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

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

Children generally tend to be fairly over active and have lesser attention spans. However, when this tends to get into their performance at school and in general with getting along with other children it may be a sign of ADD or attention deficit disorder. Let's look at some of the common symptoms of this disorder.

Symptoms of ADD

1. Problems in staying focused: One of the very basic symptom is that children will often be very inattentive even during classes and will be easily distracted by small things.

2. Problems in trying to remember things or difficulty in following instructions: Children with attention deficit disorder tend to have issues with remembering things and if given tasks, being unable to complete as they can't remember instructions properly.

3. Issues with organizing, planning and trying to finish tasks: Due to the lack of attention, kids have problems retaining information and cannot plan or finish tasks given to them on a daily basis.

4. Easily bored or loses interest: Even if a child with ADD starts with something they like, interest may wane off quickly. Thus it is difficult to make them stick to a specific work schedule which may require regular practice.

5. Lack of attention to details and making careless mistakes: This is another trait of children with attention deficit disorder. They may be able to complete a task, but it will be fraught with mistakes as they wouldn't have much attention to detail.

6. Has a tendency to not listen when someone is speaking to them: This is also very common and is usually tied to being easily distracted and thus will drift off or not listen to when someone is speaking to them.

Some Myths about ADD

a. All kids with ADD are hyperactive
b. They will eventually grow out of it
c. Medication is the only option to treat ADD
d. ADD is not really a disorder and kids need to be trained better

Most of these are half truths and the extent of the problems varies from child to child. Only proper counseling will be able to diagnose the extent of the problem and what needs to be done.

How to spot ADD in Children

ADD can be spotted in children aged below 7 years via certain symptoms. Apart from the ones mentioned above, children generally tend be abrasive towards others and can make embarrassing comments quite often. They also change tasks very quickly without completing any of them. Any distraction would force them to change their track. It is best to go to a child specialist to get your child checked out for possible symptoms.

Symptoms and Myths About Attention Deficit Disorder (ADD) and How to Spot Them in Children

Depression in children is not a very uncommon phenomenon. But if the feeling of sadness persists over a period of time with little or no change to their behavior, then it can be seen as a symptom of depression. Children who are suffering from depression need immediate and utmost care as negligence may cause severe long term effects on the child. Read on to find more about them.

Symptoms
Symptoms that indicate childhood depression vary. Some of the different symptoms which indicate depression are:
1. Social withdrawal
2. Irritability
3. Feeling of worthlessness
4. Difficulty in concentrating
5. Reduced ability to function during events
6. Continuous feelings of sadness
7. Physical complaints

Causes
1. Depression in children can be caused due to the combination of a multitude of reasons.
2. Children from a family history of depression are more likely to be suffering from depression.
3. Similarly if the parents suffer from depression then it is more than likely that the child will also suffer from depression.
4. Children from conflicted families or children and teens who are prone to substance or alcohol abuse can suffer from depression.
5. Reasons such as physical health, environment, genetic vulnerability or biochemical disturbance can lead to depression.

Treatment
The treatment process of depression in children is similar to that of adults and can be treated with psychotherapy and medication. If your child is depressed consult a general physician who after his or her diagnosis may refer you to a psychiatrist. The medical specialist will recommend psychotherapy.

In some instances, a child suffering from depression maybe be suicidal. Parents are advised to be vigilant and observe certain behavioral changes that the child may have adapted to or suddenly switched to.
Some of the signs are mentioned below:
1. Changes in eating, sleeping or activities
2. Isolating oneself even from family
3. Talking of suicide, feeling helpless or hopeless
4. Increased risk taking behavior
5. Substance abuse
6. Giving away possessions

Sessions at first and then opt for antidepressant medication if no significant progress is seen. The best results often result from a combination of prescribed medication along with multiple sessions of psychotherapy.

All About Depression in Children

Upon reaching adolescence, children's bodies undergo several changes and so do their minds. It is then that their minds are most, as well as least impressionable. And the daunting question regarding the upbringing of an adolescent is how to treat their constantly changing behavior?

Here are some of the tantrums adolescents more commonly throw, and what should ideally be your approach to it:

Your child seems to hate you: It is very common for a phase of emotional exclusionism to prevail between 16-17 years of age approximately. And the worst thing you could do is heighten that emotion by returning the hatred. Make sure you're firm against any extremely unacceptable behavior, but at the same time, show them that you're there for them no matter what.
Electronic devices become the center of their attention: Whenever you want to have an earnest conversation with your children, their attention seems to be drawn solely to their phones and computers. They feel the need to be connected to their friends and all times. Ways to monitor that are by setting limit to the maximum hours spent on devices or making them pay their own bills, which will make them more responsible rather than splurging unnecessarily. Also, if your child is not entirely secluded from the family, it is probably best not to interfere all the time.
Ignoring the curfew: Your kids often stay out later than the set limit. But it is quite possible that your curfew is unreasonable when compared to other parents' curfew. Find out what the average time limit is; it may prevent your child from bearing a grudge against you. In case they still fail to respect your curfew, make sure you spill out to them what the consequences can be, like being grounded for a week. However, in certain cases, your child may be spending time doing nothing constructive, but away from home. There may be something else going on, find out what that is.
Being friends with the wrong people: Sometimes it might happen that you think some children do not have a good influence on your child, but you cannot say that directly because adolescents tend to get very defensive about their choice of friends. Unless the adolescent is doing something harmful with the friend, like using drugs, let him exercise his choice. Otherwise, don't hesitate from seeking professional help to counsel your child.
Being over-dramatic: Every emotion is heightened in your child and you cannot tell them that what they are whining or being overjoyed about are trivial, because that's their prime focus then. Let them realize on their own how irrational they sound or else you may risk spoiling your relation with them.

Behavioral Problems in Adolescents

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