self esteem. 

When to worry? 

Plot the height of your child in the growth chart and if it is below the lower limit visit a doctor. Alternatively if your child's height is less than the formula (Height = Age in years x 6 + 77 cm) it may be a cause of concern. Growth stops at the age of 14 years in girls and 16 years in boys. Hence the child should be reviewed latest by 10 years for girls and 12 years for boys. 

What causes growth failure? 

Growth failure can be due to a number of causes including poor nutrition, lack of physical activities and low genetic potential with parents being short. Short stature can also be caused by a number of diseases like thyroid problems, growth hormone deifiency and celiac disease (wheat allergy). 

How can I improve my child's growth?

Please encourage your child to play for atleast 1 hour a day. It is important to restrict screen time including television, computer, tablets and mobiles to less than an hour. Increased protein and calcium intake with more milk, pulses and vegetables also helps in improving growth. Growth hormone is produced during sleep. Sleeping for at least eight hours a day is therefore essential for a child to achieve good growth. 

What can be done if my child is very short? 

Please consut a doctor to identify the cause of short stature. Most conditions are readily treatable. Children with growth hormone deficiency respond dramatically to growth hormone. Growth hormone is also being used now in children with turner syndrome, familial short staure, small size at birth and kidney disease. 

Time is important- act now if your child is short. 

Is My Child Short? 

Sometimes children suffer from conditions where their feet may not be in proper shape or size, something that can affect their posture. Most of the times the disorders get corrected themselves as children grow up, but there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:

1. Flatfeet

While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.

2. Toe Walking

Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.

3. Pigeon Toes

In toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when upper part of the leg bends more than it naturally should, causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually, the condition corrects on its own with age and does not interfere with sport activities which involve running.

4. Knock-Knees

It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum), since their bodies go through natural shift in alignment. Usually, treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.


Common Orthopedic Disorders In Children

Sleep is the most important aspect for a healthy beign, but for kids it is of utmost priority. Lack of sleep can often have a negative impact on the brain funtioning of kids along with accidents. Listed below are the major sleep disorders in children along with their causative factors:
1. Sleepwalking: It is not uncommon for children under the age of 10 to sleep walk. Despite being harmless on its own, the effects of sleep walking can be dangerous such as stepping outdoors or hurting themselves during sleep. If the child runs into objects while sleep walking, they might wake up and hence further worsen the situation.
2. Nightmares: They might be general or result from Post-Traumatic Stress Disorder. Nightmares, if frequent, can make falling asleep a tedious task. Nightmares in children are common and they usually begin to reduce in frequency by 9 years of age.
3. Obstructive sleep apnea: Snoring might be the result of improper respiration while sleeping and while it isn t a cause of worry, regular snoring might lead to insufficient oxygen during sleep, thus making shut eye a challenge. It might be hereditary or the result of a deviated nasal septum or blocked nose. The snoring might hamper the quality of sleep.
4. Bedwetting: This is something most children experience, but usually grow out of by the time they turn six. It doesn t need to be a cause of concern unless the frequency doesn t reduce over time and more than two instances of bedwetting take place in a week.
5. Insomnia in children: It can be due to a host of factors and coping with changes to their normal lifestyle is one of the biggest triggers. Mental disorders such as anxiety and stress due to a variety of reasons (like the death of a loved one) may also be the cause of distress and lead to troubled or incomplete sleep.
6. Excessive daytime sleepiness: Excess naps throughout the day, always feeling lethargic or experiencing trouble waking up in the morning may be symptomatic of EDS. It isn t uncommon in adults either wherein despite apparent proper sleep; energy levels seem to be low throughout the day.

6 Common Sleep Disorders in Children

A newborn baby is always vulnerable and is dependent on parents for taking appropriate care. Following the fundamental guidelines with regard to safety, which get chalked out by a paediatrician, would make sure that a baby is completely safe and healthy.

It is important to take certain measures while feeding the baby as well. Parents need to follow certain do s and don'ts in this regard as well.

Let us take a look at some of the Do s and Don'ts while taking care and feeding of newborns: 

Do s 

Be Attentive: 

Pay close attention to your baby. Research suggests that if a parent holds, bonds and touches his or her baby, they might help promote the development of the brain. Plus there could be physical, emotional and mental growth taking place as well. 

Care From Paediatricians: 

Parents must take their child for regularly scheduled visits to the paediatricians and should get their queries solved. Do follow the recommendations of your doctor to immunize your baby at 1, 2, 4, 6, 9 and 12 months.

Care About Sleep Posture: 

Always make sure to put your baby sleep on his or her back. Moreover, a baby should sleep under a comfortable temperature by wearing light clothes.

Be Concerned About Safety Measures: 

Parents should always use a car seat while travelling with the baby in a car. Follow the instructions given by the manufacturer, while trying to strap the car seat into the car and the baby in the car seat. 

Do Get Comfortable While Feeding: 

It is important to find a very comfortable position to feed the baby. Before getting started, one must make note of the fact that there is sufficient support her back and under the baby. 

Personal Touch: 

Skin-to-skin touch should be made while feeding, as and when possible. Babies get a special feeling whenever it is done. 

Take Time: 

It is important to take time while feeding the baby. Make note of the baby's cues. Mothers can resort to singing and socializing with the baby to make the duration even more comfortable. 

Don'ts 

Now, let us briefly discuss what should not be done while taking care of and feeding the newborns. The tips include: 

Do not show your irritation on the baby, while you make him or her take their bath. 

Do not allow sick people to come close or touch your baby as they would be susceptible to catching infections. 

Do not get the baby s bottles heated in a microwave. Do not feed your baby in a noisy and chaotic place. 

Do not allow the baby to fall off to sleep while you are feeding. Never let your baby sleep on the stomach as there would be a risk of Sudden Infant Death Syndrome. 

 Newborn Care  & Feeding - Do's & Dont's Of Them!

Tips to prevent irritant diaper dermatitis (diaper rash)

A mother's prime focus always is how to ensure that her child is happy and comfortable, especially when the child is too small. One of the problems which bothers many mothers who are bringing up really small children, is diaper rash. Sensitive skin, tight diaper and prolonged contact with feces and urine etc are common reasons for diaper rash or irritant diaper dermatitis.

Here are few tips to avoid diaper rash and ensuring your child is always comfortable.

1. Careful with wash: if you are using a cloth diaper, be extra careful in washing such that there is no soap remaining in the cloth.

2. Clean well: when bathing your baby, make sure you clean the area covered by diaper with a mild soap and do not rub the area while drying, since the skin is sensitive.

3. Remove soiled diaper instantly: this is the most important. However busy you are, you need to aware of the times when the diaper/cloth has been soiled. And when soiled, the diaper has to be changed at the earliest. Do not keep your baby in the diaper for all hours of the day. It is good if they are out of the diaper for some time every day.

4. Keep the diaper loose. Also, ensure that you wash the cotton diapers with fabric softeners and try to avoid wipes altogether as they have strong chemicals in them.

5. Keep a tab on rashes: if your baby does get the rashes, check with the pediatrician at the earliest. Frequent topical applications of a bland protective barrier agent (zinc oxide paste) may suffice to prevent dermatitis. There are also chances of fungal infections. Antifungal creams should be used on advice of a doctor.

If you would like to consult with me privately, please click on consult.

5 Simple Ways To Avoid Diaper Rash For Your Baby

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