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? 

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?

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!

Infantile spasm is a seizure-related disorder that is witnessed among infants and young children. The average age for getting affected with infantile spasm is four months, but some kids might experience this disorder within a month of the birth. This disease can have a subtle appearance, and as such it is difficult to recognize as a serious condition. While a full seizure in an adult is scary, the one observed among infants can be as little as a minor head drop, along with minor body shakes. This might appear to be that serious, but infantile spasm is more serious as compared to a full body convulsion in adults. Unfortunately, an infant suffering from infantile spasm is at great risk of developmental disability, if the condition is not detected and treated early.

Anticonvulsant Medication:
There are very few medicines that are approved by the FDA for treating infantile spasms. The two medicines that are widely used by doctors include Adrenocorticotropic hormone (ACTH) and Vigabatrin.

ACTH: This is the oldest approved medicine by the FDA that was first discovered in the year 1958. This injection needs to be pushed twice in a day. Children tend to gain weight and feel hungry when this injection is injected.
Vigabatrin: Vigabatrin is very well tolerated by young kids and has a successful track record of treating infantile spasms. Studies have proven that Vigabatrin can tackle tuberous sclerosis and plays an important role in improving developmental outcome.
Second line therapies:

Pyridoxine: Dependency on Pyridoxine as a cause of infantile spasm is very rare. High dosage of oral administration of pyridoxine has fetched good results for patients, who do not suffer from pyridoxine related seizures.
Valproic acid: Valproic acid has the best anecdotal rate of success. However, doctors do not recommend this medicine for kids less than 2 years of age because of possible complications.
Clonazepam: This is one of the earliest non-steroid medicine for the treatment of infantile spasm. Some of the popular medicines used are nitrazepam, benzodiazepines, and clonazepam.
Ketogenic Diet: This is a decade old practice that has come back to popularity again. Studies have shown that ketogenic diet can help 20-35 % patients of infantile spasm to keep the condition under control.
IVIG: High dosage of IVIG has been reported to be very helpful in tackling infantile spasms. The dosage ranges from 100-200 mg/kg/dose ranging for about 2-3 weeks at stretch.
Surgery: The final part of the therapy includes a surgery that removes the abnormal part of the brain. It should only be considered for patients who have not responded to therapies including Vigabatrin and ACTH. It should also be investigated whether the patient has any structural abnormalities of the brain.


Infantile Spasms - How They Can Be Treated?

Bathing  the newborn baby is a pleasurable experience both for the mother and the baby. It can also be defined as a process through which the mother and child bond. A mother understands the requirements of the child and the baby adapts itself to the cleanliness regime of the mother.
When should I start bathing my new born baby?
According to guidelines of WHO, initial bath for a term newborn weighing more than 2.5kg should be given 6 hours after birth. In the term low birth weight babies weighing less than 2.5kgs, only sponge bath is to be given, till the weight crosses 2.5kg.
Dip baths can be given once the umbilical cord falls off i.e. by 7 -10 days. Till then sponge baths are to be given.
How should I bathe my baby?
The room should be warm and free from draught of air as a wet baby can easily catch the chill. Check the temperature of the bath water before placing the baby in the bath tub. The depth of the water should be 5 cms upto the hip of the baby. Eyes can be cleaned by using one sterile water-soaked cotton swab for each eye. The Head should be washed last and dried first to prevent exposure due to large surface area. Pay special attention to skin folds of the neck, behind the ears, underarms, and diaper area. Also wash between the fingers and the toes.
What cleanser/ soap should I use for my baby?
Do not use soap for the first 1 month of life. After that, use any mild unmedicated soap or liquid cleanser with acidic/ neutral pH, that maintains the pH of the baby's skin. Avoid scented soaps and bubble baths.
How frequently should I bathe my baby?
In summer months, daily baths can be given. In winters, dip bath may be given twice/thrice a week and rest of the days, it is preferable to sponge the baby.
Hair wash can be given twice  a week.
A word of caution:
Never leave your baby unattended  to in the bath tub.Bath tub should be disinfected after use.

How Should I Bath My Baby

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